One of the causes of death is episodes of worsening breathing which is called an exacerbation. Clinical observations show that the exacerbations may be associated with the prescriptions of the sedative medications which are often taken to ease the symptoms for the respiratory disease patients. However, there is little data or literature on how to manage this issue best. Using data collected from general practices all over the country, we will establish the effect of sedative drugs and the risk of exacerbation of respiratory diseases. The findings from this study could provide more evidence of the potential harm of sedative medications.
Background
People with COPD/ asthma who take sedative medications had been shown to have higher probability of experience exacerbation, lower respiratory tract infection (LRTI) and pneumonia. However, the strength of association between the risk and the exacerbation are not yet established. At the same time, oral corticosteroid (OCS) and inhaled corticosteroid (ICS) are commonly prescribed for controlling airway inflammation in asthma.
Objectives:
The overall aim of the study is to investigate the hypothesis that certain sedative drugs often taken for chronic pain impact on the incidence and severity of outcomes, including exacerbation, lower respiratory tract infection, pneumonia and hospitalisation, in those with asthma or COPD.
Design
A real-world observational study using linked primary care, hospitalisation data of people with COPD/ asthma from 1st April 2004 to 31st December 2023. Nested case-control study and self-controlled case series study will be conducted to investigate the association between the sedative medications and outcomes.
Methods
The risk of sedative medications on the exacerbation of COPD, or exacerbation of asthma, pneumonia, LRTI will be assessed using conditional logistic regression and conditional poisson regression. In this study, we will treat OCS and ICS as other treatments in the sensitivity analysis of the association between sedative medications and the outcomes.
Outcomes to be measured include acute exacerbation of COPD (AECOPD), acute exacerbation of asthma (AAE), pneumonia, lower respiratory tract infection (LRTI), and the hospitalisation/death due to the aforementioned reasons.
Anna Meffen - Chief Investigator - University of Leicester
Lisong Zhang - Corresponding Applicant - University of Leicester
Dominick Shaw - Collaborator - University of Leicester
Laura Gray - Collaborator - University of Leicester
Tricia McKeever - Collaborator - University of Nottingham
Anna Meffen - Collaborator - University of Leicester
Anna Meffen, - Collaborator - University of Leicester
HES Admitted Patient Care;ONS Death Registration Data;Patient Level Index of Multiple Deprivation