Zhao Xuanna, Liu Gege, Liu Dewei, Zou Li, Huang Qiu, Chen Min, Li Dongming, Wu Bin, Wu Hua, Huang Dan, Wu Dong
Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.
First College for Clinical Medicine, Guangdong Medical University, Zhanjiang, Guangdong, China.
Front Psychiatry. 2024 Jan 8;14:1221767. doi: 10.3389/fpsyt.2023.1221767. eCollection 2023.
Anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD), especially older adult patients. This can complicate the disease progression and lead to increased clinical and economic burden. We sought to investigate the clinical and economic burdens associated with the presence of anxious and/or depressive symptoms among older adult COPD patients.
We screened 579 patients aged over 60 years and diagnosed with COPD via a lung function test following the 2017 Global Initiative Chronic Obstructive Lung Disease (GOLD) guidelines. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS) through face-to-face interviews at admission. Follow-up was conducted by telephone calls at 6, 12, 18, 24, and 36 months after discharge to assess clinical and economic burden. COPD-anxiety and/or depression patients were matched to patients without anxiety and depression (COPD-only) using propensity scores. Multivariate regression models were used to compare clinical and economic burden between COPD-anxiety and/or depression and COPD-only groups.
Compared with COPD-only patients, COPD patients complicated with anxiety and/or depression had increased clinical burden, including higher COPD-related outpatient visits, COPD-related hospitalizations, and length of COPD-related hospitalizations ( < 0.001). Moreover, they also had an increased economic burden, including higher annual total healthcare costs, medical costs, and pharmacy costs ( < 0.001).
Older adult COPD patients with anxiety or depression had significantly higher clinical and economic burdens than patients without these comorbidities. These findings deserve further exploration and may be useful for the formulation of relevant healthcare policies.
焦虑和抑郁在慢性阻塞性肺疾病（COPD）患者中很常见，尤其是老年患者。这会使疾病进展复杂化，并导致临床和经济负担增加。我们旨在调查老年COPD患者中焦虑和/或抑郁症状的存在所带来的临床和经济负担。
我们筛选了579名60岁以上且根据2017年全球慢性阻塞性肺疾病倡议（GOLD）指南通过肺功能测试诊断为COPD的患者。在入院时通过面对面访谈使用医院焦虑和抑郁量表（HADS）测量焦虑和抑郁。出院后6、12、18、24和36个月通过电话随访评估临床和经济负担。使用倾向得分将COPD-焦虑和/或抑郁患者与无焦虑和抑郁的患者（仅COPD）进行匹配。使用多变量回归模型比较COPD-焦虑和/或抑郁组与仅COPD组之间的临床和经济负担。
与仅患COPD的患者相比，合并焦虑和/或抑郁的COPD患者临床负担增加，包括更高的COPD相关门诊就诊次数、COPD相关住院次数以及COPD相关住院时长（<0.001）。此外，他们的经济负担也增加，包括更高的年度总医疗费用、医疗成本和药房费用（<0.001）。
患有焦虑或抑郁的老年COPD患者的临床和经济负担明显高于无这些合并症的患者。这些发现值得进一步探索，可能有助于制定相关医疗政策。
