Introduction In patients with COPD, exacerbations are among the most relevant safety measures. In this analysis of data from the observational DACCORD study, we report the frequency of exacerbations in a COPD population.
Methods To get insights into occurrence and frequency of exacerbations, data from 4,123 patients were obtained from 349 primary and secondary care centres in Germany. To be eligible for entry into DACCORD, all patients had to have a COPD diagnosis (consistent with the German Disease Management Programme definition), and had to have a change in bronchodilator maintenance medication, prior to entry. Data collected included history and treatment of exacerbations 6 months prior to inclusion, and for the duration of follow-up. Exacerbations were defined based on prescription of oral corticosteroids and/or antibiotics or on hospitalisation.
Results Mean age of the patients was 65.7 years; 36.9% of patients had severe or very severe airflow limitation (GOLD 2010). In the 6 month period prior to study inclusion, 26.4% of the patients had at least one exacerbation. Fewer patients in the subgroup with CAT30 (16.7% vs 47.9%). Interestingly, 45% of all exacerbators received inhaled corticosteroids (ICS) compared to 38.7% of the non-exacerbators. ICS treatment in patients with an exacerbation history in the 6 months prior to study inclusion was more frequent in patients with a duration of disease >1 year compared to those with disease duration
In the interim-analysis of 4,123 patients that have completed the 1st year of the observational period, 25.5% had at least one exacerbation during follow-up. In the subgroups CAT30, 22.0% and 40.2% of the patients had at least one exacerbation, respectively. A hospital stay was required for 3.5% of the patients who experienced an exacerbation of the total cohort during 12 months follow-up compared to 4.3% in the 6 month prior to the study.
Conclusion At baseline, the prevalence of patients reporting at least one exacerbation in this large real life COPD cohort was low and seems to be unchanged during 1 year follow-up.