Evidence map›Paper›PMID 39560897›Full record

Observational studyAdvances in therapy2025

Oral Corticosteroid-Related Healthcare Resource Utilization and Associated Costs in Patients with COPD.

Gary Tse, Cono Ariti, Mona Bafadhel, Alberto Papi, Victoria Carter, Jiandong Zhou, Derek Skinner, Xiao Xu, Hana Müllerová, Benjamin Emmanuel and 1 more

Abstract readObservational Study
In one paragraph

Observational study in Advances in therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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 synthesis or guideline pooled it.

  1. Pooled it
  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

11 authors.

Gary TseObservational and Pragmatic Research Institute, Singapore, Singapore.ORCID 0000-0001-5510-1253
Cono AritiObservational and Pragmatic Research Institute, Singapore, Singapore.ORCID 0000-0001-7615-0935
Mona BafadhelKing's Centre for Lung Health, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.ORCID 0000-0002-9993-2478
Alberto PapiRespiratory Medicine, Department of Translational Medicine, University of Ferrara, Ferrara, Italy.ORCID 0000-0002-6924-4500
Victoria CarterObservational and Pragmatic Research Institute, Singapore, Singapore.ORCID 0000-0002-0333-3308
Jiandong ZhouObservational and Pragmatic Research Institute, Singapore, Singapore.ORCID 0000-0003-3780-9033
Derek SkinnerObservational and Pragmatic Research Institute, Singapore, Singapore.ORCID 0000-0002-7112-9317
Xiao XuAstraZeneca, Gaithersburg, MD, USA.
Hana MüllerováAstraZeneca, Cambridge, UK.ORCID 0000-0002-0949-0101
Benjamin EmmanuelAstraZeneca, Gaithersburg, MD, USA.ORCID 0000-0003-1769-9826
David PriceObservational and Pragmatic Research Institute, Singapore, Singapore. dprice@opri.sg.ORCID 0000-0002-9728-9992

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOral corticosteroids (OCS) are used to manage chronic obstructive pulmonary disease (COPD) exacerbations but are associated with adverse outcomes that may increase healthcare resource utilization and costs. We compared attendance/costs associated with OCS-related adverse outcomes in patients who ever used OCS versus those who never used OCS and examined associations between cumulative OCS exposure and attendance/costs.

methodsThis direct matched observational cohort study used the UK Clinical Practice Research Datalink GOLD database (data range 1987-2019). Patients with a COPD diagnosis on/after April 1, 2003, and Hospital Episode Statistics linkage were included. Emergency room, specialist or primary care outpatient, and inpatient attendance were analyzed. Costs, estimated using Health and Social Care 2019 and National Health Service Reference Costs 2019-2020 reports, were adjusted for sex, age, exacerbation number, and inhaler type used in the 12 months before index date.

resultsThe OCS cohort had higher annualized disease-specific (excluding respiratory) total attendance/costs versus the non-OCS cohort (adjusted incidence rate ratio [aIRR] with 95% confidence intervals [CIs]) ranging from 37% (1.37 [1.31, 1.43]) for emergency room attendances to 149% (2.49 [2.36, 2.63]) for specialist consultations. Disease-specific (excluding respiratory) attendance/costs increased in a positive dose-response relationship for most attendance categories versus the < 0.5 g reference dose. For the 0.5 to < 1.0 g cumulative dose category, the greatest increases in disease-specific (excluding respiratory) attendance/costs occurred for primary care consultations (aIRR [95% CI] 1.38 [1.32, 1.44]). For the ≥ 10 g cumulative dose category, the greatest increases were observed for primary care consultations (aIRR [95% CI] 2.83 [2.66, 3.00]), non-elective long stays (≥ 2 days; 2.54 [2.15, 2.99]), and non-elective short stays (≤ 1 day; 2.51 [2.12, 2.98]). Similar findings were observed for all-cause attendance/costs.

conclusionAmong patients with COPD, OCS-related adverse outcomes were associated with higher attendance and costs, with a positive dose-response relationship. A graphical abstract is available with this article.

Indexed as

Adrenal Cortex HormonesHealth Care CostsPatient Acceptance of Health CarePulmonary Disease, Chronic ObstructiveAdministration, OralAgedCohort StudiesEmergency Service, HospitalFemaleHealth ResourcesHospitalizationHumansMaleMiddle AgedUnited KingdomAdrenal Cortex HormonesChronic obstructive pulmonary diseaseCohort studyCorticosteroidsCostHealthcare resource utilizationObservationalPrimary care

Identifiers

PMID39560897
PMCPMC11782346

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.