SESSION TYPE: Pulmonary Hypertension II
PRESENTED ON: Monday, October 22, 2012 at 04:00 PM - 05:30 PM
PURPOSE: Current treatment guidelines suggest that pulmonary arterial hypertension (PAH) patients should be monitored every 3-6 months as part of routine care and 3-4 months after initiation or changes in therapy. To assess monitoring of PAH patients and determine demographic differences among patients who are adequately monitored vs. not.
METHODS: Data for this study came from a large employer-based claims database. PAH patients were selected anytime between Jan 1, 2007 to Dec 31, 2009 based on at least two medical claims with an International Classification of Disease v9 (ICD-9) code of 416.0, a right heart catheterization and data for 12 months pre and a minimum of 12 to up to 36 months post index event. The first medical claim for PAH served as the index event. PAH monitoring was defined by an outpatient medical claim with an ICD-9 code of 416.0 post index event till end of study/follow-up. Adequacy of monitoring was determined by the guidelines published by the European Society of Cardiology. All patient demographic characteristics, including the specialization of physician at diagnoses, and co-existing conditions were assessed.
RESULTS: 1,281 PAH patients met study criteria with an average age of 63 years (SD=12.8), 67% females (n=858), and a mean follow up period of 748 days (SD=243). The average monitoring visits across the sample was 8 (SD=12.9). As per guidelines, 54% (n=697) met the criteria for adequate monitoring. Patients in the adequate monitoring group were significantly (p<.05) younger (62 vs. 64 years), and had higher percentage of females (70% vs. 64%) compared to those not adequately monitored. Cardiovascular-related comorbidity such as hypertension, rheumatic disease, and musculoskeletal system & connective disorders were equally distributed. However, ischemic heart disease was greater (p=0.008) in proportion among those not adequately monitored.
CONCLUSIONS: According to this study up to 46% of newly diagnosed PAH patients may be inadequately monitored.
CLINICAL IMPLICATIONS: Future research needs to look at the impact of monitoring on treatment and overall cost of managing this debilitating condition.
DISCLOSURE: Vijay Joish: Employee: Employee of sponsor of study, Bayer
David Muccino: Employee: Employee of sponsor of study, Bayer
Mark Golick: Employee: Employee of sponsor of study, Bayer
Omar Minai: Consultant fee, speaker bureau, advisory committee, etc.: Consultant on this project sponsored by Bayer
No Product/Research Disclosure InformationBayer HealthCare Pharmaceuticals, Wayne, NJ