Treating COPD

Joe Cantlupe, for HealthLeaders Media , March 16, 2011
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There is a possibility that lower-dose steroids are just as effective as high-dose injections in treating patients with chronic obstructive pulmonary disorder, which could be a significant savings for hospitals, researchers say.

COPD is a chronic, progressive disease of the airways, including the lungs, usually caused by smoking. Patients who make lifestyle changes, such as exercise and improved nutrition with medication, can deter progression of the disease.It is common for people with COPD to also have obstructive sleep apnea.

Medical debate has focused on what is the optimal dosage of corticosteroids for the treatment of COPD. A study published in the Journal of the American Medical Association concludes that lower corticosteroid medications administered orally are just as effective as the high-dose treatments. Those lower doses are considerably safer, the study says, and can save hospitals about $500 per patient. COPD accounts for $32 billion in direct healthcare costs. In 2006, there were about 600,000 hospital admissions for acute COPD, making it one of the 10 leading causes of hospitalization nationwide, the study shows.

The study noted that although the recommended treatment is to administer the lower dose orally, more than 90% of COPD patients receive the higher-dose intravenously, which increases the risk of infections.

The study examined 79,985 patients at 414 hospitals. Of these, 1.4% of the intravenously treated and 1.0% of the orally treated patients died during hospitalization. In addition, the risk of treatment failure was lower among orally treated patients, as was the length of stay.

Joe Cantlupe is a senior editor with HealthLeaders Media Online.

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