CONTEXT: Peer reviewed article on RWR in COPD | Swedish study | ARCTIC is a large, real-world, retrospective, Swedish cohort study conducted in 18,586 eligible, primary care, COPD patients
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Quality Level Mean [1 – 10]: 8
1. “It is a major cause of chronic morbidity and the third leading cause of death worldwide.1. COPD exacerbations are defined as an acute worsening of respiratory symptoms that results in additional therapy.2 Prevention of exacerbations is one of the significant components in the management of COPD as they negatively impact health status, and can result in hospitalization and re-admission, disease progression, rapid lung function decline and mortality.2 Annual rate of exacerbations varies among patients.”
2. “Exacerbations become more frequent and serious with increasing disease severity3,4 but there is also clear evidence that certain patients have more frequent exacerbations irrespective of disease severity.4 Furthermore, economic studies have demonstrated that costs increase substantially with COPD severity, and a significant economic burden of COPD can be attributed to exacerbations.5–9. In previous studies, the quantitative relationship between exacerbation frequency and the impact on different health outcomes and mortality have rarely been assessed.”
3. “The aim of this longitudinal study was to provide real-world evidence on the clinical and economic impact of exacerbation frequency among COPD patients in the Swedish primary care setting and to, more in detail, describe the relationship of exacerbations and clinical outcomes and economic consequences in COPD using a dynamic approach to exacerbations that resembles the clinical practice.”
4. “These data sources included: (i) the Longitudinal Integration Database for Health Insurance and Labour Market Studies (LISA),10 which contains socio-demographic data, including educational level, marital status and family situation, occupational status, retirement and economic compensation and social benefits; (ii) the National Patient Register,8 which contains data related to diagnosis from secondary care (ICD-10 code and associated position), including gender, age, region, hospital visits, specialty visits, hospital admissions and discharges, medical procedures and surgeries performed in inpatient and outpatient specialist settings; (iii) the National Prescription Register8 (from 2005), which tracks full details of all medications dispensed from community pharmacies’ (ATC codes), including brand name, prescription date, dose, strength, pack size, specialty of the prescriber and costs associated with the drug prescription; and (iv) the Cause of Death Register,8 which is used to collect information of the deceased such as sex, date of death and the underlying cause of death.”
5. “The study population consisted of patients aged ≥40 years who had received a physician’s diagnosis of COPD (ICD-10 code: J44), in a primary care setting (EMR database) or in a hospital setting (according to the National Patient Register).”