Clinical and economic burden of dyspnea and other COPD symptoms in a managed care setting

• Published in: International journal of chronic obstructive pulmonary disease Vol. 12; pp. 1947 - 1959
• Main Authors: Stephenson, Judith J, Wertz, Debra, Gu, Tao, Patel, Jeetvan, Dalal, Anand A
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2017; Dove Medical Press Ltd; Dove Medical Press
• Subjects: Administrative Claims, Healthcare; Adult; Aged; Ambulatory Care - economics; Analysis; Chi-Square Distribution; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Comorbidity; Costs; Cross-Sectional Studies; Databases, Factual; Demographics; Drug Costs; Dyspnea; Dyspnea - diagnosis; Dyspnea - economics; Dyspnea - physiopathology; Dyspnea - therapy; Emergency Service, Hospital - economics; Female; Generalized linear models; Health Care Costs; Health care policy; Health Care Surveys; health status; healthcare costs; healthcare resource utilization; Hospital Costs; Humans; Identification; Length of Stay - economics; Linear Models; Male; Managed Care Programs - economics; Managed Care Programs - utilization; Medical care utilization; Medical research; Middle Aged; Multivariate Analysis; Office Visits - economics; Original Research; Patient Admission - economics; Patients; Polls & surveys; Population; PPOs; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - economics; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - therapy; Retrospective Studies; Severity of Illness Index; symptoms; Time Factors; Treatment Outcome; Tuberculosis; United States; United States > US; health status; symptoms; dyspnea; health care costs; health care resource utilization; COPD
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/copd.s134618

The degree to which symptoms such as dyspnea affect patients with COPD is individualized. To address the gap between clinical symptom measures and self-perceived disease burden, we investigated the symptom status of adult patients with COPD and followed with an administrative claims analysis of health care resource utilization and costs. This was a hybrid US observational study consisting of a cross-sectional patient survey followed by a retrospective analysis of administrative claims data. The primary COPD symptom measures were the modified Medical Research Council (mMRC) Dyspnea scale and the COPD Assessment Test (CAT). A total of 673 patients completed the survey. Of these, 65% reported mMRC grades 0-1 (low symptomatology) and 35% reported mMRC grades 2-4 (high symptomatology); 25% reported CAT score <10 (low symptomatology) and 75% reported CAT score ≥10 (high symptomatology). More patients with high symptomatology (by either measure) had at least one COPD-related inpatient hospitalization, emergency room visit, physician office visit, or other outpatient services, and filled at least one COPD-related prescription medication vs patients with low symptomatology. COPD-related costs were higher for patients with high symptomatology than patients with low symptomatology. In a multivariate analysis, COPD-related costs were also higher in patients reporting severe symptoms. Patients with high COPD symptomatology utilized more health care resources and had higher COPD-related health care costs during the 6-month post-survey period than patients with low symptomatology.