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Obstructive Lung Diseases |

Burden of COPD Exacerbations in Severe and Very Severe COPD Patients: Initial Results of a Nationally Representative Patient Survey and Chart Review

Caitlyn Solem*, PhD; Shawn Sun, PhD; Cynthia Macahilig, MA; Monica Katyal, MD; Xin Gao, MD
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Pharmerit North America, Bethesda, MD


Chest. 2012;142(4_MeetingAbstracts):718A. doi:10.1378/chest.1370931
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Abstract

SESSION TYPE: COPD Posters I

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: To characterize COPD exacerbation burden in terms of exacerbation frequency and health-related quality of life (HRQoL) in severe/very severe COPD.

METHODS: A nationally representative sample of severe/very severe COPD patients experiencing a moderate or severe exacerbation within the previous 3 months was recruited by their physicians (pulmonologists or primary care). Charts were reviewed to collect patient demographic/medical information. Patients reported frequency of mild, moderate, and severe exacerbations in the previous 12 months and completed the St. George’s Respiratory Questionnaire for COPD (SGRQ-C) and EQ-5D for both current health and during their last moderate/severe exacerbation. T-tests were performed between severe/very severe COPD.

RESULTS: 206 patients (120 severe/86 very severe COPD) were included, with mean (SD) age 67.7 (10.2) years, 52% male, 87% Caucasian, and 31% current smokers. Patients were frequently managed using ICSs (85%), LABAs (84%), ICS+LABA (77%), SABAs (84%), LAMAs (76%) and 64% were on oxygen. Severe/very severe patients reported mean (SD) 2.4 (2.7)/2.6 (2.1) mild, 0.9 (1.5)/1.2 (1.3) moderate, 2.2 (0.6)/2.2 (0.5) severe exacerbations in the previous 12 months. Mean total SGRQ-C scores were 62.0 (20.2)/72.3 (20.4) for severe/very severe COPD patients on a scale of 0 (best health) to 100 (worst health), and subscale scores were 68.9 (18.3)/76.7 (18.5), 74.1 (22.0)/85.9 (21.2) and 52.4 (25.2)/62.6 (25.0) for Symptoms, Activities, and Impacts, respectively. EQ-5D indices were 0.701 (0.182)/0.593 (0.236) on a scale of 0 (death) to 1(best health) for current HRQoL and 0.585 (0.258)/0.458 (0.310) for last exacerbation, with mean (SD) differences greater for patients whose last exacerbation was severe vs. moderate [0.093 (0.205) vs. 0.172 (0.235), P<0.001]. EQ-5D and SGRQ-C scores were significantly (P<0.05) worse for patients currently with very severe (vs. severe) COPD and whose last exacerbation was severe (vs. moderate). No recall bias was identified.

CONCLUSIONS: Recently exacerbating severe/very severe COPD patients were likely to have experienced multiple exacerbations in the previous year and had poor HRQoL, both during their last exacerbation and at the time of survey, even while on maintenance medications.

CLINICAL IMPLICATIONS: Interventions aiming to further reduce the exacerbation occurrences will likely have a strong impact on COPD patient HRQoL.

DISCLOSURE: Caitlyn Solem: Consultant fee, speaker bureau, advisory committee, etc.: Consultant

Shawn Sun: Employee: Employee of Forest Research Institute

Cynthia Macahilig: Consultant fee, speaker bureau, advisory committee, etc.: Consultant

Monica Katyal: Consultant fee, speaker bureau, advisory committee, etc.: Consultant

Xin Gao: Consultant fee, speaker bureau, advisory committee, etc.: Consultant

No Product/Research Disclosure Information

Pharmerit North America, Bethesda, MD

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