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People with COPD often have other diseases: impact greater than previously thought


Individuals with chronic obstructive pulmonary disease (COPD) make up less than 13 per cent of the population but use a significant percentage of all health services in Ontario for diseases such as pneumonia, cardiovascular disease and cancer, say researchers of a study released today by the Institute for Clinical Evaluative Sciences (ICES).

COPD is a chronic, progressive respiratory disease that is most often due to smoking but can also be due to exposure to second-hand smoke, pollution or other causes. Once someone has COPD, it is incurable but symptoms and other health outcomes can be improved with treatment.

This research found individuals with COPD required roughly five times more health services for lung cancer and two times more health services for pneumonia and cardiovascular disease than people without COPD, indicating that they were more likely to suffer from these diseases.

“A great amount of the health services used by individuals with COPD were not directly for COPD but for comorbidities related to COPD—suggesting that they account for a large and previously unappreciated COPD disease burden,” says lead author Dr. Andrea Gershon, ICES scientist, and respirologist and scientist at Sunnybrook Health Sciences Centre.

The large-scale, real-world, population-based study used health administrative data to study everyone in Ontario with COPD between 2008 and 2012 and found that:

  • People with COPD make up 12.6 per cent of the adult population
  • Fifty-one per cent of individuals with COPD were between 35 and 64 years
  • People with COPD used half of all lung cancer health services in Ontario
  • People with COPD used one-third of all pneumonia and the same proportion of cardiovascular disease health services in Ontario
  • People with COPD used a quarter of all osteoporosis health services in Ontario
  • People with COPD used one-fifth of each of these health services: psychiatric; musculoskeletal; non-lung cancer in Ontario
  • Younger individuals with COPD had higher claim rates for psychiatric ambulatory and emergency department visits than older individuals

“Our study shows that people with COPD suffer much more from other diseases than people in the general population. This research emphasizes the need for both patients and their physicians to consider COPD when managing their other diseases and address their other diseases when managing their COPD,” added Gershon.

The study “Quantifying comorbidity in individuals with Chronic Obstructive Pulmonary Disease: a population study,” was published today in the European Respiratory Journal.

Authors: Gershon AS, Mecredy GC, Guan J, Victor JC, Goldstein R, To T.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

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