COMPARISON OF THE EFFECTIVENESS OF THE APPLICATION OF VARIOUS SCHEMES FOR THE TREATMENT OF BRONCHIAL ASTHMA AND COPD IN A SUPRA-CLUSTER LEVEL OF CARE INSTITUTION
DOI:
https://doi.org/10.32782/2226-2008-2025-2-7Keywords:
bronchoobstructive syndrome, effectiveness, cost-effectiveness, chronic non-communicable diseases, healthcare organizationAbstract
Bronchial asthma and COPD are among the most common diseases with bronchoobstructive syndrome, however, the effectiveness of various treatment regimens using them is still debatable.The aim of the study – studying the effectiveness of using different treatment regimens for the most common diseases with broncho- obstructive syndrome using the example of the pulmonology department of the tertiary care institution.Materials and methods. A total of 203 medical histories and data from the medical information system MedAir were analyzed, followed by an evaluation of the effectiveness of applied treatment regimens using Farrell's technical efficiency index, cost-effectiveness analysis, and related factors.Results. The analysis showed low adaptability of basic therapy regimens for patients with bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD). Technical effectiveness of treatment was achieved in only 5.2% of patients (5 out of 97), while the majority received excessive (69%) or insufficient (28%) doses of drugs. Overall treatment effectiveness was higher in patients with BA (78%) compared to patients with COPD (62%). Among the three analyzed treatment regimens, the first was the most effective in terms of technical parameters (84%), the second – in terms of cost-effectiveness (76%), and the third achieved the highest indicators in terms of both criteria (88% technical effectiveness and 82% cost-effectiveness). However, conclusions regarding the third regimen are limited due to the small number of observations (12 patients). Factors affecting cost-effectiveness were gender, diagnosis, and year of observation. Women responded better to the first treatment regimen (82%), while the second regimen was more effective for employed men (71%). Patients with asthma showed a higher treatment efficacy (12% more compared to COPD). Although patient compliance was positively correlated with treatment outcomes, its effect was not statistically significant.
References
Adeloye D, Song P, Zhu Y, Campbell H, Sheikh A, Rudan I. Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. The Lancet Respiratory Medicine. 2022 May 1; 10(5): 447–58. DOI: 10.1016/S2213-2600(21)00511-7.
Asanov EO, Shatilo VB, Dyba IA, Holubova YuI, Slipchenko VH, Poliahushko LH. Lung ventilation function and pulmonary gas exchange in elderly patients with chronic obstructive pulmonary disease during combined application of hypoxic training and respiratory training with positive end-expiratory pressure. Clinical and Preventive Medicine. 2024; 5: 12–20. DOI: 10.31612/2616-4868.5.2024.02.
Dal Negro RW, Bonadiman L, Turco P, Tognella S, Iannazzo S. Costs of illness analysis in Italian patients with chronic obstructive pulmonary disease (COPD): an update. ClinicoEconomics and outcomes research. 2015 Mar 16: 153–9. DOI: 10.2147/CEOR.S77504.
Dal Negro RW, Bonadiman L, Turco P. Prevalence of different comorbidities in COPD patients by gender and GOLD stage. Multidisciplinary respiratory medicine. 2015 Dec; 10: 1–9. DOI: 10.1186/s40248-015-0023-2.
Huang K, Yang T, Xu J, et al. Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. The Lancet. 2019 Aug 3; 394(10196): 407–18. DOI: 10.1016/S0140-6736(19)31147-X.
Jordan RE, Majothi S, Heneghan NR, et al. Supported self-management for patients with moderate to severe chronic obstructive pulmonary disease (COPD): an evidence synthesis and economic analysis. Health Technology Assessment (Winchester, England). 2015 May; 19(36): 1. DOI: 10.3310/hta19360.
Kachkovska V, Kovchun A, Dudchenko I, Prystupa L. Effectiveness of complex treatment of patients with early-onset and late-onset bronchial asthma associated with obesity. Eastern Ukrainian Medical Journal. 2024; 12(1): 148–159. DOI: 10.21272/eumj.2024;12(1):148-159.
Manfrin A, Tinelli M, Thomas T, Krska J. A cluster randomised control trial to evaluate the effectiveness and cost- effectiveness of the Italian medicines use review (I-MUR) for asthma patients. BMC Health Services Research. 2017 Dec; 17: 1–3. DOI: 10.1186/s12913-017-2245-9.
McLean S, Hoogendoorn M, Hoogenveen RT, et al. Projecting the COPD population and costs in England and Scotland: 2011 to 2030. Scientific reports. 2016 Sep 1; 6(1): 31893. DOI: 10.1038/srep31893.
Nurmagambetov T, Kuwahara R, Garbe P. The economic burden of asthma in the United States, 2008–2013. Annals of the American Thoracic Society. 2018 Mar; 15(3): 348–56. DOI: 10.1513/AnnalsATS.201703-259OC.
O'Neill S, Sweeney J, Patterson CC, et al. The cost of treating severe refractory asthma in the UK: an economic analysis from the British Thoracic Society Difficult Asthma Registry. Thorax. 2015 Apr 1; 70(4): 376–8. DOI: 10.1136/thoraxjnl-2013-204114.
Pate CA, Zahran HS, Qin X, Johnson C, Hummelman E, Malilay J. Asthma Surveillance – United States, 2006–2018. MMWR Surveill Summ. 2021 Sep 17; 70(5): 1–32. DOI: 10.15585/mmwr.ss7005a1.
Putcha N, Drummond MB, Wise RA, Hansel NN. Comorbidities and Chronic Obstructive Pulmonary Disease: Prevalence, Influence on Outcomes, and Management. Semin Respir Crit Care Med. 2015 Aug; 36(4): 575–91. DOI: 10.1055/ s-0035-1556063.
Stern J, Pier J, Litonjua AA. Asthma epidemiology and risk factors. Semin Immunopathol. 2020 Feb; 42(1): 5–15. DOI: 10.1007/s00281-020-00785-1.
Varmaghani M, Dehghani M, Heidari E, Sharifi F, Moghaddam SS, Farzadfar F. Global prevalence of chronic obstructive pulmonary disease: systematic review and meta-analysis. East Mediterr Health J. 2019 Mar 19; 25(1): 47–57. DOI: 10.26719/ emhj.18.01.
Wacker ME, Jörres RA, Schulz H, et al. Direct and indirect costs of COPD and its comorbidities: results from the German COSYCONET study. Respiratory medicine. 2016 Feb 1; 111: 39–46. DOI: 10.1016/j.rmed.2015.12.00.
Zein JG, Udeh BL, Teague WG, et al. Impact of age and sex on outcomes and hospital cost of acute asthma in the United States, 2011–2012. PLoS One. 2016 Jun 13; 11(6): e0157301. DOI: 10.1371/journal.pone.0157301.
