Resource use study in COPD (RUSIC): A prospective study to, quantify the effects of COPD exacerbations on health care resource use among COPD patients

BACKGROUND: There is increasing interest in health Care resources[I-CL Use (HRU) in Canada, particularly in resources associated With acute] exacerbations of chronic obstructive pulmonary discase (COPD). OBJECTIVE: To identify HRU due to exacerbations of COPD. METHODS: A 52-week, multicentre, prospective, observational Study of HRU due to exacerbations in patients with moderate to severe COPD was performed. Patients were recruited from primary care physicians and respirologists in urban and rural centres in Canada. RESULTS: In total, 524 subjects (59% men) completed the Study. Then- mean age was 68.2 +/- 9.4 years, with a forced expiratory voluirle in 1 s of 1.01 +/- 0.4 L. Patients, had significant comorbiditics. There were 691 acute exacerbations of COPD, Which occurred in 53% of patients: 119 patients (23%) experienced one actite exacerbation, 70 patients (13%) had two,o acute exacerbations and 89 paticrits (17%) had three OF more acute exacerbations. Seventy-five patients were admirred to hospital, with an average length of stay of 13.2 days. Fourteen of the patients spent Little in an intensive care unit (average length of stay 5.6 days). Factors associated with acure exacerbations of COPD included lower forced expiratory VOILane in I s (P < 0.001), high number of respiratory medications prescribed (P=0.037), regular use of oral corticosteroids (OCSs) (P=0.008) and presence of depression (P < 0.001). Of the 75 patients hospitalized, only 53 received OCSS, four received referral for rehabilitation and 15 were referred for home care. CONCLUSIONS: The present Study showed a high prevalence of COPD exacerbations, which likely impacted on HRU. There was evidence of a lack of appropriate management of exacerbations, especially with respect to Use of OCSS, and referral for Pulmonary rehabilitation and home care.