The Increased Health Burden of Asthma—COPD Overlap Syndrome

Using patient-reported outcomes and data on healthcare utilization, researchers from the Yale School of Medicine have been able to compare the health burden of asthma—COPD overlap syndrome (ACOS) with asthma or chronic obstructive pulmonary disease (COPD) alone.

They published their findings, which build on previous studies suggesting ACOS has a greater health burden than asthma or COPD alone, in the International Journal of Chronic Obstructive Pulmonary Disease.

They used data from the Medical Expenditure Panel Survey and evaluated patient-reported outcomes and healthcare utilization among individuals aged 40 to 85 years who had asthma or COPD. The patient-reported outcomes included activities of daily living, mobility, social/recreational activities, disability days in bed, and health status, while healthcare utilization included outpatient and emergency department visits, as well as hospitalization.

“Patient-reported outcomes are especially meaningful, as these include functional activities that are highly valued by patients and are the basis for patient-centered care,” the authors wrote.

There was a total of 3486 participants: 1585 with asthma alone, 1294 with COPD alone, and 607 with ACOS.

Participants with ACOS were significantly more likely to be older, less educated, currently be a smoker, and have cardiovascular disease, cancer, and depression than people with just asthma. Compared with COPD alone, patients with ACOS were more likely to be female and have depression, but less likely to be older and married.

Patients with ACOS consistently reported increased disability days in bed, a worse physical health status, and limitations in mobility and social/recreational activities when compared with participants who had asthma or COPD alone. Patients with ACOS had more respiratory-based outpatient and emergency department visits.

According to the authors, the study results should inform public health policy and clinical practice regarding ACOS.

“At the patient level, clinical practice guidelines that direct the management of obstructive airway disease in middle-aged and older persons should consider the impact of ACOS on patient-reported outcomes,” the researchers wrote.