dc.contributor |
Universitat de Barcelona |
dc.contributor.author |
Miravitlles Fernández, Marc |
dc.contributor.author |
Huerta, Alicia |
dc.contributor.author |
Fernández-Villar, José Alberto |
dc.contributor.author |
Alcázar, Bernardino |
dc.contributor.author |
Villa, Guillermo |
dc.contributor.author |
Forné, Carles |
dc.contributor.author |
Cuesta, Maribel |
dc.contributor.author |
Crespo, Carlos |
dc.contributor.author |
García Río, Francisco |
dc.date |
2014-10-13T13:41:09Z |
dc.date |
2014-10-13T13:41:09Z |
dc.date |
2014-09-05 |
dc.date |
2014-10-13T13:41:10Z |
dc.identifier.citation |
1477-7525 |
dc.identifier.citation |
643066 |
dc.identifier.uri |
http://hdl.handle.net/2445/58544 |
dc.format |
12 p. |
dc.format |
application/pdf |
dc.language.iso |
eng |
dc.publisher |
BioMed Central |
dc.relation |
Reproducció del document publicat a: http://dx.doi.org/10.1186/s12955-014-0120-5 |
dc.relation |
Health And Quality Of Life Outcomes, 2014, vol. 12, num. 9, p. 120 |
dc.relation |
http://dx.doi.org/10.1186/s12955-014-0120-5 |
dc.rights |
cc-by (c) Miravitlles Fernández, Marc et al., 2014 |
dc.rights |
info:eu-repo/semantics/openAccess |
dc.rights |
http://creativecommons.org/licenses/by/3.0/es |
dc.subject |
Malalties pulmonars obstructives cròniques |
dc.subject |
Espanya |
dc.subject |
Economia de la salut |
dc.subject |
Chronic obstructive pulmonary diseases |
dc.subject |
Spain |
dc.subject |
Medical economics |
dc.title |
Generic utilities in chronic obstructive pulmonary disease patients stratified according to different staging systems. |
dc.type |
info:eu-repo/semantics/article |
dc.type |
info:eu-repo/semantics/publishedVersion |
dc.description.abstract |
Background To determine generic utilities for Spanish chronic obstructive pulmonary disease (COPD) patients stratified by different classifications: GOLD 2007, GOLD 2013, GesEPOC 2012 and BODEx index. Methods Multicentre, observational, cross-sectional study. Patients were aged ≥40 years, with spirometrically confirmed COPD. Utility values were derived from EQ-5D-3 L. Means, standard deviations (SD), medians and interquartile ranges (IQR) were computed based on the different classifications. Differences in median utilities between groups were assessed by non-parametric tests. Results 346 patients were included, of which 85.5% were male with a mean age of 67.9 (SD = 9.7) years and a mean duration of COPD of 7.6 (SD = 5.8) years; 80.3% were ex-smokers and the mean smoking history was 54.2 (SD = 33.2) pack-years. Median utilities (IQR) by GOLD 2007 were 0.87 (0.22) for moderate; 0.80 (0.26) for severe and 0.67 (0.42) for very-severe patients (p < 0.001 for all comparisons). Median utilities by GOLD 2013 were group A: 1.0 (0.09); group B: 0.87 (0.13); group C: 1.0 (0.16); group D: 0.74 (0.29); comparisons were statistically significant (p < 0.001) except A vs C. Median utilities by GesEPOC phenotypes were 0.84 (0.33) for non exacerbator; 0.80 (0.26) for COPD-asthma overlap; 0.71 (0.62) for exacerbator with emphysema; 0.72 (0.57) for exacerbator with chronic bronchitis (p < 0.001). Comparisons between patients with or without exacerbations and between patients with COPD-asthma overlap and exacerbator with chronic bronchitis were statistically-significant (p < 0.001). Median utilities by BODEx index were: group 0 2: 0.89 (0.20); group 3 4: 0.80 (0.27); group 5 6: 0.67 (0.29); group 7 9: 0.41 (0.31). All comparisons were significant (p < 0.001) except between groups 3 4 and 5 6. Conclusion Irrespective of the classification used utilities were associated to disease severity. Some clinical phenotypes were associated with worse utilities, probably related to a higher frequency of exacerbations. GOLD 2007 guidelines and BODEx index better discriminated patients with a worse health status than GOLD 2013 guidelines, while GOLD 2013 guidelines were better able to identify a smaller group of patients with the best health. |