Risk and temporal order of disease diagnosis of comorbidities in patients with COPD: a population health perspective

• Published in: BMJ open respiratory research Vol. 5; no. 1; p. e000302
• Main Authors: Tényi, Ákos, Vela, Emili, Cano, Isaac, Cleries, Montserrat, Monterde, David, Gomez-Cabrero, David, Roca, Josep
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01-01-2018; BMJ Publishing Group
• Subjects: Chronic illnesses; Chronic Obstructive Pulmonary Disease; Chronic obstructive pulmonary diseases; Comorbiditat; Comorbidity; Datasets; Epidemiology; Gene expression; Health care policy; Health maintenance organizations; Health risk assessment; HMOs; Hospitals; Malalties pulmonars obstructives cròniques; Medical diagnosis; Medicin och hälsovetenskap; Mortality; Patients; Population; Primary care; Public health; Salut pública; Surveillance; United States > US; COPD ÀÜ mechanisms; COPD epidemiology; systemic disease and lungs; clinical epidemiology
• ISSN: 2052-4439; 2052-4439
• DOI: 10.1136/bmjresp-2018-000302

IntroductionComorbidities in patients with chronic obstructive pulmonary disease (COPD) generate a major burden on healthcare. Identification of cost-effective strategies aiming at preventing and enhancing management of comorbid conditions in patients with COPD requires deeper knowledge on epidemiological patterns and on shared biological pathways explaining co-occurrence of diseases.MethodsThe study assesses the co-occurrence of several chronic conditions in patients with COPD using two different datasets: Catalan Healthcare Surveillance System (CHSS) (ES, 1.4 million registries) and Medicare (USA, 13 million registries). Temporal order of disease diagnosis was analysed in the CHSS dataset.ResultsThe results demonstrate higher prevalence of most of the diseases, as comorbid conditions, in elderly (>65) patients with COPD compared with non-COPD subjects, an effect observed in both CHSS and Medicare datasets. Analysis of temporal order of disease diagnosis showed that comorbid conditions in elderly patients with COPD tend to appear after the diagnosis of the obstructive disease, rather than before it.ConclusionThe results provide a population health perspective of the comorbidity challenge in patients with COPD, indicating the increased risk of developing comorbid conditions in these patients. The research reinforces the need for novel approaches in the prevention and management of comorbidities in patients with COPD to effectively reduce the overall burden of the disease on these patients.