Assistive products for long-term care among older people with chronic obstructive pulmonary disease in Japan: A retrospective cohort study

Abstract

Background: Assistive products support energy conservation in older adults with chronic obstructive pulmonary disease (COPD) that exhibits some disease-specific symptoms, such as dyspnea. This study aimed to determine the utilization of assistive products and evaluate its association with COPD. Methods:We conducted a retrospective cohort study using anonymized medical and long-term care insurance claims data obtained from a Japanese city. The participants were ≥65 years old and first certified as requiring long-term care between April 2015 and March 2020. We selected seven types of assistive products that could support the daily activities of older adults with COPD: handrails/grab bars, ramps, canes, walkers, wheelchairs, electronic beds, and bathing aids. After stratifying care needs levels into care needs level 2 or lower, indicating partial care, and care needs level 3 or higher, indicating total care, we conducted multivariable logistic regression analyses to evaluate the association between the presence or absence of COPD and the use of each assistive product during the six months following certification, adjusting for sociodemographic and physical characteristics. Results:Among 18,597 participants, 769 (4.1%) had COPD. The assistive productsfrequently used by participants with COPD included handrails/grab bars (12.6%), electronic beds (7.3%), and bathing aids (5.4%) among those who required partial care, and electronic beds (37.8%), handrails/grab bars (25.2%), and wheelchairs (15.6%) among those who required total care. Among participants who required partial care (n=15,460), those with COPD were less likely to use handrails/grab bars (adjusted odds ratio [AOR], 0.74; 95% confidence interval [CI], 0.58–0.95) and more likely to use bathing aids (AOR, 1.55; 95% CI, 1.07–2.27)compared with those without COPD. Among participants requiring total care (n=3,137), those with COPD were more likely to use electronic beds (AOR, 1.47; 95% CI, 1.01–2.15) than those without COPD. Conclusions:Older adults with COPD were more likely to use assistive products for bathing and beds than those without, which may help in self-care activities, but the use of handrails/grab bars might be suboptimal in those with COPD. Healthcare providers and policymakers should draw more attention to assistive product use for managing respiratory symptoms in older people with COPD.