中东和北非的慢性阻塞性肺疾病及其相关医疗资源消耗：BREATHE 研究。

Chronic obstructive pulmonary disease and associated healthcare resource consumption in the Middle East and North Africa: the BREATHE study.

机构信息

Adnan Menderes University, Aydin, Turkey.

出版信息

Respir Med. 2012 Dec;106 Suppl 2:S75-85. doi: 10.1016/S0954-6111(12)70016-1.

Abstract

Data on COPD-related healthcare resources use are rarely documented in developing countries. This article presents data on COPD-related healthcare resource consumption in the Middle East, North Africa and Pakistan and addresses the association of this variable with illness severity. A large survey of COPD was conducted in eleven countries of the region, namely Algeria, Egypt, Jordan, Lebanon, Morocco, Pakistan, Saudi-Arabia, Syria, Tunisia, Turkey and United Arab Emirates, using a standardised methodology. A total of 62,086 subjects were screened. This identified 2,187 subjects fulfilling the "epidemiological" definition of COPD. A detailed questionnaire was administered to document data on COPD-related healthcare consumption. Symptom severity was assessed using the COPD Assessment Test (CAT). 1,392 subjects were analysable. Physician consultations were the most frequently used healthcare resource, ranging from 43,118 [95% CI: 755-85,548] consultations in UAE to 4,276,800 [95% CI: 2,320,164-6,230,763] in Pakistan, followed by emergency room visits, ranging from 15,917 [95% CI: 0-34,807] visits in UAE to 683,697 [95% CI: 496,993-869,737] in Turkey and hospitalisations, ranging from 15,563 [95% CI: 7,911-23,215] in UAE to 476,674 [95% CI: 301,258-652,090] in Turkey. The use of each resource increased proportionally with the GOLD 2011 severity groups and was significantly (p < 0.0001) higher in subjects with more symptoms compared to those with lower symptoms and in subjects with exacerbations to those without exacerbations. The occurrence of exacerbations and the CAT score were independently associated with use of each healthcare resource. In conclusion, the BREATHE study revealed that physician consultation is the most frequently COPD-related healthcare resource used in the region. It showed that the deterioration of COPD symptoms and the frequency of exacerbations raised healthcare resource consumption.

摘要

在发展中国家，有关 COPD 相关医疗资源使用的数据很少有记录。本文介绍了中东、北非和巴基斯坦的 COPD 相关医疗资源消耗数据，并探讨了这一变量与疾病严重程度的关系。该地区的 11 个国家（阿尔及利亚、埃及、约旦、黎巴嫩、摩洛哥、巴基斯坦、沙特阿拉伯、叙利亚、突尼斯、土耳其和阿拉伯联合酋长国）进行了一项大型 COPD 调查，使用了标准化方法。共筛选了 62086 名受试者。这确定了 2187 名符合 COPD“流行病学”定义的受试者。详细的问卷用于记录 COPD 相关医疗保健消费的数据。使用 COPD 评估测试（CAT）评估症状严重程度。对 1392 名受试者进行了分析。医生咨询是使用最频繁的医疗资源，从阿联酋的 43118 次（95%CI：755-85548）咨询到巴基斯坦的 4276800 次（95%CI：2320164-6230763），其次是急诊就诊，从阿联酋的 15917 次（95%CI：0-34807）就诊到土耳其的 683697 次（95%CI：496993-869737），再到住院治疗，从阿联酋的 15563 次（95%CI：7911-23215）就诊到土耳其的 476674 次（95%CI：301258-652090）。随着 GOLD 2011 严重程度组的增加，每种资源的使用比例都相应增加，并且与症状较轻的患者相比，症状较重的患者和有加重的患者相比，使用每种资源的差异具有统计学意义（p<0.0001）。加重的发生和 CAT 评分与每种医疗资源的使用独立相关。总之，BREATHE 研究表明，在该地区，医生咨询是最常使用的 COPD 相关医疗资源。它表明 COPD 症状的恶化和加重的频率增加了医疗资源的消耗。