Evidence map›Paper›PMID 34848952›Full record

ArticleInternational journal of chronic obstructive pulmonary disease

Economic Impact of Low Adherence to COPD Management Guidelines in Spain.

Marc Miravitlles, Alexandra Solé, Helena Aguilar, Ana Ampudia, Jaume Costa-Samarra, Maria Mallén-Alberdi, Diana Nieves

Abstract read
In one paragraph

Article in International journal of chronic obstructive pulmonary disease. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Marc MiravitllesPneumology Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER for Respiratory Diseases (CIBERES), Barcelona, Spain.ORCID 0000-0002-9850-9520
Alexandra SoléMarket Access Department of Boehringer Ingelheim SA, Barcelona, Spain.
Helena AguilarMedical Department of Boehringer Ingelheim SA, Barcelona, Spain.
Ana AmpudiaMarket Access Department of Boehringer Ingelheim SA, Barcelona, Spain.
Jaume Costa-SamarraOblikue Consulting SL, Barcelona, Spain.ORCID 0000-0003-4613-3506
Maria Mallén-AlberdiOblikue Consulting SL, Barcelona, Spain.ORCID 0000-0003-2114-5279
Diana NievesOblikue Consulting SL, Barcelona, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe objective of this study was to assess the non-adherence level of Spanish clinical practice to guideline recommendations for the treatment of chronic obstructive pulmonary disease (COPD) and to estimate the potential impact on pharmaceutical expenditure resulting from transitioning current treatment patterns according to guidelines.

methodsA model was developed to compare current prescribing patterns with two alternative scenarios: the first aligned with the Global Initiative for Chronic Obstructive Lung Disease (GOLD 2020) recommendations, and the second with the Spanish Guidelines for COPD (GesEPOC 2017). Current treatment practice was obtained from publications that describe treatment patterns by pulmonology departments in Spain. The economic impact between patterns was calculated from the perspective of the Spanish National Health System (NHS), considering the annual pharmacological costs of COPD inhaled maintenance therapy. Two additional analyses were performed: one that included current prescribing patterns of patients managed by pulmonology and primary care centers in Spain (published aggregated data); and another that only considered the appropriate use of inhaled corticosteroids (ICS) treatment according to guidelines.

resultsIt was estimated that 54% and 38% of patients were not treated in line with GOLD and GesEPOC recommendations, respectively, mainly due to a broader use of ICS-based therapies. Adapting treatment to recommendations could provide a potential annual cost-saving of €17,792,022 (according to GOLD) and €5,881,785 (according to GesEPOC). In scenario analysis 1, a 26% of non-adherence to GesEPOC guideline was observed with a potential annual pharmacological cost-saving of €2,707,554. In scenario analysis 2, considering only inappropriate use of ICS treatment, an annual cost-saving of €17,863,750 (according to GOLD) and €9,904,409 (according to GesEPOC) was calculated.

conclusionMore than a third of treatments for COPD patients in Spain are not prescribed in accordance with guideline recommendations. The adaptation of clinical practice to guideline recommendations could provide important cost-savings for the Spanish NHS.

Indexed as

Pulmonary Disease, Chronic ObstructiveAdrenal Cortex HormonesBronchodilator AgentsGuideline AdherenceHumansPractice Patterns, Physicians'Respiratory TherapySpainAdrenal Cortex HormonesBronchodilator Agentschronic obstructive pulmonary diseasecostrecommendationsSpanishtreatment

Identifiers

PMID34848952
PMCPMC8611727

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.