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Diffuse Lung Disease |

Comorbidity Burden and Healthcare Resource Use in Patients With Idiopathic Pulmonary Fibrosis (IPF) in the United States (US) Military Health System

Yanni Yu, MA; Earl Goehring; Bao-Anh Nguyen-Khoa; Jennifer Holmes; Judith Jones, PhD; Amber Evans, MPH; Nicholas Sicignano
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Naval Hospital Camp Lejeune, Camp Lejeune, NC


Chest. 2014;146(4_MeetingAbstracts):373A. doi:10.1378/chest.1991635
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Abstract

SESSION TITLE: Interstitial Lung Disease Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Limited data have been published on comorbidity burden and healthcare resource use (HRU) in patients with IPF. The objectives of this study were to quantify comorbidity burden, mortality and HRU among IPF patients in the US Department of Defense (DoD) Military Health System (MHS).

METHODS: Adult patients with a new IPF diagnosis were identified in the DoD-MHS database from 10/2006 to 3/2012 if they had ≥2 claims of idiopathic interstitial pneumonia (ICD-9-CM 516.3) OR one claim of 516.3 and one claim of post-inflammatory pulmonary fibrosis (ICD-9-CM 515). The date of the first 516.3 claim was defined as the index date. The IPF diagnosis was confirmed through review of clinical notes including computed tomography/lung biopsy results. IPF-related comorbidities defined in the 2011 ATS guidelines were assessed for one year pre-index; mortality was estimated for one-year and 5-year post-index; all-cause HRU was assessed for one year post-index and measured as hospitalizations, outpatient visits/services, emergency room (ER) visits, and non-drug interventions (oxygen therapy/pulmonary rehabilitation).

RESULTS: 67 newly diagnosed IPF patients (mean age: 66 years; 43% female) were confirmed by clinical notes. Comorbidities assessed at baseline include hypertension (76%), chronic obstructive pulmonary disease (33%), diabetes mellitus (30%), obstructive sleep apnea (16%), and congestive heart failure (13%). Observed mortality rates at year 1 and year 5 post-index were 15% (n=10) and 22% (n=15) respectively. Among the 51 patients with ≥ 12 months of data: 59% were admitted to hospital [mean (SD) length of stay=9.3 (12.4) days] and 43% to ER within the first year post-index; they accrued 30 hospitalizations, 235 ER visits, 612 outpatient service encounters, 317 office visits, 276 claims for oxygen therapy, 81 claims for pulmonary rehabilitation, 15 lung biopsy procedures, and 34 CT/HRCT procedures within the first year post-index.

CONCLUSIONS: High comorbidity burden and mortality as well as considerable HRU post-IPF diagnosis were observed in this study cohort. This descriptive analysis provides a basis for future investigations in IPF.

CLINICAL IMPLICATIONS: Innovative disease management and effective treatments are needed for IPF patients.

DISCLOSURE: Yanni Yu: Employee: This study was funded by Boehringer-Ingelheim Pharmaceuticals, Inc. I am an employee of Boehringer-Ingelheim Pharmaceuticals, Inc. Amber Evans: Employee: I am an employee of Health ResearchTx, which has a business agreement with Boehringer-Ingelheim Nicholas Sicignano: Other: I am an employee of Health ResearchTx, which received consulting fees from Boehringer Ingelheim Pharmaceuticals, Inc. The following authors have nothing to disclose: Earl Goehring, Bao-Anh Nguyen-Khoa, Jennifer Holmes, Judith Jones

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