Projections of 10-year mortality in patients with COPD in the UK using the CHOPIN policy model

Abstract

<b>Background:</b> Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Comorbidities and their management play a key role in COPD prognosis and survival. Modelling may be used to estimate the impact of health policies on future trajectories of COPD-related mortality. <b>Aim:</b> To project the number and cause of deaths in patients with COPD in the UK over 10 years. <b>Methods:</b> A dynamic population Markov model (COPD Health Outcome Policy and InterventioN; CHOPIN) was developed using published time-varying transition rates specified by age, sex and smoking status to predict the course of COPD-specific exacerbations, progression and cause-specific mortality over 10 years in the UK (2021–2030). <b>Results:</b> Annual COPD-specific deaths were predicted to increase from 123,606 in 2021 to 140,129 in 2030, leading to cumulative deaths of 1,321,563 in the same period (425,876 following severe exacerbations). Cancer and cardiovascular (CV) comorbidities were the main projected causes of death and tended to occur in less severe disease states, while respiratory deaths were frequent in more severe states (Figure). <b>Conclusion:</b> This model predicted COPD-related mortality over a 10-year period, suggesting higher death rates from cancer and CV causes than respiratory causes, and may be used to predict the impact of specific COPD health policy interventions.