Chronic Obstructive Pulmonary Disease (COPD) is a collection of lung diseases that narrow the airways, causing breathing difficulties and other symptoms such as persistent cough or chest infections and asthma is a disease that inflames the airways inside the lungs making it hard for enough air to pass through and for a person to breathe normally. Together these diseases are the most common types of lung diseases that occur in England and the way that these diseases are managed has changed over time. We plan to investigate whether the management of these diseases has had an impact on whether patients with COPD or Asthma are more likely to die compared to healthy people. This information will help future public health initiatives and clinical practice by helping to explain whether treatments or guidelines have made an impact on potentially avoidable deaths.
Asthma and Chronic Obstructive Pulmonary Disease (COPD) continue to be an important cause of morbidity, mortality, and health-care costs in the United Kingdom (UK). Improvements in disease management in primary care over the last 20 years have widely been attributed to incentive-driven activities in addition to better treatments and earlier diagnosis. However whether these changes are related to the excess risk of death among respiratory disease patients has yet to be investigated. This cohort study, using linked CPRD, HES and ONS data, aims to understand whether there is an association between trends in common disease management metrics, outcomes and excess mortality rates among patients with COPD, Asthma or both. Interrupted time series analysis will be used to understand which major interventions are related to trends and a multilevel regression model for excess mortality rates will be used to quantify the association between disease management achievements, outcomes and excess mortality in these three populations.
COPD exacerbation rate per 100 patients
Asthma attack rate per 100 patients
% COPD patients prescribed oral steroid
Hospitalisation rate per 100 patients
Excess mortality rate
Jennifer Quint - Chief Investigator - Imperial College London
Alicia Gayle - Corresponding Applicant - Imperial College London
HES Admitted Patient Care;ONS Death Registration Data;Practice Level Index of Multiple Deprivation