Variation in Demographic and Clinical Characteristics of Patients with COPD Receiving Care in US Primary Care: Data from the Advancing the Patient EXperience (APEX) in COPD Registry

Chester Fox; Wilson Pace; Elias Brandt; Victoria Carter; Ku-Lang Chang; Chelsea Edwards; Alexander Evans; Gabriela Gaona; MeiLan K Han; Alan Kaplan; Rachel Kent; Janwillem W H Kocks; Maja Kruszyk; Le Lievre Chantal; Tessa LiVoti; Cathy Mahle; Barry Make; Amanda Ratigan; Asif Shaikh; Neil Skolnik; Brooklyn Stanley; Barbara P Yawn; David B Price

doi:10.2147/POR.S342736

Variation in Demographic and Clinical Characteristics of Patients with COPD Receiving Care in US Primary Care: Data from the Advancing the Patient EXperience (APEX) in COPD Registry

Pragmat Obs Res. 2022 Apr 29:13:17-31. doi: 10.2147/POR.S342736. eCollection 2022.

Authors

Chester Fox^{1

2}, Wilson Pace^{1

3}, Elias Brandt¹, Victoria Carter^{4

5}, Ku-Lang Chang⁶, Chelsea Edwards⁷, Alexander Evans⁴, Gabriela Gaona¹, MeiLan K Han⁸, Alan Kaplan^{5

9

10}, Rachel Kent¹, Janwillem W H Kocks^{5

11

12

13}, Maja Kruszyk^{5

7}, Le Lievre Chantal^{5

7}, Tessa LiVoti^{4

5}, Cathy Mahle¹⁴, Barry Make¹⁵, Amanda Ratigan¹, Asif Shaikh¹⁴, Neil Skolnik^{16

17}, Brooklyn Stanley⁴, Barbara P Yawn¹⁷, David B Price^{4

5

18}

Affiliations

¹ DARTNet Institute, Aurora, CO, USA.
² University at Buffalo, Buffalo, NY, USA.
³ University of Colorado, Denver, CO, USA.
⁴ Optimum Patient Care, Cambridge, UK.
⁵ Observational and Pragmatic Research Institute, Singapore.
⁶ University of Florida College of Medicine, Gainesville, FL, USA.
⁷ Optimum Patient Care, Brisbane, Queensland, Australia.
⁸ University of Michigan, Ann Arbor, MI, USA.
⁹ Family Physician Airways Group of Canada, Stouffville, Ontario, Canada.
¹⁰ University of Toronto, Toronto, Canada.
¹¹ General Practitioners Research Institute, Groningen, the Netherlands.
¹² Groningen Research Institute Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
¹³ Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
¹⁴ Boehringer Ingelheim, Ridgefield, CT, USA.
¹⁵ Department of Medicine, NJH, Denver, CO, USA.
¹⁶ Abington Jefferson Health, Jenkintown, PA, USA.
¹⁷ University of Minnesota, Minneapolis, MN, USA.
¹⁸ Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.

Abstract

Introduction: Little is known about the variability in chronic obstructive pulmonary disease (COPD) management and how it may be affected by patient characteristics across different healthcare systems in the US. This study aims to describe demographic and clinical characteristics of people with COPD and compare management across five primary care medical groups in the US.

Methods: This is a retrospective observational registry study utilizing electronic health records stored in the Advancing the Patient Experience (APEX) COPD registry. The APEX registry contains data from five US healthcare organizations located in Texas, Ohio, Colorado, New York, and North Carolina. Data on demographic and clinical characteristics of primary care patients with COPD between December 2019 and January 2020 were extracted and compared.

Results: A total of 17,192 patients with COPD were included in analysis: Texas (n = 811), Ohio (n = 8722), Colorado (n = 472), New York (n = 1149) and North Carolina (n = 6038). The majority of patients at each location were female (>54%) and overweight/obese (>60%). Inter-location variabilities were noted in terms of age, race/ethnicity, exacerbation frequency, treatment pattern, and prevalence of comorbid conditions. Patients from the Colorado site experienced the lowest number of exacerbations per year while those from the New York site reported the highest number. Hypertension was the most common co-morbidity at 4 of 5 sites with the highest prevalence in New York. Depression was the most common co-morbidity in Ohio. Treatment patterns also varied by site; Colorado had the highest proportion of patients not on any treatment. ICS/LABA was the most commonly prescribed treatment except in Ohio, where ICS/LABA/LAMA was most common.

Conclusions and relevance: Our data show heterogeneity in demographic, clinical, and treatment characteristics of patients diagnosed with COPD who are managed in primary care across different healthcare organizations in the US.

Keywords: observational study; patient-reported outcomes; quality of care; research database.

Grants and funding

APEX COPD is established and maintained by Optimum Patient Care (OPC) Global Limited; and research was conducted by the Observational & Pragmatic Research Institute Pte Ltd (OPRI). The establishment of the APEX registry was co-funded by OPC Global and Boehringer Ingelheim Pharmaceuticals, Inc. (BIPI). OPC Global retains intellectual property rights to the APEX registry.