A Real-World Study on Italian Administrative Healthcare Data to Describe Patients With Chronic Obstructive Pulmonary Disease by Therapeutic Pattern and Exacerbation Rate
Author(s)
Carlo Piccinni, PhD1, Giulia Ronconi, PharmD1, Letizia Dondi, BS1, Silvia Calabria, PharmD1, Leonardo dondi, BS1, Irene Dell'Anno, PhD1, alice addesi, BS2, Immacolata Esposito, Sr., PhD2, Ovidio Brignoli, BS3, Fabiano Di Marco, BS4, Claudio Micheletto, BS5, Nello Martini, BS1.
1Fondazione ReS (Ricerca e Salute) - Research and Health Foundation, Roma, Italy, 2Drugs & Health, Roma, Italy, 3Italian College of General Practitioners and Primary Care, Florence, Italy, 4Department of Health Science, Università degli Studi di Milano, Milan, Italy, 5Respiratory Medicine Unit, Verona University Hospital, Verona, Italy.
1Fondazione ReS (Ricerca e Salute) - Research and Health Foundation, Roma, Italy, 2Drugs & Health, Roma, Italy, 3Italian College of General Practitioners and Primary Care, Florence, Italy, 4Department of Health Science, Università degli Studi di Milano, Milan, Italy, 5Respiratory Medicine Unit, Verona University Hospital, Verona, Italy.
OBJECTIVES: To describe patients with chronic obstructive pulmonary disease (COPD) according to the therapeutic strategy and assess the occurrence of acute exacerbation (AECOPD) and concurrent therapeutic changes, through administrative data from the Italian National Health Service.
METHODS: From the database of Fondazione Ricerca e Salute (ReS) (4.6 million inhabitants), patients aged ≥45 years with COPD in 2023 were categorized according to the therapeutic strategy (index date=first drug dispensation in 2023) into patients receiving triple therapy (TT), as single-inhaler (SI) or multiple-inhaler (MI), dual therapy (DT), other respiratory strategies and none of the previous (i.e., untreated). Demographics, comorbidities, occurrence of moderate and/or severe AECOPD within 12 months preceding the index date, and therapeutic strategies before AECOPD were assessed.
RESULTS: COPD patients were 82,034 (32.3/1,000 inhabitants aged ≥45; mean age was 75 years, 61.0% were male). By therapeutic strategy, 10,247 (12.5%) patients received SI-TT, 9583 (11.7%) MI-TT, 33,359 (40.7%) DT, 19,511 (23.8%) other strategies, and 9334 (11.4%) were untreated. Male patients were the majority. On average, DT patients were the youngest (mean age: 73 years), and MI-TT patients were the oldest (76 years). Around 60% of patients receiving TT, 62.1% DT and 59.3% other strategies had ≥3 comorbidities; cardio-metabolic chronic diseases were the most frequent. A previous AECOPD occurred in 4859 (47.4%), 3071 (32.0%), 9497 (28.5%) and 4904 (25.1%) patients receiving SI-TT, MI-TT, DT and other strategies, respectively. Despite the moderate/severe AECOPD, escalation to TT occurred in 27.4% and 19.6% patients previously receiving DT and other strategies, respectively, and in 19.1% of untreated patients.
CONCLUSIONS: From this study, we observed that a relevant proportion of COPD patients did not experience a treatment escalation after the occurrence of moderate/severe AECOPD despite GOLD recommendations. The treatment patterns might be affected by the presence of prescription restrictions for TT introduced in Italy in 2021.
METHODS: From the database of Fondazione Ricerca e Salute (ReS) (4.6 million inhabitants), patients aged ≥45 years with COPD in 2023 were categorized according to the therapeutic strategy (index date=first drug dispensation in 2023) into patients receiving triple therapy (TT), as single-inhaler (SI) or multiple-inhaler (MI), dual therapy (DT), other respiratory strategies and none of the previous (i.e., untreated). Demographics, comorbidities, occurrence of moderate and/or severe AECOPD within 12 months preceding the index date, and therapeutic strategies before AECOPD were assessed.
RESULTS: COPD patients were 82,034 (32.3/1,000 inhabitants aged ≥45; mean age was 75 years, 61.0% were male). By therapeutic strategy, 10,247 (12.5%) patients received SI-TT, 9583 (11.7%) MI-TT, 33,359 (40.7%) DT, 19,511 (23.8%) other strategies, and 9334 (11.4%) were untreated. Male patients were the majority. On average, DT patients were the youngest (mean age: 73 years), and MI-TT patients were the oldest (76 years). Around 60% of patients receiving TT, 62.1% DT and 59.3% other strategies had ≥3 comorbidities; cardio-metabolic chronic diseases were the most frequent. A previous AECOPD occurred in 4859 (47.4%), 3071 (32.0%), 9497 (28.5%) and 4904 (25.1%) patients receiving SI-TT, MI-TT, DT and other strategies, respectively. Despite the moderate/severe AECOPD, escalation to TT occurred in 27.4% and 19.6% patients previously receiving DT and other strategies, respectively, and in 19.1% of untreated patients.
CONCLUSIONS: From this study, we observed that a relevant proportion of COPD patients did not experience a treatment escalation after the occurrence of moderate/severe AECOPD despite GOLD recommendations. The treatment patterns might be affected by the presence of prescription restrictions for TT introduced in Italy in 2021.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH6
Topic
Epidemiology & Public Health, Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Public Health
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)