Chronic obstructive pulmonary disease (COPD), also known as chronic bronchitis or emphysema is a lung disease often caused by smoking. It is very common and is becoming more common. It causes a huge burden to patients with respect to day-to-day symptoms and is associated with an increased risk of death compared with the general population. Many people with chronic obstructive pulmonary disease have periods of acute deterioration, usually triggered by a chest infection, called an acute exacerbation. These exacerbations are associated with worsening symptoms, for example, increased shortness of breath, or increase in sputum and/or cough. Exacerbations are important to try and prevent and treat promptly because they worsen quality of life and are associated with hospitalisation and worsening in lung function and sometimes death. People who have lots of exacerbations of COPD have increased morbidity and healthcare resource utilisation (HCRU). We aim to quantify the environmental impact of COPD care, by undertaking a retrospective, cohort, healthCARe‒Based envirONmental cost of treatment (CARBON) study estimating greenhouse gas (GHG) emissions in England associated with the management of patients living with COPD comparing people with different numbers of exacerbations. Targeting improved COPD exacerbations may elicit significant declines in carbon emissions, enabling healthcare systems to meet their carbon emission reduction goals.
Chronic obstructive pulmonary disease (COPD), also known as chronic bronchitis or emphysema is a lung disease often caused by smoking. It is very common and is becoming more common. It causes a huge burden to patients with respect to day-to-day symptoms and is associated with an increased risk of death compared with the general population. Many people with chronic obstructive pulmonary disease have periods of acute deterioration, usually triggered by a chest infection, called an acute exacerbation. These exacerbations are associated with worsening symptoms, for example, increased shortness of breath, or increase in sputum and/or cough. Exacerbations are important to try and prevent and treat promptly because they worsen quality of life and are associated with hospitalisation and worsening in lung function and sometimes death. People who have lots of exacerbations of COPD have increased morbidity and healthcare resource utilisation (HCRU).
We aim to quantify the environmental impact of COPD care, by undertaking a retrospective, cohort, healthCARe‒Based envirONmental cost of treatment (CARBON) study estimating greenhouse gas (GHG) emissions in England associated with the management of individuals living with COPD comparing people with different numbers of exacerbations. Targeting improved COPD exacerbations may elicit significant declines in carbon emissions, enabling healthcare systems to meet their carbon emission reduction goals.
People with COPD registered within the Clinical Practice Research Datalink (2014-2019) who contribute data to Aurum and are eligible for linkage with HES APC, OP, ONS mortality data and IMD data will be included. GHG emissions, measured as carbon dioxide equivalent (CO2e), will be estimated for (i) COPD-related medication use, and (ii) inpatient and outpatient care during a 24-month follow-up of patients with COPD classified at baseline by their severity (exacerbation frequency) as per the EXACOS-UK study (20_103R).
Annualised carbon footprint for HCRU for people with COPD in England
(i) HCRU over the first 24 months of follow-up (intermediate outcome);
(ii) GHG emission associated with this HCRU (final outcome).
Jennifer Quint - Chief Investigator - Imperial College London
Emily Graul - Corresponding Applicant - Imperial College London
Clementine Nordon - Collaborator - AstraZeneca Ltd - UK Headquarters
Constantinos Kallis - Collaborator - Imperial College London
Hannah Whittaker - Collaborator - Imperial College London
HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation