Obstructive Lung Diseases |

Hospital Readmissions Among Patients With Chronic Obstructive Pulmonary Disease (COPD) Treated With Arformoterol or Tiotropium 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):714A. doi:10.1378/chest.2279106
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SESSION TYPE: Original Investigation Poster

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

PURPOSE: This study compared hospital readmission rates in patients hospitalized for COPD and treated with nebulized arformoterol tartrate or inhaled tiotropium bromide.

METHODS: This retrospective analysis utilized data from Premier, Inc. (Charlotte, NC), the largest nationwide hospital-based administrative database. Patients with COPD and ≥40 years of age were included if they were hospitalized between January 1, 2011, and June 30, 2012, had no diagnosis for asthma, and were treated with arformoterol or tiotropium. Tiotropium patients were propensity-score matched (1:1) to arformoterol patients using demographics, hospital characteristics, comorbid diagnoses, and service use characteristics prior to initiating the index medication. Concomitant medication use at any time during the admission was statistically controlled for in the analysis. The primary outcome variable was all-cause readmission within one calendar month. Outcome analyses incorporated the match and controlled for concomitant medications using either conditional logistic regressions for dichotomous variables or negative binomial generalized estimating equation regressions for number of readmissions. Raw means and percentages were reported along with adjusted odds ratios (ORs) and P values.

RESULTS: A total of 1971 patients received arformoterol and were matched to 1971 patients treated with tiotropium. After propensity-score matching, no statistically significant differences existed in background variables between treatment groups. Rates of 1-month, all-cause readmissions were similar for arformoterol- and tiotropium-treated patients (21.1% vs. 22.1%, OR = 1.11, P = 0.33). Additionally, there were no significant differences between treatment groups in 30-day COPD (12.7% vs. 14.4%, OR = 1.10, P = 0.46), 6-month all-cause (41.4% vs. 40.7%, OR = 1.08, P = 0.41) or 6-month COPD (26.5% vs. 28.1%, OR = 1.11, P = 0.31) readmission rates. The total number of all-cause (0.73 vs. 0.72, P = 0.88) and COPD (0.46 vs. 0.42, P = 0.34) readmissions in the 6-month follow-up period did not differ between treatments.

CONCLUSIONS: In this analysis, readmission risk was similar for COPD patients treated with nebulized arformoterol or inhaled tiotropium. 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 dry powder inhaled tiotropium bromide for hospitalized patients with COPD.

DISCLOSURE: Mike Stensland: Other: Mike 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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