Obstructive Lung Diseases |

Hospital Readmissions Among Patients With Chronic Obstructive Pulmonary Disease (COPD) Treated With Arformoterol or Fluticasone/Salmeterol FREE TO VIEW

Mike Stensland, PhD; Vamsi Bollu, PhD; James Donohue, MD
Author and Funding Information

Agile Outcomes Research, Inc, Rochester, MN

Chest. 2015;148(4_MeetingAbstracts):716A. doi:10.1378/chest.2278614
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: To compare readmission rates among patients treated with nebulized arformoterol tartrate (ARF) or inhaled fluticasone propionate/salmeterol xinafoate (FLU/SAL) for the treatment of COPD.

METHODS: This retrospective analysis utilized data from a large hospital-based administrative database (Premier, Inc., Charlotte, NC) to identify COPD patients ≥40 years of age, hospitalized between January 1, 2011, and June 30, 2012, not diagnosed with asthma, and treated with ARF or FLU/SAL. FLU/SAL patients were propensity-score matched (1:1) to the ARF patients using demographics, hospital characteristics, comorbid diagnoses, and service use characteristics prior to initiating the index medication. The primary outcome variable was all-cause readmission within one calendar month. Concomitant medication use at any time during the admission and background variables that remained significantly different after matching were statistically controlled for in the analyses. For dichotomous variables, conditional logistic regression incorporated the match while controlling for other variables. For number of readmissions, negative binomial regressions were fit using generalized estimating equations to incorporate the match while controlling for other variables. Raw means and percentages were reported along with adjusted odds ratios (ORs) and P values.

RESULTS: A total of 2739 patients treated with ARF were matched to 2739 who received FLU/SAL. Rates of 1-month, all-cause readmissions were similar for ARF- and FLU/SAL-treated patients (20.8% vs. 20.9%, OR = 1.05, P = 0.60). Additionally, there were no significant differences between treatment groups in 30-day COPD (12.6% vs. 13.4%, OR = 1.11, P = 0.39), 6-month all-cause (40.3% vs. 40.3%, OR = 1.08, P = 0.31) or 6-month COPD (27.6% vs. 27.9%, OR = 1.11, P = 0.22) readmission rates. The total number of all-cause (0.73 vs. 0.71, P = 0.80) and COPD (0.45 vs. 0.42, P = 0.58) readmissions in the 6-month follow-up period did not differ between treatments.

CONCLUSIONS: In this study, readmission risk was similar in patients with COPD treated with nebulized ARF or inhaled FLU/SAL. Although the treatment cohorts were matched on observed background variables, patients may have differed on unmeasured variables.

CLINICAL IMPLICATIONS: Nebulized arformoterol tartrate appears to represent a potential alternative to inhaled fluticasone propionate/salmeterol xinafoate for patients with COPD.

DISCLOSURE: Mike Stensland: Other: Michael Stensland is a full-time employee and sole owner of Agile Outcomes Research, Inc. Agile Outcomes Research, Inc was hired by Sunovion Pharmaceuticals to complete this research. Vamsi Bollu: Employee: Vamsi Bollu is an employee of and has stock ownership of Sunovion Pharmaceuticals, Inc. James Donohue: Consultant fee, speaker bureau, advisory committee, etc.: James Donohue receives consultancy fees from Sunovion Pharmaceuticals Inc., Boehringer Ingelheim, and GlaxoSmithKline.

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