Exacerbaciones de la enfermedad pulmonar obstructiva crónica (EPOC) y patrónes de tratamiento en Chile: datos del estudio PATTERN: Exacerbaciones y tratamiento del EPOC en Chile

Abstract

Objective: To describe treatment and exacerbations among patients with a spirometric-confirmed chronic obstructive pulmonary disease (COPD) diagnosis in a Chilean center.

Methods: Retrospective cohort study with data from ≥40 years old subjects, with health problems related to COPD (J40-J44 ICD-10 codes or Explicit Health Guarantee [GES-38] code), and FEV1/FVC <0.7 post-bronchodilation, between 2018-2020, where it was analyzed one-year pre and post index (Feb/2019). It was analyzed moderate exacerbations (antibiotic and/or oral corticoids prescription) and severe (urgency visit and/or hospitalization).

Results: 1,317 patients with spirometric-confirmed COPD were included (mean age 72 years, 50.3% women). In the baseline 15% had only moderate exacerbations and 2% had at least one severe exacerbation. Individuals with moderate/severe exacerbations had a greater number of events during follow-up (≥1 episode: no moderate/severe exacerbation (9.9%), only moderate exacerbations (34.9%); at least one severe exacerbation (39.3%)). In most patients, no treatment prescription was identified (78.3% baseline; 81.5% follow-up). At least one ICS, LABA or LAMA was prescribed in 18.3% at baseline and 15.0% during follow-up. Most patients were treated with dual (53.1%) and triple (21.3%) therapy. Individuals with moderate/severe exacerbations were mainly prescribed with at least one ICS, LABA or LAMA.

Conclusion: New exacerbations were more frequent among people who had experienced a previous exacerbation. Furthermore, those with previous exacerbations had a higher frequency of prescribed treatment.