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β‐Blocker Therapy in Veterans with Asthma or Chronic Obstructive Pulmonary Disease
Author(s) -
Barnett Mitchell J.,
Milavetz Gary,
Kaboli Peter J.
Publication year - 2005
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.2005.25.11.1550
Subject(s) - medicine , copd , asthma , retrospective cohort study , comorbidity , outpatient clinic , odds ratio , emergency medicine , obstructive lung disease , physical therapy
Study Objectives . To determine whether an association exists between health care resource use and β‐blocker therapy in patients with asthma or chronic obstructive pulmonary disease (COPD), and to determine whether any significant differences exist between type of β‐blocker agent administered and resource use. Design . Retrospective cohort study. Data Source . Three Veterans Administration (VA) databases with information from hospitals and clinics in Iowa and Nebraska. Patients . A total of 8390 veterans with a diagnosis of asthma or COPD receiving treatment with a β‐blocker or another cardiovascular agent. Measurements and Main Results . Clinic visits and hospital admissions for asthma or COPD that occurred in 2000–2001 were identified using electronic administrative data files. Analyses were adjusted for comorbidity and patient demographics. Mean patient age was 67 years, and 97% of the patients were men. In unadjusted analyses, patients taking β‐blockers had more hospital admissions, similar inpatient length of stay (LOS), and fewer outpatient clinic visits for asthma or COPD. In adjusted analyses, however, no difference was noted in the odds of hospital admission or in LOS, and patients had fewer clinic visits related to asthma or COPD. The hazard ratio for hospital admission for asthma or COPD during the observation year was similar for patients taking and not taking β‐blockers, and no difference was noted with selective versus nonselective β‐blockers. However, the hospital admission rate was lower with atenolol than metoprolol. Conclusion . Patients taking β‐blockers did not have more hospital admissions or clinic visits for their asthma or COPD than patients not taking these agents. When clinically indicated, β‐blockers—especially atenolol—should be considered for patients with asthma or COPD.