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.
- US primary care
- blood eosinophil count
- electronic medical records
- patient reported outcomes