Pharmacoeconomic analysis of therapy of acute exacerbation of chronic obstructive pulmonary disease in a large Krasnoyarsk hospital
https://doi.org/10.18093/0869-0189-2015-25-3-320-326
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Abstract
The aim of this study was to evaluate cost structure and rationality of pharmacotherapy of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in a pulmonology department of a multiprofile Krasnoyarsk hospital in 2014. Methods. This was a retrospective 1-year study evaluating pharmacotherapy of AECOPD according to electronic medical reports. Medication therapy and frequency of administration of certain drugs were evaluated using frequency analysis. Rationality of medication therapy and treatment expenses were analyzed with ABC/VEN analysis. Results. One hundred and thirty one electronic medical reports were analyzed. Frequency analysis showed that all patients received the combined bronchodilator Berodual and the expectorant bromhexine. Moreover, 81.7% of patients received antibiotics, 75.6% received systemic steroids and 41.2% received inhaled corticosteroids. This is consistent with current scientific trends and recent recommendations. ABC/VEN-analysis showed a rational pharmacotherapy expenditure of funds in patients with AECOPD. The main expenses were associated with vital drugs (58.2%) followed by pharmacotherapy of comorbidity (41.8%) which was administered to 87.8% of the patients. Anticoagulants had the highest cost (22.5% of the total pharmacotherapy of AECOPD). Second-line drugs were not used in the treatment of AECOPD. Conclusion. The main portion of cost of AECOPD pharmacotherapy was related to pathogenic treatment followed by treatment for comorbidity and prevention as the former greatly effects severity and outcomes of COPD.
About the Authors
T. V. Gaygol'nikRussian Federation
PhD student, Department of Internal Medicine N2, State Institution «V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University», Healthcare Ministry of Russia; tel.: (902) 913-15-39;
I. V. Demko
Russian Federation
MD, Professor, Head of Department of Internal Medicine N2, State Institution «V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University», Healthcare Ministry of Russia; tel.: (913) 507-84-08;
E. N. Bochanova
Russian Federation
PhD, Associate Professor, Department of Pharmacology, State Institution «V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University», Healthcare Ministry of Russia; tel.: (913) 522-16-58;
N. V. Gordeeva
Russian Federation
Gordeeva Natal'ya Vladimirovna, PhD, Senior Researcher, Department of Internal Medicine N2, State Institution «V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University», Healthcare Ministry of Russia; tel.: (913) 199-06-53;
A. Yu. Kraposhina
Russian Federation
PhD, Assistant Lecturer, Department of Internal Medicine N2, State Institution «V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University», Healthcare Ministry of Russia; tel.: (902) 990-37-67;
I. A. Solov'eva
Russian Federation
PhD, Assistant Lecturer, Department of Internal Medicine N2, State Institution «V.F.Voyno-Yasenetskiy Krasnoyarsk State Medical University», Healthcare Ministry of Russia; tel.: (913) 835-26-43;
References
1. Chuchalin A.G., Khaltaev N., Antonov N.S. et al. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. Int. J. Chron. Obstruct. Pulm. Dis. 2014; 9 (1): 963-974.
2. Chuchalin A.G., Aisanov Z.R., Avdeev S.N. i dr. Rossiiskoe respiratornoe obshchestvo. Federal'nye klinicheskie rekomendatsii po diagnostike i lecheniyu khronicheskoi obstruktivnoi bolezni legkikh: metodicheskie rekomendatsii. Pul'monologiya. 2014; 3: 15-36.
3. Krysanov I.S. Analiz stoimosti khronicheskoi obstruktivnoi bolezni legkikh v Rossiiskoi Federatsii. Kachestvennaya klinicheskaya praktika. 2014; 2: 51-56.
4. Gibson G.J., Loddenkemper R., Sibille Y., Lundback B. The European Lung White Book. Sheffield: European Respiratory Society; 2013 Available from: http://www.erswhitebook.org/files/public/Chapters/13_COPD.pdf (Accessed Feb. 14, 2015).
5. The American Lung Association. Epidemiology and statistics unit. Trends in COPD (Chronic Bronchitis and Emphysema): Morbidity and mortality 2013. Available from: http://www.lung.org/finding-cures/our-research/trend-reports/copd-trend-report.pdf (Accessed Feb. 11, 2015).
6. Perera P.N., Armstrong E.P., Sherrill D.L. et al. Acute exacerbations of COPD in the United States: Inpatient burden and predictors of costs and mortality. Int. J. Chron. Obstruct. Pulm. Dis. 2012; 9 (2): 131-141.
7. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. Global Initiative for Chronic Obstructive Lung Disease; 2015. Available from: http://www.goldcopd.org/uploads/users/files/GOLD_Report_2015.pdf (Accessed Feb. 4, 2015).
8. Chuchalin A.G., red. Respiratornaya meditsina. M.: GEOTAR-Media; 2007. T. 1.
9. Mannino D.M., Higuchi K., Yu T.-C. et al. Economic burden of chronic obstructive pulmonary disease by presence of comorbidities. Chest. Published online Feb. 12, 2015. 10.1378/chest.14-2434. Available from: http://journal.publications.chestnet.org/article.aspx?articleID=2119206 (Accessed Feb. 23, 2015).
10. Fabbri L.M., Luppi F., Begh#é B et al. Complex chronic comorbidities of COPD Eur. Respir. J. 2008; 31: 204-212.
11. Vorob'ev P.A., red. Kliniko-ekonomicheskii analiz M.: N'yudiamed; 2008.
12. Savel'ev V.S., Gel'fand B.R., Yakovlev S.V. Strategiya i taktika primeneniya antimikrobnykh sredstv v lechebnykh uchrezhdeniyakh Rossii: Rossiiskie natsional'nye rekomendatsii M.: OOO «Kompaniya BORGES»; 2012.
13. Stefan M.S., Rothberg M.B., Shieh M.S. et al. Association between antibiotic treatment and outcomes in patients hospitalized with acute exacerbation of COPD treated with systemic steroids. Chest. 2013; 143 (1): 82-90.
14. Avdeev S.N. Khronicheskaya obstruktivnaya bolezn' legkikh: obostreniya. Pul'monologiya. 2013; 3: 5-19.
15. Yakovlev S.V., Sidorenko S.V., Rafal'skii V.V., Spichak T.V. Strategiya i taktika ratsional'nogo primeneniya antimikrobnykh sredstv v ambulatornoi praktike: Rossiiskie prakticheskie rekomendatsii. M.: Presto; 2014.
16. Kahn S.R., Lim W., Dunn A.S. et al. Prevention of VTE in nonsurgical patients. Antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141 (2): 195-226.
17. Belousov D.Yu., Afanas'eva E.V., Kirienko A.I. i dr. Farmakoepidemiologicheskaya i kliniko-ekonomicheskaya otsenka profilaktiki venoznykh tromboembolicheskikh oslozhnenii (real'naya praktika naznachenii). Kachestvennaya klinicheskaya praktika. 2013; 2: 2-17.
18. Stepashkin K.N., Petrova M.M., Demko I.V. Vliyanie komorbidnoi kardiovaskulyarnoi patologii na kachestvo zhizni bol'nykh khronicheskoi obstruktivnoi bolezn'yu legkikh. Sibirskoe meditsinskoe obozrenie. 2013; 4: 66-69.
19. Korreia L.L., Lebedev T.Yu., Efremova O.A. i dr. Problema polimorbidnosti pri sochetanii khronicheskoi obstruktivnoi bolezni legkikh i nekotorykh serdechno-sosudistykh zabolevanii. Nauchnye vedomosti BelGU. Seriya: Meditsina. Farmatsiya. 2013 (vyp. 21); 4 (147): 12-17.
20. Au D.H., Bryson C.L., Fan V.S. et al. Beta-blockers as single-agent therapy for hypertension and the risk of mortality among patient with chronic obstructive pulmonary disease. Am. J. Med. 2004; 117 (12): 925-931.
Review
For citations:
Gaygol'nik T.V., Demko I.V., Bochanova E.N., Gordeeva N.V., Kraposhina A.Yu., Solov'eva I.A. Pharmacoeconomic analysis of therapy of acute exacerbation of chronic obstructive pulmonary disease in a large Krasnoyarsk hospital. PULMONOLOGIYA. 2015;25(3):320-326. (In Russ.) https://doi.org/10.18093/0869-0189-2015-25-3-320-326
ISSN 2541-9617 (Online)