Self-treatment lowers overall health care costs for chronic obstructive pulmonary disorder sufferers

May 17 2009

Individuals suffering from chronic obstructive pulmonary disorder (COPD) can experience significant savings in healthcare costs by employing a self-treatment program with the judicious use of medications, according to the results of a new study. The self-treatment program achieves these savings by reducing the duration of flare-ups.

Dutch researchers presented their findings on Sunday, May 17, at the American Thoracic Society's 105th International Conference in San Diego.

"The course of COPD is characterized by episodes of acute deteriorations in respiratory health, termed 'exacerbations,'" said lead author Tanja Effing, Ph.D., a researcher with the Department of Pulmonary Disease at the Medisch Spectrum Twente in Enschede, the Netherlands. "These exacerbations account for much of the morbidity, mortality and hospital admissions in COPD patients."

The investigators tracked the outcomes of 142 patients divided into two groups. Participants in the first group were instructed in individual drug therapy and other responses to take in the event of an exacerbation. Patients in the second group received no instruction in the self-treatment of exacerbations.

Exacerbations were defined as a clearly negative change in two major symptoms, or one major symptom and one minor symptom. Major symptoms included breathlessness and mucous production and color, while minor symptoms included cough, wheeze, running nose, sore throat and fever.

Patients in both groups were also instructed to maintain journals recording any COPD-related events, as well as medication routines.

In comparing the results of the two groups, researchers noted a significant decrease in doctor's office visits during the study period for the group that received self-treatment training.

"Our results showed that the self-treatment of exacerbations leads to fewer exacerbation days, in combination with an increase in the use of medications," Dr. Effing noted. "Moreover, analyses of the cost-effectiveness of the self-treatment strategy indicated this group experienced cost savings as a result of fewer hospitalizations and healthcare contacts."

Researchers also sought to determine if the self-treatment group would tend to overmedicate when given the option, but Dr. Effing said the study's results indicated that over-medication was not an issue.

"The number of reported courses of medication in the self-treatment group was still lower than the actual number of exacerbations reported in the diaries," Dr. Effing noted. "Given the rise in prevalence of COPD and the costs associated with its treatment, we suggest implementation of programs incorporating careful instruction in self-treatment as part of effective self-management programs in COPD patients with frequent exacerbations."