Incidence and Healthcare Burden of Pertussis among Older Adults with and without Pre-Existing Chronic Obstructive Pulmonary Disease or Asthma in South Korea

Abstract

A retrospective cohort study was conducted to examine trends in the incidence and burden of pertussis among adults ≥50 years in South Korea, with/without pre-existing chronic obstructive pulmonary disease (COPD) or asthma. The nationwide Health Insurance Review and Assessment Service (HIRA) database was used to identify patients ≥50 years diagnosed with pertussis (2009–2018). Mean annual incidence of pertussis per 100 000 persons and overall mean incidence rate ratios (IRR) were calculated for patients with pre-existing COPD or asthma versus those with neither. Incremental healthcare costs (all-cause and pertussis-related) and healthcare utilisation (number of outpatient visits, emergency room visits, and number and length of hospitalisations) up to 12 months after, compared to 3 months before pertussis diagnosis, were also measured for each group (matched on sex, age, and Charlson Comorbidity Index). Of 1011 pertussis cases, 175 had asthma, 96 had COPD (not mutually exclusive), and 796 had neither. Overall mean pertussis incidence was 2.5, 3.4, and 0.5 for adults with pre-existing COPD, asthma, and those with neither. IRR (95% confidence interval) of pertussis for adults with pre-existing COPD and asthma was 4.9 (4.0–‍6.1) and 6.7 (5.7–7.9). Both COPD-pertussis and asthma-pertussis groups had higher mean incremental all-cause costs and length of hospitalisations than the general-pertussis group 3 months following pertussis diagnosis. In conclusion, individuals ≥50 years in South Korea with pre-existing COPD or asthma were at an increased risk of being diagnosed with pertussis and had higher healthcare resource utilisation than those without these conditions.

Keywords:

• Adult
• asthma
• COPD
• pertussis
• South Korea
• vaccination
• whooping cough

Acknowledgements

The authors acknowledge Kyu-Bin Oh, GSK, Singapore, and Bruce A. Mungall, formerly GSK, Singapore, for contributions to the design of the study, Yunha Noh, Sungkyunkwan University, Suwon, South Korea, for contributions to the analysis and interpretation of the data, and Roeland Van Kerckhoven, GSK, Belgium, for publication management. The authors also thank Costello Medical for editorial assistance and publication coordination, on behalf of GSK, and acknowledge Kaity McCafferty Layte, Costello Medical, UK for medical writing and editorial assistance based on authors’ input and direction, and Sharon Lee, Costello Medical, Singapore, for publication coordination and editorial support.

Authors’ contributions

Substantial contributions to study conception and design: JC, JYS, HK, JHK, AHC, HJC, YMO, AG, SS; substantial contributions to analysis and interpretation of the data: JC, JYS, HK, JHK, AHC, HJC, YMO, AG, SS; drafting the article or revising it critically for important intellectual content: JC, JYS, HK, JHK, AHC, HJC, YMO, AG, SS; final approval of the version of the article to be published: JC, JYS, HK, JHK, AHC, HJC, YMO, AG, SS.

Consent for publication

Not applicable.

Data availability statement

The data that support the findings of this study are not publicly available as they are owned by the statutory health insurances. The datasets supporting the conclusions of this article are included within the article and its additional files.

Disclosure statement

JC, AG, SS: employed by the GSK group of companies and hold GSK shares; HK: employed by the GSK group of companies; HJC, AC, JHK: declare that they have no competing interests; JYS: research funding from the Ministry of Food and Drug Safety, Ministry of Health and Welfare, Government-wide R&D Fund project for Infectious Disease Research (GFID) and National Research Foundation of South Korea and grants from GSK, Amgen, Pfizer, Hoffmann-La Roche, Dong-A ST, and Yungjin, outside the submitted work; YMO: personal fees from Boehringer Ingelheim, Boehringer Ingelheim Korea, GSK Korea and Novartis Korea, outside the submitted work.

Ethics approval and consent to participate

As the databases used for this study consist of Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliant de-identified data, no ethics committee approval was required.

Additional information

Funding

This study was sponsored by GlaxoSmithKline Biologicals SA (Study identifier eTrack 214574). Support for third-party writing assistance for this article, provided by Kaity McCafferty Layte, Costello Medical, UK, and Sharon Lee, Costello Medical, Singapore, was funded by GSK in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3).