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Co-Morbidity Patterns Identified Using Latent Class Analysis of Medications Predict All-Cause Mortality Independent of Other Known Risk Factors: The COPDGene® Study

Authors :
Kendra A. Young
Erin Austin
Terri H. Beaty
Michael R. Jacobs
Katherine A. Pratte
Yisha Li
M.F. Ragland
Stephen I. Rennard
R Tal-Singer
Elizabeth A. Regan
Christina Wern
Barry J. Make
Gregory L. Kinney
John E. Hokanson
Source :
Clinical Epidemiology. 12:1171-1181
Publication Year :
2020
Publisher :
Informa UK Limited, 2020.

Abstract

Purpose Medication patterns include all medications in an individual's clinical profile. We aimed to identify chronic co-morbidity treatment patterns through medication use among COPDGene participants and determine whether these patterns were associated with mortality, acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and quality of life. Materials and methods Participants analyzed here completed Phase 1 (P1) and/or Phase 2 (P2) of COPDGene. Latent class analysis (LCA) was used to identify medication patterns and assign individuals into unobserved LCA classes. Mortality, AECOPD, and the St. George's Respiratory Questionnaire (SGRQ) health status were compared in different LCA classes through survival analysis, logistic regression, and Kruskal-Wallis test, respectively. Results LCA identified 8 medication patterns from 32 classes of chronic comorbid medications. A total of 8110 out of 10,127 participants with complete covariate information were included. Survival analysis adjusted for covariates showed, compared to a low medication use class, mortality was highest in participants with hypertension+diabetes+statin+antiplatelet medication group. Participants in hypertension+SSRI+statin medication group had the highest odds of AECOPD and the highest SGRQ score at both P1 and P2. Conclusion Medication pattern can serve as a good indicator of an individual's comorbidities profile and improves models predicting clinical outcomes.

Details

ISSN :
11791349
Volume :
12
Database :
OpenAIRE
Journal :
Clinical Epidemiology
Accession number :
edsair.doi...........bfd21bba7c7bc936a83c7332e17f62ea
Full Text :
https://doi.org/10.2147/clep.s279075