Burden of Pertussis in COPD: A Retrospective Database Study in England

Abstract

Chronic obstructive pulmonary disease (COPD) may increase the risk and severity of pertussis infection. Health care resource utilization (HCRU) and direct medical costs (DMC) of treating pertussis among patients with COPD are unknown. Reported incidence of pertussis among individuals aged ≥ 50 years with COPD was assessed in Clinical Practice Research Datalink and Hospital Episode Statistics databases during 2009–2018 using a retrospective cohort design. HCRU and DMC from the National Health Service perspective were compared between patients with COPD and pertussis and propensity score-matched patients with COPD without pertussis. Seventy-eight new pertussis events were identified among 387 086 patients with COPD aged ≥ 50 years (incidence rate: 4.73; 95% confidence interval 3.74–5.91 per 100 000 person-years). HCRU and DMC were assessed among 67 patients with COPD and pertussis and 267 matched controls. During the month before the pertussis diagnosis, the rates of general practitioner (GP)/nurse visits (4289 vs. 1774 per 100 patient-years) and accident and emergency visits (182 vs. 18 per 100 patient-years) were higher in the pertussis cohort; GP/nurse visits (2935 vs. 1705 per 100 patient-years) were also higher during the following 2 months (all p < 0.001). During the month before the pertussis diagnosis, annualized per-patient total DMC were £2012 higher in the pertussis cohort (£3729 vs. £1717; p < 0.001); during the following 2 months, they were £2407 higher (£5498 vs. £3091; p < 0.001). In conclusion, a pertussis episode among individuals with COPD resulted in significant increases in HCRU and DMC around the pertussis event.

Keywords:

• Chronic obstructive pulmonary disease
• direct medical costs
• health care resource utilization
• incidence
• pertussis

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Author contributions

All authors were involved in the conception and/or design of the study; Emmanuel Aris, Lauriane Harrington, Amit Bhavsar, Jason C. Simeone, Anna Ramond, Kinga Meszaros, Dimitra Lambrelli, and Piyali Mukherjee acquired and analyzed the data; all authors drafted the manuscript and were members of the writing committee.

Prior presentation

1. ERS 2020. Aris E, Akpo EI, Bhavsar A, et al. Burden of pertussis in COPD: a retrospective database study in England [abstract]. Eur Respir J. 2020;56:2468.

2. ERS 2020. Aris E, Akpo EI, Bhavsar A, et al. The burden of pertussis in adults with asthma: a retrospective database study in England [abstract]. Eur Respir J. 2020;56:4926.

Data availability

The datasets generated and/or analyzed during the current study are not publicly available as CPRD data are accessed via a license, the terms of which do not allow for the sharing of raw data.

Disclaimer This study is based in part on data from the Clinical Practice Research Datalink obtained under license from the UK Medicines and Healthcare products Regulatory Agency. However, the interpretation and conclusions contained in this report are those of the authors alone.

Declaration of interest

Emmanuel Aris, Lauriane Harrington, Amit Bhavsar, Kinga Meszaros, and Piyali Mukherjee are employed by the GSK group of companies. Emmanuel Aris, Kinga Meszaros, and Piyali Mukherjee hold shares in the GSK group of companies. Jason C. Simeone, Anna Ramond, and Dimitra Lambrelli are employed by Evidera Inc., which received funding from the GSK group of companies to complete the work disclosed in this manuscript. Alberto Papi is a board member of the GSK group of companies, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, Mundipharma, Novartis, Roche, Sanofi/Regeneron, TEVA and Zambon; he also declares having received consulting and lecturing fees from the GSK group of companies, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, Mundipharma, Novartis, Sanofi/Regeneron, TEVA and Zambon; and consulting fees from Edmondparma and Roche; and lecturing fees from Menarini; and grant support for vaccine studies from the GSK group of companies, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, Fondazione Chiesi, Fondazione Maugeri, Menarini and TEVA; and travel expenses reimbursement from the GSK group of companies, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, Menarini, Mundipharma, Novartis, Roche, Sanofi/Regeneron, TEVA and Zambon. Claus F. Vogelmeier reports grants and personal fees from the GSK group of companies, AstraZeneca, Boehringer Ingelheim, Grifols and Novartis, and personal fees from Chiesi, CSL Behring, MedUpdate, Menarini and Nuvaira.

Acknowledgements

The authors are grateful to Robert Donaldson and Evie Merinopoulou (Evidera Inc., London) for their contribution to the study as well as Esse Ifebi Herve Akpo, Yves Brabant and Elisa Turriani (GSK, Belgium) for their support during the early phases of the study. The authors would like to thank Business & Decision Life Sciences platform for editorial assistance, writing support and manuscript coordination, on behalf of GSK. Gauhar Masgutova (Business & Decision Life Sciences, on behalf of GSK) coordinated manuscript development and editorial support. Jenny Lloyd (Compass Medical Communications Ltd., on behalf of GSK) provided medical writing support.

Additional information

Funding

GlaxoSmithKline Biologicals SA funded this study and was involved in all stages of study conduct, including analysis of the data. GlaxoSmithKline Biologicals SA also took in charge all costs associated with the development and publication of this manuscript.