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Canadian Respiratory Journal
Volume 2017, Article ID 8184915, 10 pages
Research Article

The Burden of Illness Related to Chronic Obstructive Pulmonary Disease Exacerbations in Québec, Canada

1GlaxoSmithKline, Research Triangle Park, Durham, NC, USA
2GlaxoSmithKline, Mississauga, ON, Canada
3JSS Medical Research Inc., Saint Laurent, QC, Canada
4Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, USA
5GlaxoSmithKline, Collegeville, PA, USA
6McGill University, Montreal, QC, Canada

Correspondence should be addressed to John S. Sampalis; moc.hcraeserssj@snoissimbus

Received 18 January 2017; Revised 11 April 2017; Accepted 15 May 2017; Published 20 June 2017

Academic Editor: Angelo G. Corsico

Copyright © 2017 Tam Dang-Tan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Chronic obstructive pulmonary disease (COPD) prevalence in Canada has risen over time. COPD-related exacerbations contribute to the increased health care utilization (HCU) in this population. This study investigated the impact of exacerbations on COPD-related HCU. Methods. This retrospective observational cohort study used patient data from the Québec provincial health insurance databases. Eligible patients with a new HCU claim with a diagnostic billing for COPD during 2001–2010 were followed until March 31, 2011. Exacerbation rates and time to first exacerbation were assessed. Unadjusted analyses and multivariable models compared the rate of HCU by exacerbation classification (any [moderate/severe], moderate, or severe). Results. The exacerbation event rate in patients with an exacerbation was 34.3 events/100 patient-years (22.7 for moderate exacerbations and 11.6 for severe exacerbations). Median time to first exacerbation of any classification was 37 months. In unadjusted analyses, COPD-related HCU significantly increased with exacerbation severity. In the multivariable, HCU rates were significantly higher after exacerbation versus before exacerbation () for patients with an exacerbation or moderate exacerbations. For severe exacerbations, general practitioner, respiratory specialist, emergency room, and hospital visits were significantly higher after exacerbation versus before exacerbation (). Conclusions. Exacerbations were associated with increased HCU, which was more pronounced for patients with severe exacerbations. Interventions to reduce the risk of exacerbations in patients with COPD may reduce disease burden.