Patient-Reported Burden of Illness in a Prevalent COPD Population Treated with Long-Acting Muscarinic Antagonist Monotherapy: A Claims-Linked Patient Survey Study

• Published in: Pulmonary therapy 2019-06, Vol.5 (1), p.69-80
• Main Authors: Hahn, Beth, Stanford, Richard H., Goolsby Hunter, Alyssa, Essoi, Breanna, White, John, Ray, Riju
• Format: Article
• Language: English
• Subjects: Bronchodilator agents; Chronic obstructive pulmonary disease; COPD; Dyspnea; Family Medicine; General Practice; Health surveys; Internal Medicine; Medicine; Medicine & Public Health; Original Research; Patient-reported outcomes; Patients; Pharmacoeconomics and Health Outcomes; Pharmacotherapy; Pneumology/Respiratory System; Quality of Life Research
• ISSN: 2364-1754; 2364-1746; 2364-1746
• DOI: 10.1007/s41030-019-0091-0

Introduction Symptom burden in inadequately controlled chronic obstructive pulmonary disease (COPD) considerably impacts quality of life, healthcare resource utilization (HCRU) and associated costs. This claims-linked cross-sectional survey study assessed symptom burden and HCRU among a prevalent population of COPD patients prescribed long-acting muscarinic antagonist (LAMA) monotherapy. Methods Patients were identified using claims data from the Optum Research Database. Eligible patients were aged ≥ 40 years with 12 months’ continuous enrollment in a US health plan, ≥ 2 medical claims containing COPD diagnosis codes ≥ 30 days apart, and ≥ 2 claims for LAMA monotherapy in the latter half of the 12-month sample identification period. Patients were mailed a cross-sectional survey assessing patient-reported outcomes (PROs) [COPD assessment test (CAT) and modified medical research council dyspnea scale (mMRC)], clinical characteristics, smoking history, and demographics. Patients also completed the Exacerbations of Chronic Pulmonary Disease Tool (EXACT-PRO) daily diary for 7 days. HCRU was assessed from claims data. Results The study included 433 patients with a self-reported healthcare provider COPD diagnosis, and both claims-based and self-reported LAMA monotherapy treatment (mean age 71.0 years; 59.8% female). Most patients (85.5%) reported a high symptom burden (CAT score ≥ 10), 45.5% had high levels of dyspnea (mMRC grade ≥ 2), and 64.4% reported more severe daily symptoms by the EXACT-PRO. Most patients (71.6%) reported high scores on ≥ 2 PROs. More patients with high symptom burden had COPD-related emergency department visits than those with lower disease burden (27.6% vs 12.7%, P  = 0.012). Conclusions In conclusion, a large proportion of patients with COPD receiving LAMA monotherapy experienced a high symptom burden and may benefit from therapy escalation. Healthcare professionals can use validated PROs to help them assess symptom burden. Funding GlaxoSmithKline (GSK study number: 205862)