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Impact of Chronic Obstructive Pulmonary Disease Exacerbations on Patients and Payers

Academic Unit of Respiratory Medicine, University College, London, United Kingdom

Correspondence and requests for reprints should be addressed to Jadwiga A. Wedzicha, M.D., Academic Unit of Respiratory Medicine, Royal Free and University College Medical School, Rowland Hill Street, Hampstead, London NW3 2PF, UK. E-mail: j.a.wedzicha{at}medsch.ucl.ac.uk

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is not only an established major cause of mortality and morbidity but is increasing in worldwide prevalence despite current medical interventions. The natural history of COPD is punctuated by periods of acute symptomatic, physiologic, and functional deterioration or exacerbations. These events are responsible for considerable additional morbidity and mortality and impact on patients' long-term health status. Despite advances in understanding disease mechanisms and in treatment, exacerbations continue to be the major cause of COPD-associated hospitalization, and provision for their management incurs considerable health care costs. Although pharmacologic therapies may improve clinical outcomes, these benefits must be optimized by prompt diagnosis and delivery. This will require improved understanding of this complex disease by physicians and patients alike.

Key Words: chronic obstructive pulmonary disease • clinical outcomes • exacerbations

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