Abstract
Purpose: To describe demographic and clinical characteristics of chronic obstructive pulmonary disease patients managed in U.S. primary care.
Methods: This was an observational registry study using data from the Chronic Obstructive Pulmonary Disease Optimum Patient Care DARTNet Research Database from which the Advancing the Patient Experience Chronic Obstructive Pulmonary Disease registry is derived. Registry patients were ≥35 years old at diagnosis. Electronic health record data were collected from both registries, supplemented with patient reported information/outcomes from the Advancing the Patient Experience registry from 5 primary care groups in Texas, Ohio, Colorado, New York, and North Carolina (June 2019-Nov 2020).
Results: Of 17,192 patients included overall, 1,354 were included in the Advancing the Patient Experience registry. Overall, patients were predominantly female (56.4%;n=9,689/17,192), white (64.0%;n=9,732/15,216), current/ex-smokers (80.2%;n=13,784/17,192) and over-weight/obese (69.0%;n=11,628/16,849). Inhaled corticosteroid/long-acting β2-agonist and inhaled corticosteroid/long-acting muscarinic antagonist were the most commonly prescribed maintenance treatments (29.5% and 27.1%, of patients respectively), although 3.3% (n=565/17,192) were untreated, 9.2% (n=1,587/17,192) were on short-acting bronchodilators mono, and 4.4% (n=756/17,192) on inhaled corticosteroid mono. Despite treatment, 38.3% (n=6,579/17,192) of patients experienced ≥1 exacerbation (last 12 months). These findings were mirrored in the Advancing Patient Experience registry with many patients reporting high/very high impact of disease on their health (43.8%; n=580/1,322), a breathlessness score ≥2 (44.7%; n=588/1,315) and ≥1 exacerbation in the last 12 months (49.9%; n=646/1,294).
Conclusions: Our findings highlight the high exacerbation, symptom, and treatment burdens experienced by chronic obstructive pulmonary disease patients managed in U.S. primary care, and the need for more real-life effectiveness trials to better support decision making at the primary care level.
Methods: This was an observational registry study using data from the Chronic Obstructive Pulmonary Disease Optimum Patient Care DARTNet Research Database from which the Advancing the Patient Experience Chronic Obstructive Pulmonary Disease registry is derived. Registry patients were ≥35 years old at diagnosis. Electronic health record data were collected from both registries, supplemented with patient reported information/outcomes from the Advancing the Patient Experience registry from 5 primary care groups in Texas, Ohio, Colorado, New York, and North Carolina (June 2019-Nov 2020).
Results: Of 17,192 patients included overall, 1,354 were included in the Advancing the Patient Experience registry. Overall, patients were predominantly female (56.4%;n=9,689/17,192), white (64.0%;n=9,732/15,216), current/ex-smokers (80.2%;n=13,784/17,192) and over-weight/obese (69.0%;n=11,628/16,849). Inhaled corticosteroid/long-acting β2-agonist and inhaled corticosteroid/long-acting muscarinic antagonist were the most commonly prescribed maintenance treatments (29.5% and 27.1%, of patients respectively), although 3.3% (n=565/17,192) were untreated, 9.2% (n=1,587/17,192) were on short-acting bronchodilators mono, and 4.4% (n=756/17,192) on inhaled corticosteroid mono. Despite treatment, 38.3% (n=6,579/17,192) of patients experienced ≥1 exacerbation (last 12 months). These findings were mirrored in the Advancing Patient Experience registry with many patients reporting high/very high impact of disease on their health (43.8%; n=580/1,322), a breathlessness score ≥2 (44.7%; n=588/1,315) and ≥1 exacerbation in the last 12 months (49.9%; n=646/1,294).
Conclusions: Our findings highlight the high exacerbation, symptom, and treatment burdens experienced by chronic obstructive pulmonary disease patients managed in U.S. primary care, and the need for more real-life effectiveness trials to better support decision making at the primary care level.
| Original language | English |
|---|---|
| Pages (from-to) | 319-327 |
| Number of pages | 9 |
| Journal | Annals of Family Medicine |
| Volume | 20 |
| Issue number | 4 |
| Early online date | 25 Jul 2022 |
| DOIs | |
| Publication status | Published - 1 Aug 2022 |
Bibliographical note
Support: The COPD-RD is established and maintained by Optimum Patient Care (OPC) Global Limited and DARTNet Institute; and research was conducted by the Observational & Pragmatic Research Institute Pte Ltd (OPRI). APEX COPD is co-funded by OPC Global and Boehringer Ingelheim Pharmaceuticals, Inc (BIPI). COPD-RD is funded by OPC Global and the DARTNet Institute. The author(s) meet criteria for authorship as recommended by the International Committee of Medical Journal Editors. The authors received no direct compensation related to the development of the manuscript. Writing, editorial support, and/or formatting assistance was provided by Dr. Lisa Buttle of Medscript Ltd, Ireland, which was funded by BIPI. BIPI was given the opportunity to review the manuscript for medical and scientific accuracy as well as intellectual property considerations.Acknowledgements
Kidane Gebremariam is acknowledged for his contribution to protocol development. We would also like to acknowledge Ms. Audrey Ang (BSc, Hons) of the Observational and Pragmatic Research Institute (OPRI), Singapore, for editorial and formatting assistance which supported the development of this publication.
Keywords
- APEX
- COPD
- US primary care
- registry
- asthma
- exacerbations
- blood eosinophil count
- electronic medical records
- patient reported outcomes