Wilson D Pace1,2, Elias Brandt1, Victoria A Carter3, Ku-Lang Chang4, Chelsea L Edwards5, Alexander Evans3, Chester Fox1,6, Gabriela Gaona1, MeiLan K Han7, Alan G Kaplan8,9,10, Rachel Kent1, Janwillem W H Kocks8,11, Maja Kruszyk5, Chantal E Le Lievre5, Tessa Li Voti3, Cathy Mahle12, Barry Make13, Amanda R Ratigan1, Asif Shaikh12, Neil Skolnik14,15, Brooklyn Stanley3,8, Barbara P Yawn16,17, David B Price18,19. 1. DARTNet Institute, Aurora, Colorado. 2. University of Colorado Denver, Denver, Colorado. 3. Optimum Patient Care, Cambridge, United Kingdom. 4. University of Florida College of Medicine, Gainesville, Florida. 5. Optimum Patient Care, Brisbane, Australia. 6. University at Buffalo, Buffalo, New York. 7. University of Michigan, Ann Arbor, Michigan. 8. Observational & Pragmatic Research Institute, Singapore. 9. Family Physician Airways Group of Canada, Stouffville, Ontario, Canada. 10. University of Toronto, Toronto, Canada. 11. General Practitioners Research Institute, Groningen, The Netherlands. 12. Boehringer Ingelheim, Ridgefield, Connecticut. 13. Department of Medicine, National Jewish Health, Denver, Colorado. 14. Thomas Jefferson University, Woodbury, New Jersey. 15. Abington Jefferson Health, Jenkintown, Pennsylvania. 16. University of Minnesota, Minneapolis, Minnesota. 17. COPD Foundation, Washington, DC. 18. Observational & Pragmatic Research Institute, Singapore; dprice@opri.sg. 19. Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.
Abstract
PURPOSE: To describe demographic and clinical characteristics of chronic obstructive pulmonary disease patients managed in US primary care. METHODS: This was an observational registry study using data from the Chronic Obstructive Pulmonary Disease (COPD) Optimum Patient Care DARTNet Research Database from which the Advancing the Patient Experience COPD registry is derived. Registry patients were aged ≥35 years 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 through November 2020). RESULTS: Of 17,192 patients included, 1,354 were also in the Advancing the Patient Experience registry. Patients were predominantly female (56%; 9,689/17,192), White (64%; 9,732/15,225), current/ex-smokers (80%; 13,784/17,192), and overweight/obese (69%; 11,628/16,849). The most commonly prescribed maintenance treatments were inhaled corticosteroid with a long-acting β2-agonist (30%) and inhaled corticosteroid with a long-acting muscarinic antagonist (27%). Although 3% (565/17,192) of patitents were untreated, 9% (1,587/17,192) were on short-acting bronchodilator monotherapy, and 4% (756/17,192) were on inhaled corticosteroid monotherapy. Despite treatment, 38% (6,579/17,192) of patients experienced 1 or more exacerbations in the last 12 months. These findings were mirrored in the Advancing Patient Experience registry with many patients reporting high or very high impact of disease on their health (43%; 580/1,322), a breathlessness score 2 or more (45%; 588/1,315), and 1 or more exacerbation in the last 12 months (50%; 646/1,294). CONCLUSIONS: Our findings highlight the high exacerbation, symptom, and treatment burdens experienced by COPD patients managed in US primary care, and the need for more real-life effectiveness trials to support decision making at the primary care level.
PURPOSE: To describe demographic and clinical characteristics of chronic obstructive pulmonary disease patients managed in US primary care. METHODS: This was an observational registry study using data from the Chronic Obstructive Pulmonary Disease (COPD) Optimum Patient Care DARTNet Research Database from which the Advancing the Patient Experience COPD registry is derived. Registry patients were aged ≥35 years 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 through November 2020). RESULTS: Of 17,192 patients included, 1,354 were also in the Advancing the Patient Experience registry. Patients were predominantly female (56%; 9,689/17,192), White (64%; 9,732/15,225), current/ex-smokers (80%; 13,784/17,192), and overweight/obese (69%; 11,628/16,849). The most commonly prescribed maintenance treatments were inhaled corticosteroid with a long-acting β2-agonist (30%) and inhaled corticosteroid with a long-acting muscarinic antagonist (27%). Although 3% (565/17,192) of patitents were untreated, 9% (1,587/17,192) were on short-acting bronchodilator monotherapy, and 4% (756/17,192) were on inhaled corticosteroid monotherapy. Despite treatment, 38% (6,579/17,192) of patients experienced 1 or more exacerbations in the last 12 months. These findings were mirrored in the Advancing Patient Experience registry with many patients reporting high or very high impact of disease on their health (43%; 580/1,322), a breathlessness score 2 or more (45%; 588/1,315), and 1 or more exacerbation in the last 12 months (50%; 646/1,294). CONCLUSIONS: Our findings highlight the high exacerbation, symptom, and treatment burdens experienced by COPD patients managed in US primary care, and the need for more real-life effectiveness trials to support decision making at the primary care level.
Authors: Barbara P Yawn; Alan Kaplan; Wilson D Pace; Janwillem W H Kocks; Lakmini Bulathsinhala; Victoria A Carter; Ku-Lang Chang; Chelsea L Edwards; Chester Fox; Gabriela Gaona; Gokul Gopalan; MeiLan K Han; Maja Kruszyk; Chantal E Le Lievre; Cathy D Mahle; Barry Make; Zoe K Philip; Chris Price; Amanda R Ratigan; Asif Shaikh; Neil Skolnik; Brooklyn Stanley; David B Price Journal: J Am Board Fam Med Date: 2021 Jan-Feb Impact factor: 2.657
Authors: Ioanna Tsiligianni; Miguel Román Rodríguez; Karin Lisspers; Tze LeeTan; Antonio Infantino Journal: NPJ Prim Care Respir Med Date: 2017-02-15 Impact factor: 2.871
Authors: Kieran J Rothnie; Hana Müllerová; John R Hurst; Liam Smeeth; Kourtney Davis; Sara L Thomas; Jennifer K Quint Journal: PLoS One Date: 2016-03-09 Impact factor: 3.240
Authors: Marjan Kerkhof; Jaco Voorham; Paul Dorinsky; Claudia Cabrera; Patrick Darken; Janwillem Wh Kocks; Mohsen Sadatsafavi; Don D Sin; Victoria Carter; David B Price Journal: Thorax Date: 2020-06-12 Impact factor: 9.139
Authors: Benjamin M Smith; Miranda Kirby; Eric A Hoffman; Richard A Kronmal; Shawn D Aaron; Norrina B Allen; Alain Bertoni; Harvey O Coxson; Chris Cooper; David J Couper; Gerard Criner; Mark T Dransfield; MeiLan K Han; Nadia N Hansel; David R Jacobs; Joel D Kaufman; Ching-Long Lin; Ani Manichaikul; Fernando J Martinez; Erin D Michos; Elizabeth C Oelsner; Robert Paine; Karol E Watson; Andrea Benedetti; Wan C Tan; Jean Bourbeau; Prescott G Woodruff; R Graham Barr Journal: JAMA Date: 2020-06-09 Impact factor: 56.272