PDF(Pubmed)
Abstract：
UNASSIGNED: Anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD), especially older adult patients. This can complicate the disease progression and lead to increased clinical and economic burden. We sought to investigate the clinical and economic burdens associated with the presence of anxious and/or depressive symptoms among older adult COPD patients.
UNASSIGNED: We screened 579 patients aged over 60 years and diagnosed with COPD via a lung function test following the 2017 Global Initiative Chronic Obstructive Lung Disease (GOLD) guidelines. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS) through face-to-face interviews at admission. Follow-up was conducted by telephone calls at 6, 12, 18, 24, and 36 months after discharge to assess clinical and economic burden. COPD-anxiety and/or depression patients were matched to patients without anxiety and depression (COPD-only) using propensity scores. Multivariate regression models were used to compare clinical and economic burden between COPD-anxiety and/or depression and COPD-only groups.
UNASSIGNED: Compared with COPD-only patients, COPD patients complicated with anxiety and/or depression had increased clinical burden, including higher COPD-related outpatient visits, COPD-related hospitalizations, and length of COPD-related hospitalizations (p < 0.001). Moreover, they also had an increased economic burden, including higher annual total healthcare costs, medical costs, and pharmacy costs (p < 0.001).
UNASSIGNED: Older adult COPD patients with anxiety or depression had significantly higher clinical and economic burdens than patients without these comorbidities. These findings deserve further exploration and may be useful for the formulation of relevant healthcare policies.
UNASSIGNED: We screened 579 patients aged over 60 years and diagnosed with COPD via a lung function test following the 2017 Global Initiative Chronic Obstructive Lung Disease (GOLD) guidelines. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS) through face-to-face interviews at admission. Follow-up was conducted by telephone calls at 6, 12, 18, 24, and 36 months after discharge to assess clinical and economic burden. COPD-anxiety and/or depression patients were matched to patients without anxiety and depression (COPD-only) using propensity scores. Multivariate regression models were used to compare clinical and economic burden between COPD-anxiety and/or depression and COPD-only groups.
UNASSIGNED: Compared with COPD-only patients, COPD patients complicated with anxiety and/or depression had increased clinical burden, including higher COPD-related outpatient visits, COPD-related hospitalizations, and length of COPD-related hospitalizations (p < 0.001). Moreover, they also had an increased economic burden, including higher annual total healthcare costs, medical costs, and pharmacy costs (p < 0.001).
UNASSIGNED: Older adult COPD patients with anxiety or depression had significantly higher clinical and economic burdens than patients without these comorbidities. These findings deserve further exploration and may be useful for the formulation of relevant healthcare policies.
摘要：
■焦虑和抑郁在慢性阻塞性肺疾病（COPD）患者中很常见，尤其是老年患者。这会使疾病进展复杂化并导致增加的临床和经济负担。我们试图调查老年COPD患者中与焦虑和/或抑郁症状相关的临床和经济负担。
我们根据2017年全球倡议慢性阻塞性肺疾病（GOLD）指南，筛选了579名年龄超过60岁并通过肺功能测试诊断为COPD的患者。入院时使用医院焦虑和抑郁量表（HADS）通过面对面访谈来测量焦虑和抑郁。在出院后6、12、18、24和36个月通过电话进行随访，以评估临床和经济负担。使用倾向评分将COPD-焦虑和/或抑郁患者与没有焦虑和抑郁（仅COPD）的患者进行匹配。使用多因素回归模型比较COPD-焦虑和/或抑郁组和仅COPD组的临床和经济负担。
■与仅COPD患者相比，COPD患者并发焦虑和/或抑郁增加了临床负担，包括COPD相关门诊量较高，COPD相关住院，与COPD相关的住院时间（p<0.001）。此外，他们也增加了经济负担，包括较高的年度医疗总费用，医疗费用,和药品费用（p<0.001）。
■伴有焦虑或抑郁的老年COPD患者的临床和经济负担明显高于没有这些合并症的患者。这些发现值得进一步探索，可能对制定相关医疗政策有用。
我们根据2017年全球倡议慢性阻塞性肺疾病（GOLD）指南，筛选了579名年龄超过60岁并通过肺功能测试诊断为COPD的患者。入院时使用医院焦虑和抑郁量表（HADS）通过面对面访谈来测量焦虑和抑郁。在出院后6、12、18、24和36个月通过电话进行随访，以评估临床和经济负担。使用倾向评分将COPD-焦虑和/或抑郁患者与没有焦虑和抑郁（仅COPD）的患者进行匹配。使用多因素回归模型比较COPD-焦虑和/或抑郁组和仅COPD组的临床和经济负担。
■与仅COPD患者相比，COPD患者并发焦虑和/或抑郁增加了临床负担，包括COPD相关门诊量较高，COPD相关住院，与COPD相关的住院时间（p<0.001）。此外，他们也增加了经济负担，包括较高的年度医疗总费用，医疗费用,和药品费用（p<0.001）。
■伴有焦虑或抑郁的老年COPD患者的临床和经济负担明显高于没有这些合并症的患者。这些发现值得进一步探索，可能对制定相关医疗政策有用。
