TY - JOUR
T1 - Socioeconomic inequality in the use of prescription medications for smoking cessation among patients with COPD
T2 - A nationwide study
AU - Tøttenborg, Sandra Søgaard
AU - Clark, Alice Jessie
AU - Wernich Thomsen, Reimar
AU - Johnsen, Søren Paaske
AU - Lange, Peter
PY - 2018/5/29
Y1 - 2018/5/29
N2 - Background: Bupropion and varenicline can substantially improve the chances of smoking cessation in patients with COPD, but are unsubsidized and relatively costly. We examined overall use and socioeconomic patterns of use among patients with COPD. Patients and methods: We identified 4,741 COPD patients reporting to be smokers at their first contact for COPD during 2008-2012 in the Danish register of COPD, which covers all pulmonary outpatient clinics in Denmark. Patients were followed for 6 months in the National Prescription Registry. Logistic regression analyses were used to calculate the ORs with corresponding 95% CI of redeeming a prescription for any of the smoking cessation medications in strata of baseline characteristics. Results: During 6 months from first consultation, only 5% redeemed a prescription for bupropion or varenicline. Younger age, female sex, higher education, and higher income were associated with an increased likelihood, while non-Danish ethnicity, living alone, and very severe COPD were associated with a lower likelihood of redeeming bupropion or varenicline. Conclusion: Despite their proven effectiveness, bupropion and varenicline are sparingly used among COPD patients followed in the hospital outpatient setting with the lowest use among the socioeconomically disadvantaged. This highlights a missed opportunity for intervention.
AB - Background: Bupropion and varenicline can substantially improve the chances of smoking cessation in patients with COPD, but are unsubsidized and relatively costly. We examined overall use and socioeconomic patterns of use among patients with COPD. Patients and methods: We identified 4,741 COPD patients reporting to be smokers at their first contact for COPD during 2008-2012 in the Danish register of COPD, which covers all pulmonary outpatient clinics in Denmark. Patients were followed for 6 months in the National Prescription Registry. Logistic regression analyses were used to calculate the ORs with corresponding 95% CI of redeeming a prescription for any of the smoking cessation medications in strata of baseline characteristics. Results: During 6 months from first consultation, only 5% redeemed a prescription for bupropion or varenicline. Younger age, female sex, higher education, and higher income were associated with an increased likelihood, while non-Danish ethnicity, living alone, and very severe COPD were associated with a lower likelihood of redeeming bupropion or varenicline. Conclusion: Despite their proven effectiveness, bupropion and varenicline are sparingly used among COPD patients followed in the hospital outpatient setting with the lowest use among the socioeconomically disadvantaged. This highlights a missed opportunity for intervention.
UR - http://www.scopus.com/inward/record.url?scp=85048282327&partnerID=8YFLogxK
U2 - 10.2147/COPD.S158954
DO - 10.2147/COPD.S158954
M3 - Journal article
C2 - 29881267
AN - SCOPUS:85048282327
SN - 1176-9106
VL - 13
SP - 1775
EP - 1781
JO - International Journal of Chronic Obstructive Pulmonary Disease
JF - International Journal of Chronic Obstructive Pulmonary Disease
ER -