A COST-EFFECTIVE ANALYSIS OF TIOTROPIUM WITH FORMOTEROL AND BUDESONIDE WITH FORMOTEROL BASED ON EFFICACY AND QUALITY OF LIFE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS
DOI:
https://doi.org/10.22159/ajpcr.2018.v11i11.27991Keywords:
Chronic obstructive pulmonary disease, Tiotropium, Budesonide, Formoterol, Pulmonary function test, Forced expiratory volume 1 Forced vital capacity, Pulmonary rehabilitationAbstract
Objectives: The primary objective of the study was to conduct the cost-effective analysis of tiotropium with formoterol versus budesonide with formoterol in the management of Stage-I chronic obstructive pulmonary disease (COPD) based on efficacy and quality of life (QoL). The study also aims to analyze the improvement of the QoL through pulmonary rehabilitation. The secondary objective was to evaluate the incidence of depression and anxiety in COPD patients.
Methods: A prospective interventional study, with a sample size of 74 patients diagnosed with COPD Stage-I was conducted for 6 months. The study population was divided based on simple randomization into two main groups, one receiving tiotropium with formoterol and the other receiving budesonide with formoterol. Based on spirometry, their pulmonary function test (PFT) was recorded. The patients QoL was recorded using the WHOQoL-BREF questionnaire.
Results: Data of 74 patients were collected for both the zero-degree and first-degree follow-up. The patients demonstrated good compliance with the transinhaler of the prescribed drugs. A significant improvement after providing pulmonary rehabilitation in PFT, i.e., forced expiratory volume1/ forced vital capacity values (p=0.000**) and the WHOQoL scoring (P = 0.001**) was observed in patients receiving tiotropium with formoterol. Tiotropium with formoterol was found to be more cost-effective treatment than budesonide with formoterol.
Conclusion: The study showed that transinhalation of 9 mcg/12 mcg tiotropium/formoterol once a day is a better cost-effective treatment than 200 mcg/6 mcg transinhalation of budesonide/formoterol twice a day.
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References
Khan PA, Sujala A, Nousheen S, Fatima AF, Ala HB, Reddy P. A comparative evaluation of the efficacy of triple drug therapy with dual drug therapy in COPD patients. Int J Pharm Pharm Sci 2018;10:105-9.
Barnes PJ. Chronic obstructive pulmonary disease: A growing but neglected global epidemic. PLoS Med 2007;4:e112.
Global Initiative for Chronic Obstructive Lung Disease. Global Strategy For The Diagnosis, Management, And Prevention Of Chronic Obstructive Pulmonary Disease.; 2016. Available from: https://www.goldcopd.org/global-strategy-diagnosis-management-prevention-copd-2016.
Altaf M, Masood QM, Ahmed TZ, Ilyaz M, Basha SA. Health related quality of life assessment using St. George’s respiratory questionnaire in chronic obstructive pulmonary disease patients on combined inhaled corticosteroids and bronchodilators. Int J Pharm Pharm Sci 2016;8:445 9.
Paz-DÃaz H, Montes de Oca M, López JM, Celli BR. Pulmonary rehabilitation improves depression, anxiety, dyspnea and health status in patients with COPD. Am J Phys Med Rehabil 2007;86:30-6.
Jindal SK, Aggarwal AN, Chaudhry K, Chhabra SK, D’Souza GA, Gupta D, et al. A multicentric study on epidemiology of chronic obstructive pulmonary disease and its relationship with tobacco smoking and environmental tobacco smoke exposure. Indian J Chest Dis Allied Sci 2006;48:23-9.
Perng DW, Wu CC, Su KC, Lee YC, Perng RP, Tao CW, et al. Additive benefits of tiotropium in COPD patients treated with long-acting beta agonists and corticosteroids. Respirology 2006;11:598-602.
Wijkstra PJ, Ten Vergert EM, van Altena R, Otten V, Kraan J, Postma DS, et al. Long term benefits of rehabilitation at home on quality of life and exercise tolerance in patients with chronic obstructive pulmonary disease. Thorax 1995;50:824-8.
Mittmann N, Hernandez P, Mellström C, Brannman L, Welte T. Cost effectiveness of budesonide/formoterol added to tiotropium bromide versus placebo added to tiotropium bromide in patients with chronic obstructive pulmonary disease: Australian, canadian and swedish healthcare perspectives. Pharmacoeconomics 2011;29:403-14.
Schane RE, Walter LC, Dinno A, Covinsky KE, Woodruff PG. Prevalence and risk factors for depressive symptoms in persons with chronic obstructive pulmonary disease. J Gen Intern Med 2008;23:1757 62.
Withers NJ, Rudkin ST, White RJ. Anxiety and depression in severe chronic obstructive pulmonary disease: The effects of pulmonary rehabilitation. J Cardiopulm Rehabil 1999;19:362-5.
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