Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12890-017-0571-7
Title: Burden of asthma and COPD overlap (ACO) in Taiwan: A nationwide population-based study
Authors: Shantakumar, S 
Pwu, R.-F
D'Silva, L
Wurst, K
Kuo, Y.-W
Yang, Y.-Y
Juan, Y.-C
Chan, K.A
Keywords: beta 2 adrenergic receptor stimulating agent
corticosteroid
corticosteroid
adult
aged
Article
asthma
asthma chronic obstructive lung disease overlap
asthma chronic obstructive lung disease overlap
chronic obstructive lung disease
cohort analysis
comorbidity
controlled study
disease burden
disease exacerbation
disease severity
drug cost
female
health care cost
health care utilization
hospital care
hospital patient
human
ICD-9
ICD-9-CM
incidence
lung disease
major clinical study
male
middle aged
national health insurance
outpatient
population research
retrospective study
Taiwan
age
ambulatory care
asthma
chronic obstructive lung disease
economics
health care planning
hospitalization
recurrent disease
sex factor
statistics and numerical data
very elderly
Adrenal Cortex Hormones
Adrenergic beta-2 Receptor Agonists
Age Factors
Aged
Aged, 80 and over
Ambulatory Care
Asthma
Drug Costs
Female
Health Resources
Hospitalization
Humans
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive
Retrospective Studies
Sex Factors
Symptom Flare Up
Taiwan
Issue Date: 2018
Citation: Shantakumar, S, Pwu, R.-F, D'Silva, L, Wurst, K, Kuo, Y.-W, Yang, Y.-Y, Juan, Y.-C, Chan, K.A (2018). Burden of asthma and COPD overlap (ACO) in Taiwan: A nationwide population-based study. BMC Pulmonary Medicine 18 (1) : 16. ScholarBank@NUS Repository. https://doi.org/10.1186/s12890-017-0571-7
Rights: Attribution 4.0 International
Abstract: Background: Patients with symptoms of both asthma and chronic obstructive pulmonary disease (COPD) may be classified with the term asthma-COPD overlap (ACO). ACO is of considerable interest as it is currently poorly characterised and has been associated with worse health outcomes and higher healthcare costs compared with COPD or asthma alone. Patients with ACO in Asia remain poorly described, and there is limited information regarding their resource utilisation compared with patients with asthma or COPD only. This study investigated the characteristics, disease burden and medical resource utilisation of patients with ACO in Taiwan. Methods: This was a retrospective cohort study of patients identified from National Health Insurance (NHI) claims data in Taiwan in 2009-2011. Patients were classified into incident ACO, COPD or asthma cohorts according to International Classification of Disease, ninth revision, clinical modification codes in claims. Eligible patients were ≥40 years of age with 12 months' continuous enrolment in the NHI programme pre- and post-index date (date of the first relevant medical claim). Results: Patients with ACO (N = 22,328) and COPD (N = 69,648) were older and more likely to be male than those with asthma (N = 50,293). Patients with ACO had more comorbidities and exacerbations, with higher medication use: short-acting β 2-agonist prescriptions ranged from 30.4% of patients (asthma cohort) to 43.6% (ACO cohort), and inhaled corticosteroid/long-acting β 2 -agonist combination prescriptions ranged from 11.1% (COPD cohort) to 35.0% (ACO cohort) in the 12 months following index. Patients with ACO generally had the highest medication costs of any cohort (long-acting muscarinic antagonist costs ranged from $227/patient [asthma cohort] to $349/patient [ACO cohort]); they also experienced more respiratory-related hospital visits than patients with asthma or COPD (mean outpatient/inpatient visits per patient post-index: 9.1/1.9 [ACO cohort] vs 5.7/1.4 [asthma cohort] and 6.4/1.7 [COPD cohort]). Conclusions: Patients with ACO in Taiwan experience a greater disease burden with greater healthcare resource utilisation, and higher costs, than patients with asthma or COPD alone. © 2018 The Author(s).
Source Title: BMC Pulmonary Medicine
URI: https://scholarbank.nus.edu.sg/handle/10635/181218
ISSN: 14712466
DOI: 10.1186/s12890-017-0571-7
Rights: Attribution 4.0 International
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