SESSION TYPE: New Insights into COPD
PRESENTED ON: Monday, October 22, 2012 at 04:00 PM - 05:30 PM
PURPOSE: COPD is the fourth leading cause of death in the United States. The average cost of COPD exacerbation ranges from $7242 to $44,904 depending on severity. Primary care physicians can play critical roles in controlling the risk factors for COPD exacerbation in the outpatient population and reduce the economic burden on healthcare.
METHODS: A total of 89 patients (47% of eligible patients) between the ages 18 and 75 with an established diagnosis of COPD were selected from the clinic registry. Patient interviews and chart reviews were done to determine age, gender, GOLD staging, current management, smoking status, and pulmonary rehabilitation in last 2 years. The primary outcome was healthcare resource utilization for COPD exacerbation in the past 6 months, including hospitalizations, ER visits, acute office visits, and calls to the physician office for antibiotics. Regression analysis was calculated to determine the association of risk factors with the primary outcomes. The study was powered at 80%.
RESULTS: A total of 62% of patients were males and 41% had GOLD stage 2 COPD. Multivariate analysis showed that patients who were not on appropriate treatment were more likely to have utilized healthcare resources in the past 6 months (P<0.005). GOLD Stage, smoking status, age, and gender did not show a statistically significant association with utilization of healthcare resources. Only 8% of patients were referred for pulmonary rehabilitation.
CONCLUSIONS: Being on appropriate treatment is the single most important factor that determines the risk of acute exacerbations of COPD. Despite its well documented benefits in COPD patients, pulmonary rehabilitation was extremely underutilized by primary care physicians.
CLINICAL IMPLICATIONS: Primary care physicians can play a significant role in reducing the healthcare financial burden by using appropriate treatment for COPD as outlined by the ACP/ACCP/ATS/ERS guidelines. Pulmonary rehabilitation, if utilized, has proven effects in improving symptoms.
DISCLOSURE: The following authors have nothing to disclose: Furqan Shoaib Siddiqi, Rachael Hauser, Peg Bicker, Jennifer Jackson
No Product/Research Disclosure InformationUniversity of Kansas School of Medicine Wichita, Wichita, KS