Background: Chronic obstructive pulmonary disease (COPD) is prevalent in rural areas of the USA. Long-acting inhaled bronchodilators (LABDs) are a key tool in COPD management and are underutilized. The purpose of this study was to determine whether rates of prescriptions for LABD differed by payer among patients with COPD in a rural healthcare network. Methods: In analysis 1, a random sample of patients with spirometry- and symptom-confirmed COPD over April 1, 2017 to December 31, 2019 was identified. Patient characteristics, including payer status, extracted from medical records were compared for those who did and did not have any prescriptions for LABD during the study window. In analysis 2, patients with one or more COPD-related hospitalizations during the same time period were identified and similar comparisons were made by LABD prescription status. Results: Among a random sample of patients with spirometry-confirmed COPD, 93.0% had been prescribed LABD during the study window with no difference in proportion by payer. Among the 461 patients with a COPD-related hospitalization, 388 (84.2%) had been prescribed LABD, again with no difference in prescriptions by payer. Those with a COPD-related hospitalization who had been prescribed LABD were younger, had lower body mass index, were more likely to be current smokers and had higher rates of hospitalizations for COPD during the study period than those not prescribed LABD. Conclusion: While disparities in LABD utilization may occur due to cost or other barriers to filling prescriptions, in our study, prescriptions for LABD were common and did not differ by payer status. Copyright 2022, Brunner et al.
Background: Chronic obstructive pulmonary disease (COPD) is prevalent in rural areas of the USA. Long-acting inhaled bronchodilators (LABDs) are a key tool in COPD management and are underutilized. The purpose of this study was to determine whether rates of prescriptions for LABD differed by payer among patients with COPD in a rural healthcare network. Methods: In analysis 1, a random sample of patients with spirometry- and symptom-confirmed COPD over April 1, 2017 to December 31, 2019 was identified. Patient characteristics, including payer status, extracted from medical records were compared for those who did and did not have any prescriptions for LABD during the study window. In analysis 2, patients with one or more COPD-related hospitalizations during the same time period were identified and similar comparisons were made by LABD prescription status. Results: Among a random sample of patients with spirometry-confirmed COPD, 93.0% had been prescribed LABD during the study window with no difference in proportion by payer. Among the 461 patients with a COPD-related hospitalization, 388 (84.2%) had been prescribed LABD, again with no difference in prescriptions by payer. Those with a COPD-related hospitalization who had been prescribed LABD were younger, had lower body mass index, were more likely to be current smokers and had higher rates of hospitalizations for COPD during the study period than those not prescribed LABD. Conclusion: While disparities in LABD utilization may occur due to cost or other barriers to filling prescriptions, in our study, prescriptions for LABD were common and did not differ by payer status. Copyright 2022, Brunner et al.
Authors: Adam W Gaffney; Laura Hawks; Alexander C White; Steffie Woolhandler; David Himmelstein; David C Christiani; Danny McCormick Journal: J Rural Health Date: 2020-10-11 Impact factor: 4.333
Authors: Paul Moore; Graham T Atkins; Stephanie Cramb; Janet B Croft; Lisa Davis; Rowena J Dolor; Daniel Doyle; Maggie Elehwany; Cara James; Alana Knudson; John Linnell; David Mannino; Jean M Rommes; Akshay Sood; Eric Stockton; David N Weissman; Mike Witte; Eugenia Wyatt; William C Yarbrough; Barbara P Yawn; Lenora Johnson; Tom Morris; James P Kiley; Neyal J Ammary-Risch; Antonello Punturieri Journal: J Rural Health Date: 2019-01-24 Impact factor: 4.333
Authors: Robert M Burkes; Amanda J Gassett; Agathe S Ceppe; Wayne Anderson; Wanda K O'Neal; Prescott G Woodruff; Jerry A Krishnan; R Graham Barr; MeiLan K Han; Fernando J Martinez; Alejandro P Comellas; Allison A Lambert; Joel D Kaufman; Mark T Dransfield; J Michael Wells; Richard E Kanner; Robert Paine; Eugene R Bleecker; Laura M Paulin; Nadia N Hansel; M Bradley Drummond Journal: Ann Am Thorac Soc Date: 2018-07
Authors: Janet B Croft; Anne G Wheaton; Yong Liu; Fang Xu; Hua Lu; Kevin A Matthews; Timothy J Cunningham; Yan Wang; James B Holt Journal: MMWR Morb Mortal Wkly Rep Date: 2018-02-23 Impact factor: 17.586