Abstract
Objective: The objective of this study was to compare rates of different types of
acute exacerbations of COPD (AECOPDs) and healthcare utilization among patients
with different severities of COPD. Methods: Data for this study was obtained from
the PHARMO Database Network, which includes drug dispensing records from
pharmacies, hospitalization records and information from general practitioners.
Patients with moderate to very severe COPD (GOLD II-III-IV) and a moderate or
severe AECOPD between 2000 and 2010 were included in the study. Moderate and
severe AECOPDs were defi ned by drug use and hospitalizations respectively. Study
patients were followed from the fi rst AECOPD to end of registration in PHARMO,
death or end of study period, whichever occurred fi rst. During follow-up, all
recurrent AECOPDs were characterized and healthcare utilization was assessed.
RESULTS: Of 886 patients in the study, 52% had GOLD-II, 34% GOLD-III and 14%
had GOLD-IV. The overall AECOPD recurrence rate per person year (PY) increased
from 0.63 for patients with GOLD-II to 1.09 for patients with GOLD-III and 1.33 for
patients with GOLD-IV. The rate of severe AECOPD was 0.06, 0.14 and 0.17 per PY,
respectively. Conclusion: AECOPD recurrence rates and healthcare utilization are
signifi cantly higher among patients with more severe COPD.