Survival Analysis of COPD Patients in a 13-Year Nationwide Cohort Study of the Brazilian National Health System

Frontiers in Big Data

Valéria Maria Augusto¹  Francisco Assis Acúrcio²  Brian Godman³  Isabella de Figueiredo Zuppo⁷  Augusto Afonso Guerra⁷  Juliana de Oliveira Costa⁸  Juliana Álvares-Teodoro^1,10  Ludmila Peres Gargano^1,10  Mariana Martins Gonzaga do Nascimento^1,10 

[1] Excellence in Health, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil;Centre for Big Data Research in Health, Faculty of Medicine and Health, The University of New South Wales, Sydney, NSW, Australia;Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates;Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil;Department of Pharmaceutical Products, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil;Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom;Department of Social Pharmacy, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil;School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia;School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa;;Sistema Único de Saúde (SUS) Collaborating Centre – Technology Assessment &

关键词: survival analysis;    cohort study;    chronic obstructive pulmonary disease (COPD);    real world data (RWD);    record linkage;    Brazil;   

DOI  :  10.3389/fdata.2021.788268

来源: DOAJ

【 摘 要 】

BackgroundChronic obstructive pulmonary disease (COPD) has an appreciable socioeconomical impact in low- and middle-income countries, but most epidemiological data originate from high-income countries. For this reason, it is especially important to understand survival and factors associated with survival in COPD patients in these countries.ObjectiveTo assess survival of COPD patients in Brazil, to identify risk factors associated with overall survival, including treatment options funded by the Brazilian National Health System (SUS).MethodologyWe built a retrospective cohort study of patients dispensed COPD treatment in SUS, from 2003 to 2015 using a National Database created from the record linkage of administrative databases. We further matched patients 1:1 based on sex, age and year of entry to assess the effect of the medicines on patient survival. We used the Kaplan-Meier method to estimate overall survival of patients, and Cox's model of proportional risks to assess risk factors.ResultThirty seven thousand and nine hundred and thirty eight patients were included. Patient's survival rates at 1 and 10 years were 97.6% (CI 95% 97.4–97.8) and 83.1% (CI 95% 81.9–84.3), respectively. The multivariate analysis showed that male patients, over 65 years old and underweight had an increased risk of death. Therapeutic regimens containing a bronchodilator in a free dose along with a fixed-dose combination of corticosteroid and bronchodilator seem to be a protective factor when compared to other regimens.ConclusionOur findings contribute to the knowledge of COPD patients' profile, survival rate and related risk factors, providing new evidence that supports the debate about pharmacological therapy and healthcare of these patients.

【 授权许可】

Unknown