Health Care Resource Utilization and Exacerbation Rates in Patients with COPD Stratified by Disease Severity in a Commercially Insured Population
| العنوان: | Health Care Resource Utilization and Exacerbation Rates in Patients with COPD Stratified by Disease Severity in a Commercially Insured Population |
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| المؤلفون: | Mayura Shinde, Shuchita Kaila, Mark B Napier, Asif Shaikh, Anna E. Wallace, Valentina Bayer, Vincent J. Willey, Joseph Singer |
| المصدر: | Journal of Managed Care & Specialty Pharmacy. 25:205-217 |
| بيانات النشر: | Academy of Managed Care Pharmacy, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, Spirometry, medicine.medical_specialty, Databases, Factual, Exacerbation, Vital Capacity, Population, Pharmaceutical Science, Pharmacy, Severity of Illness Index, Cohort Studies, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, Forced Expiratory Volume, Severity of illness, Health care, Humans, Medicine, 030212 general & internal medicine, education, Intensive care medicine, Aged, Retrospective Studies, education.field_of_study, COPD, Insurance, Health, medicine.diagnostic_test, business.industry, 030503 health policy & services, Health Policy, Retrospective cohort study, Health Care Costs, Middle Aged, medicine.disease, United States, respiratory tract diseases, Hospitalization, Multivariate Analysis, Health Resources, Female, 0305 other medical science, business, Delivery of Health Care, Cohort study |
| الوصف: | Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality and is associated with substantial economic burden. There is a lack of data regarding COPD outcomes and costs in a real-world setting, particularly by Global Initiative for Chronic Obstructive Lung Disease (GOLD) severity.To (a) characterize a commercially insured U.S. population with COPD and (b) assess prevalence of exacerbations, health care resource utilization (HCRU), costs, and treatment patterns in a cohort of patients with confirmed COPD, overall and stratified by GOLD stage.This retrospective observational cohort study used administrative claims data from the HealthCore Integrated Research Database to identify patients with ≥ 1 inpatient, emergency room (ER), or office visit claim for COPD between January 1, 2012, and November 30, 2013, and continuous enrollment for 1 year before and 2 years after the first COPD diagnosis date. Patients with a spirometry claim within 12 months were eligible for medical record abstraction to confirm COPD diagnosis (forced expiratory volume in 1 second [FEV53,484 patients newly diagnosed with COPD were identified who met initial inclusion criteria: 14,293 (27%) had a qualifying spirometry claim, and 1,505 had confirmed COPD (GOLD 1, 333 [22%]; GOLD 2, 823 [55%]; GOLD 3, 317 [21%]; GOLD 4, 32 [2%]). Patients with greater disease severity had higher rates of moderate/severe COPD exacerbations (GOLD 1 and 2, 40.4 and 48.9 per 100 person-years, respectively; GOLD 3 and 4, 83.6 and 89.1 per 100 person-years, respectively). All-cause and COPD-related inpatient admissions, COPD-related office visits, and COPD-related ER visits were more prevalent with more severe GOLD classification. Mean annual COPD-related medical costs increased with GOLD classification ($5,945 for GOLD 1 patients, $18,070 for GOLD 4). COPD maintenance medication was filled by 42%, 56%, 73%, and 75% of patients in GOLD 1-4 (57% overall), respectively; combination corticosteroid/long-acting beta2-agonist inhalers were the most commonly used medication, regardless of GOLD classification. Patients with more severe disease had greater adherence (range 44%-68% of days covered for GOLD 1-4) and persistence (range 107-209 days for GOLD 1-4).Trends toward increases in exacerbations, HCRU, and costs were observed as airflow limitation worsened. Adherence and persistence with COPD maintenance therapy was suboptimal even with severe disease.This study was supported by Boehringer Ingelheim Pharmaceuticals (Ridgefield, CT), which was given the opportunity to review the manuscript for medical and scientific accuracy, as well as intellectual property considerations. Willey and Singer are employees of HealthCore (parent company Anthem), which received funding from Boehringer Ingelheim to complete this study. Wallace and Shinde were employed by HealthCore at the time of this study. Wallace and Singer report stock ownership in Anthem. Napier is an employee of Anthem. Kaila, Bayer, and Shaikh are employees of Boehringer Ingelheim Pharmaceuticsls. Portions of this research were presented at the following conferences: (a) A. Wallace, S. Kaila, V. Zubek, A. Shaikh, M. Shinde, V. Willey, M. Napier, and J. Singer, Healthcare resource utilization, costs, and exacerbation rates in patients with COPD stratified by GOLD airflow limitation classification in a US commercially insured population, presented at AMCP Nexus 2017; October 16-19, 2017; Dallas, TX; and (b) A.E. Wallace, V. Zubek, S. Kaila, A. Shaikh, M. Shinde, V. Willey, M.B. Napier, and J.R. Singer, Real-world treatment patterns among newly diagnosed COPD patients according to GOLD airflow limitation severity classification in a U.S. commercially insured/Medicare Advantage population, presented at CHEST 2017 Annual Meeting; October 28-November 1, 2017; Toronto, Ontario, Canada. |
| تدمد: | 2376-1032 2376-0540 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b74fd8fc14b0f0f42ce2ad5ad96e6078 https://doi.org/10.18553/jmcp.2019.25.2.205 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....b74fd8fc14b0f0f42ce2ad5ad96e6078 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 23761032 23760540 |
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