COPD Population in US Primary Care: Data From the Optimum Patient Care DARTNet Research Database and the Advancing the Patient Experience in COPD Registry.

Autor: Pace WD; DARTNet Institute, Aurora, Colorado.; University of Colorado Denver, Denver, Colorado., Brandt E; DARTNet Institute, Aurora, Colorado., Carter VA; Optimum Patient Care, Cambridge, United Kingdom., Chang KL; University of Florida College of Medicine, Gainesville, Florida., Edwards CL; Optimum Patient Care, Brisbane, Australia., Evans A; Optimum Patient Care, Cambridge, United Kingdom., Fox C; DARTNet Institute, Aurora, Colorado.; University at Buffalo, Buffalo, New York., Gaona G; DARTNet Institute, Aurora, Colorado., Han MK; University of Michigan, Ann Arbor, Michigan., Kaplan AG; Observational & Pragmatic Research Institute, Singapore.; Family Physician Airways Group of Canada, Stouffville, Ontario, Canada.; University of Toronto, Toronto, Canada., Kent R; DARTNet Institute, Aurora, Colorado., Kocks JWH; Observational & Pragmatic Research Institute, Singapore.; General Practitioners Research Institute, Groningen, The Netherlands., Kruszyk M; Optimum Patient Care, Brisbane, Australia., Le Lievre CE; Optimum Patient Care, Brisbane, Australia., Li Voti T; Optimum Patient Care, Cambridge, United Kingdom., Mahle C; Boehringer Ingelheim, Ridgefield, Connecticut., Make B; Department of Medicine, National Jewish Health, Denver, Colorado., Ratigan AR; DARTNet Institute, Aurora, Colorado., Shaikh A; Boehringer Ingelheim, Ridgefield, Connecticut., Skolnik N; Thomas Jefferson University, Woodbury, New Jersey.; Abington Jefferson Health, Jenkintown, Pennsylvania., Stanley B; Optimum Patient Care, Cambridge, United Kingdom.; Observational & Pragmatic Research Institute, Singapore., Yawn BP; University of Minnesota, Minneapolis, Minnesota.; COPD Foundation, Washington, DC., Price DB; Observational & Pragmatic Research Institute, Singapore; dprice@opri.sg.; Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.
Jazyk: angličtina
Zdroj: Annals of family medicine [Ann Fam Med] 2022 Jul-Aug; Vol. 20 (4), pp. 319-327.
DOI: 10.1370/afm.2829
Abstrakt: 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 β 2 -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.
(© 2022 Annals of Family Medicine, Inc.)
Databáze: MEDLINE