Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers

David Singer,1 Lindsay GS Bengtson,2 Caitlin Elliott,2 Ami R Buikema,2 Jessica Franchino-Elder1 1Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA; 2Health Economics and Outcomes Research, Optum, Eden Prairie, MN, USACorrespondence: David SingerBoehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USATel +1-203-791-6409Email David_2.singerBoehringer-Ingelheim.comBackground: Chronic obstructive pulmonary disease (COPD) is often managed with inhaled long-acting muscarinic antagonists (LAMAs), yet real-world data on healthcare resource utilization (HRU) by inhaler type are lacking. This study compared HRU after LAMA initiation with a soft mist inhaler (SMI) versus a dry powder inhaler (DPI).Patients and Methods: Inclusion criteria were COPD diagnosis, age ≥ 40 years, LAMA initiation (index date = first LAMA SMI or DPI claim 9/1/14— 6/30/18), and Medicare Advantage enrollment 1 year pre-index (baseline) to ≥ 30 days post-index (follow-up). Patients were followed to the earliest of discontinuation, switch, disenrollment, 1 year, or study end (7/31/18). Exclusion criteria were asthma, cystic fibrosis, or lung cancer diagnoses, unavailable demographics, multiple index LAMAs, or baseline LAMA use. Cohorts (SMI or DPI) were balanced on baseline characteristics using inverse probability of treatment weighting. Outcomes included per patient per month (PPPM) COPD-related HRU encounters, and exacerbations (defined as moderate [ambulatory visit with corticosteroid or antibiotic within +- 7 days] or severe [emergency visit or inpatient admission]); and 30-day readmissions following COPD-related hospitalizations.Results: After weighting, cohorts (SMI [n=5360] and DPI [n=22,880]) were similar in age (72 and 73 years, respectively), gender (both 52% female), and COPD severity score (31.3 and 31.5, respectively). Cohorts had similar counts of follow-up HRU encounters. However, the SMI cohort had fewer (mean +- standard deviation) COPD-related exacerbations (0.054+- 0.082 vs DPI cohort 0.059+- 0.088 PPPM, p< 0.001) overall. Moreover, the SMI cohort had fewer severe exacerbations (0.030+- 0.058 vs DPI: 0.034+- 0.065 PPPM, p< 0.001). Hospitalizations among SMI patients had a lower adjusted odds of readmission versus hospitalizations among DPI patients (odds ratio: 0.656, 95% confidence interval= 0.460, 0.937; p=0.020).Conclusion: SMI initiators had significantly fewer COPD-related exacerbations than DPI initiators. In addition, lower odds of readmissions were observed following COPD-related hospitalizations among the SMI cohort, as compared with the DPI cohort.Keywords: chronic obstructive pulmonary disease, COPD, long-acting muscarinic antagonist, LAMA, soft mist inhaler, SMI, dry powder inhaler, DPI, healthcare resource utilization, readmissions, exacerbations Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Singer D [verfasserIn] Bengtson LG [verfasserIn] Elliott C [verfasserIn] Buikema AR [verfasserIn] Franchino-Elder J [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2020

Schlagwörter:	chronic obstructive pulmonary disease (copd) long-acting muscarinic antagonist (lama) soft mist inhaler (smi) dry powder inhaler (dpi) healthcare resource utilization readmissions exacerbations

Übergeordnetes Werk:	In: International Journal of COPD - Dove Medical Press, 2009, (2020), Seite 3239-3250
Übergeordnetes Werk:	year:2020 ; pages:3239-3250

Links:	Link aufrufen Link aufrufen Journal toc

Katalog-ID:	DOAJ052521176

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245	1	0	\|a Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers
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520			\|a David Singer,1 Lindsay GS Bengtson,2 Caitlin Elliott,2 Ami R Buikema,2 Jessica Franchino-Elder1 1Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA; 2Health Economics and Outcomes Research, Optum, Eden Prairie, MN, USACorrespondence: David SingerBoehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USATel +1-203-791-6409Email David_2.singerBoehringer-Ingelheim.comBackground: Chronic obstructive pulmonary disease (COPD) is often managed with inhaled long-acting muscarinic antagonists (LAMAs), yet real-world data on healthcare resource utilization (HRU) by inhaler type are lacking. This study compared HRU after LAMA initiation with a soft mist inhaler (SMI) versus a dry powder inhaler (DPI).Patients and Methods: Inclusion criteria were COPD diagnosis, age ≥ 40 years, LAMA initiation (index date = first LAMA SMI or DPI claim 9/1/14— 6/30/18), and Medicare Advantage enrollment 1 year pre-index (baseline) to ≥ 30 days post-index (follow-up). Patients were followed to the earliest of discontinuation, switch, disenrollment, 1 year, or study end (7/31/18). Exclusion criteria were asthma, cystic fibrosis, or lung cancer diagnoses, unavailable demographics, multiple index LAMAs, or baseline LAMA use. Cohorts (SMI or DPI) were balanced on baseline characteristics using inverse probability of treatment weighting. Outcomes included per patient per month (PPPM) COPD-related HRU encounters, and exacerbations (defined as moderate [ambulatory visit with corticosteroid or antibiotic within +- 7 days] or severe [emergency visit or inpatient admission]); and 30-day readmissions following COPD-related hospitalizations.Results: After weighting, cohorts (SMI [n=5360] and DPI [n=22,880]) were similar in age (72 and 73 years, respectively), gender (both 52% female), and COPD severity score (31.3 and 31.5, respectively). Cohorts had similar counts of follow-up HRU encounters. However, the SMI cohort had fewer (mean +- standard deviation) COPD-related exacerbations (0.054+- 0.082 vs DPI cohort 0.059+- 0.088 PPPM, p< 0.001) overall. Moreover, the SMI cohort had fewer severe exacerbations (0.030+- 0.058 vs DPI: 0.034+- 0.065 PPPM, p< 0.001). Hospitalizations among SMI patients had a lower adjusted odds of readmission versus hospitalizations among DPI patients (odds ratio: 0.656, 95% confidence interval= 0.460, 0.937; p=0.020).Conclusion: SMI initiators had significantly fewer COPD-related exacerbations than DPI initiators. In addition, lower odds of readmissions were observed following COPD-related hospitalizations among the SMI cohort, as compared with the DPI cohort.Keywords: chronic obstructive pulmonary disease, COPD, long-acting muscarinic antagonist, LAMA, soft mist inhaler, SMI, dry powder inhaler, DPI, healthcare resource utilization, readmissions, exacerbations
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allfields	(DE-627)DOAJ052521176 (DE-599)DOAJ84a30f856b2e42959b9c9b39a5096fa4 DE-627 ger DE-627 rakwb eng RC705-779 Singer D verfasserin aut Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier David Singer,1 Lindsay GS Bengtson,2 Caitlin Elliott,2 Ami R Buikema,2 Jessica Franchino-Elder1 1Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA; 2Health Economics and Outcomes Research, Optum, Eden Prairie, MN, USACorrespondence: David SingerBoehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USATel +1-203-791-6409Email David_2.singerBoehringer-Ingelheim.comBackground: Chronic obstructive pulmonary disease (COPD) is often managed with inhaled long-acting muscarinic antagonists (LAMAs), yet real-world data on healthcare resource utilization (HRU) by inhaler type are lacking. This study compared HRU after LAMA initiation with a soft mist inhaler (SMI) versus a dry powder inhaler (DPI).Patients and Methods: Inclusion criteria were COPD diagnosis, age ≥ 40 years, LAMA initiation (index date = first LAMA SMI or DPI claim 9/1/14— 6/30/18), and Medicare Advantage enrollment 1 year pre-index (baseline) to ≥ 30 days post-index (follow-up). Patients were followed to the earliest of discontinuation, switch, disenrollment, 1 year, or study end (7/31/18). Exclusion criteria were asthma, cystic fibrosis, or lung cancer diagnoses, unavailable demographics, multiple index LAMAs, or baseline LAMA use. Cohorts (SMI or DPI) were balanced on baseline characteristics using inverse probability of treatment weighting. Outcomes included per patient per month (PPPM) COPD-related HRU encounters, and exacerbations (defined as moderate [ambulatory visit with corticosteroid or antibiotic within +- 7 days] or severe [emergency visit or inpatient admission]); and 30-day readmissions following COPD-related hospitalizations.Results: After weighting, cohorts (SMI [n=5360] and DPI [n=22,880]) were similar in age (72 and 73 years, respectively), gender (both 52% female), and COPD severity score (31.3 and 31.5, respectively). Cohorts had similar counts of follow-up HRU encounters. However, the SMI cohort had fewer (mean +- standard deviation) COPD-related exacerbations (0.054+- 0.082 vs DPI cohort 0.059+- 0.088 PPPM, p< 0.001) overall. Moreover, the SMI cohort had fewer severe exacerbations (0.030+- 0.058 vs DPI: 0.034+- 0.065 PPPM, p< 0.001). Hospitalizations among SMI patients had a lower adjusted odds of readmission versus hospitalizations among DPI patients (odds ratio: 0.656, 95% confidence interval= 0.460, 0.937; p=0.020).Conclusion: SMI initiators had significantly fewer COPD-related exacerbations than DPI initiators. In addition, lower odds of readmissions were observed following COPD-related hospitalizations among the SMI cohort, as compared with the DPI cohort.Keywords: chronic obstructive pulmonary disease, COPD, long-acting muscarinic antagonist, LAMA, soft mist inhaler, SMI, dry powder inhaler, DPI, healthcare resource utilization, readmissions, exacerbations chronic obstructive pulmonary disease (copd) long-acting muscarinic antagonist (lama) soft mist inhaler (smi) dry powder inhaler (dpi) healthcare resource utilization readmissions exacerbations Diseases of the respiratory system Bengtson LG verfasserin aut Elliott C verfasserin aut Buikema AR verfasserin aut Franchino-Elder J verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2020), Seite 3239-3250 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2020 pages:3239-3250 https://doaj.org/article/84a30f856b2e42959b9c9b39a5096fa4 kostenfrei https://www.dovepress.com/healthcare-resource-utilization-exacerbations-and-readmissions-among-m-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2020 3239-3250
spelling	(DE-627)DOAJ052521176 (DE-599)DOAJ84a30f856b2e42959b9c9b39a5096fa4 DE-627 ger DE-627 rakwb eng RC705-779 Singer D verfasserin aut Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier David Singer,1 Lindsay GS Bengtson,2 Caitlin Elliott,2 Ami R Buikema,2 Jessica Franchino-Elder1 1Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA; 2Health Economics and Outcomes Research, Optum, Eden Prairie, MN, USACorrespondence: David SingerBoehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USATel +1-203-791-6409Email David_2.singerBoehringer-Ingelheim.comBackground: Chronic obstructive pulmonary disease (COPD) is often managed with inhaled long-acting muscarinic antagonists (LAMAs), yet real-world data on healthcare resource utilization (HRU) by inhaler type are lacking. This study compared HRU after LAMA initiation with a soft mist inhaler (SMI) versus a dry powder inhaler (DPI).Patients and Methods: Inclusion criteria were COPD diagnosis, age ≥ 40 years, LAMA initiation (index date = first LAMA SMI or DPI claim 9/1/14— 6/30/18), and Medicare Advantage enrollment 1 year pre-index (baseline) to ≥ 30 days post-index (follow-up). Patients were followed to the earliest of discontinuation, switch, disenrollment, 1 year, or study end (7/31/18). Exclusion criteria were asthma, cystic fibrosis, or lung cancer diagnoses, unavailable demographics, multiple index LAMAs, or baseline LAMA use. Cohorts (SMI or DPI) were balanced on baseline characteristics using inverse probability of treatment weighting. Outcomes included per patient per month (PPPM) COPD-related HRU encounters, and exacerbations (defined as moderate [ambulatory visit with corticosteroid or antibiotic within +- 7 days] or severe [emergency visit or inpatient admission]); and 30-day readmissions following COPD-related hospitalizations.Results: After weighting, cohorts (SMI [n=5360] and DPI [n=22,880]) were similar in age (72 and 73 years, respectively), gender (both 52% female), and COPD severity score (31.3 and 31.5, respectively). Cohorts had similar counts of follow-up HRU encounters. However, the SMI cohort had fewer (mean +- standard deviation) COPD-related exacerbations (0.054+- 0.082 vs DPI cohort 0.059+- 0.088 PPPM, p< 0.001) overall. Moreover, the SMI cohort had fewer severe exacerbations (0.030+- 0.058 vs DPI: 0.034+- 0.065 PPPM, p< 0.001). Hospitalizations among SMI patients had a lower adjusted odds of readmission versus hospitalizations among DPI patients (odds ratio: 0.656, 95% confidence interval= 0.460, 0.937; p=0.020).Conclusion: SMI initiators had significantly fewer COPD-related exacerbations than DPI initiators. In addition, lower odds of readmissions were observed following COPD-related hospitalizations among the SMI cohort, as compared with the DPI cohort.Keywords: chronic obstructive pulmonary disease, COPD, long-acting muscarinic antagonist, LAMA, soft mist inhaler, SMI, dry powder inhaler, DPI, healthcare resource utilization, readmissions, exacerbations chronic obstructive pulmonary disease (copd) long-acting muscarinic antagonist (lama) soft mist inhaler (smi) dry powder inhaler (dpi) healthcare resource utilization readmissions exacerbations Diseases of the respiratory system Bengtson LG verfasserin aut Elliott C verfasserin aut Buikema AR verfasserin aut Franchino-Elder J verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2020), Seite 3239-3250 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2020 pages:3239-3250 https://doaj.org/article/84a30f856b2e42959b9c9b39a5096fa4 kostenfrei https://www.dovepress.com/healthcare-resource-utilization-exacerbations-and-readmissions-among-m-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2020 3239-3250
allfields_unstemmed	(DE-627)DOAJ052521176 (DE-599)DOAJ84a30f856b2e42959b9c9b39a5096fa4 DE-627 ger DE-627 rakwb eng RC705-779 Singer D verfasserin aut Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier David Singer,1 Lindsay GS Bengtson,2 Caitlin Elliott,2 Ami R Buikema,2 Jessica Franchino-Elder1 1Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA; 2Health Economics and Outcomes Research, Optum, Eden Prairie, MN, USACorrespondence: David SingerBoehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USATel +1-203-791-6409Email David_2.singerBoehringer-Ingelheim.comBackground: Chronic obstructive pulmonary disease (COPD) is often managed with inhaled long-acting muscarinic antagonists (LAMAs), yet real-world data on healthcare resource utilization (HRU) by inhaler type are lacking. This study compared HRU after LAMA initiation with a soft mist inhaler (SMI) versus a dry powder inhaler (DPI).Patients and Methods: Inclusion criteria were COPD diagnosis, age ≥ 40 years, LAMA initiation (index date = first LAMA SMI or DPI claim 9/1/14— 6/30/18), and Medicare Advantage enrollment 1 year pre-index (baseline) to ≥ 30 days post-index (follow-up). Patients were followed to the earliest of discontinuation, switch, disenrollment, 1 year, or study end (7/31/18). Exclusion criteria were asthma, cystic fibrosis, or lung cancer diagnoses, unavailable demographics, multiple index LAMAs, or baseline LAMA use. Cohorts (SMI or DPI) were balanced on baseline characteristics using inverse probability of treatment weighting. Outcomes included per patient per month (PPPM) COPD-related HRU encounters, and exacerbations (defined as moderate [ambulatory visit with corticosteroid or antibiotic within +- 7 days] or severe [emergency visit or inpatient admission]); and 30-day readmissions following COPD-related hospitalizations.Results: After weighting, cohorts (SMI [n=5360] and DPI [n=22,880]) were similar in age (72 and 73 years, respectively), gender (both 52% female), and COPD severity score (31.3 and 31.5, respectively). Cohorts had similar counts of follow-up HRU encounters. However, the SMI cohort had fewer (mean +- standard deviation) COPD-related exacerbations (0.054+- 0.082 vs DPI cohort 0.059+- 0.088 PPPM, p< 0.001) overall. Moreover, the SMI cohort had fewer severe exacerbations (0.030+- 0.058 vs DPI: 0.034+- 0.065 PPPM, p< 0.001). Hospitalizations among SMI patients had a lower adjusted odds of readmission versus hospitalizations among DPI patients (odds ratio: 0.656, 95% confidence interval= 0.460, 0.937; p=0.020).Conclusion: SMI initiators had significantly fewer COPD-related exacerbations than DPI initiators. In addition, lower odds of readmissions were observed following COPD-related hospitalizations among the SMI cohort, as compared with the DPI cohort.Keywords: chronic obstructive pulmonary disease, COPD, long-acting muscarinic antagonist, LAMA, soft mist inhaler, SMI, dry powder inhaler, DPI, healthcare resource utilization, readmissions, exacerbations chronic obstructive pulmonary disease (copd) long-acting muscarinic antagonist (lama) soft mist inhaler (smi) dry powder inhaler (dpi) healthcare resource utilization readmissions exacerbations Diseases of the respiratory system Bengtson LG verfasserin aut Elliott C verfasserin aut Buikema AR verfasserin aut Franchino-Elder J verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2020), Seite 3239-3250 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2020 pages:3239-3250 https://doaj.org/article/84a30f856b2e42959b9c9b39a5096fa4 kostenfrei https://www.dovepress.com/healthcare-resource-utilization-exacerbations-and-readmissions-among-m-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2020 3239-3250
allfieldsGer	(DE-627)DOAJ052521176 (DE-599)DOAJ84a30f856b2e42959b9c9b39a5096fa4 DE-627 ger DE-627 rakwb eng RC705-779 Singer D verfasserin aut Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier David Singer,1 Lindsay GS Bengtson,2 Caitlin Elliott,2 Ami R Buikema,2 Jessica Franchino-Elder1 1Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA; 2Health Economics and Outcomes Research, Optum, Eden Prairie, MN, USACorrespondence: David SingerBoehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USATel +1-203-791-6409Email David_2.singerBoehringer-Ingelheim.comBackground: Chronic obstructive pulmonary disease (COPD) is often managed with inhaled long-acting muscarinic antagonists (LAMAs), yet real-world data on healthcare resource utilization (HRU) by inhaler type are lacking. This study compared HRU after LAMA initiation with a soft mist inhaler (SMI) versus a dry powder inhaler (DPI).Patients and Methods: Inclusion criteria were COPD diagnosis, age ≥ 40 years, LAMA initiation (index date = first LAMA SMI or DPI claim 9/1/14— 6/30/18), and Medicare Advantage enrollment 1 year pre-index (baseline) to ≥ 30 days post-index (follow-up). Patients were followed to the earliest of discontinuation, switch, disenrollment, 1 year, or study end (7/31/18). Exclusion criteria were asthma, cystic fibrosis, or lung cancer diagnoses, unavailable demographics, multiple index LAMAs, or baseline LAMA use. Cohorts (SMI or DPI) were balanced on baseline characteristics using inverse probability of treatment weighting. Outcomes included per patient per month (PPPM) COPD-related HRU encounters, and exacerbations (defined as moderate [ambulatory visit with corticosteroid or antibiotic within +- 7 days] or severe [emergency visit or inpatient admission]); and 30-day readmissions following COPD-related hospitalizations.Results: After weighting, cohorts (SMI [n=5360] and DPI [n=22,880]) were similar in age (72 and 73 years, respectively), gender (both 52% female), and COPD severity score (31.3 and 31.5, respectively). Cohorts had similar counts of follow-up HRU encounters. However, the SMI cohort had fewer (mean +- standard deviation) COPD-related exacerbations (0.054+- 0.082 vs DPI cohort 0.059+- 0.088 PPPM, p< 0.001) overall. Moreover, the SMI cohort had fewer severe exacerbations (0.030+- 0.058 vs DPI: 0.034+- 0.065 PPPM, p< 0.001). Hospitalizations among SMI patients had a lower adjusted odds of readmission versus hospitalizations among DPI patients (odds ratio: 0.656, 95% confidence interval= 0.460, 0.937; p=0.020).Conclusion: SMI initiators had significantly fewer COPD-related exacerbations than DPI initiators. In addition, lower odds of readmissions were observed following COPD-related hospitalizations among the SMI cohort, as compared with the DPI cohort.Keywords: chronic obstructive pulmonary disease, COPD, long-acting muscarinic antagonist, LAMA, soft mist inhaler, SMI, dry powder inhaler, DPI, healthcare resource utilization, readmissions, exacerbations chronic obstructive pulmonary disease (copd) long-acting muscarinic antagonist (lama) soft mist inhaler (smi) dry powder inhaler (dpi) healthcare resource utilization readmissions exacerbations Diseases of the respiratory system Bengtson LG verfasserin aut Elliott C verfasserin aut Buikema AR verfasserin aut Franchino-Elder J verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2020), Seite 3239-3250 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2020 pages:3239-3250 https://doaj.org/article/84a30f856b2e42959b9c9b39a5096fa4 kostenfrei https://www.dovepress.com/healthcare-resource-utilization-exacerbations-and-readmissions-among-m-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2020 3239-3250
allfieldsSound	(DE-627)DOAJ052521176 (DE-599)DOAJ84a30f856b2e42959b9c9b39a5096fa4 DE-627 ger DE-627 rakwb eng RC705-779 Singer D verfasserin aut Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier David Singer,1 Lindsay GS Bengtson,2 Caitlin Elliott,2 Ami R Buikema,2 Jessica Franchino-Elder1 1Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA; 2Health Economics and Outcomes Research, Optum, Eden Prairie, MN, USACorrespondence: David SingerBoehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USATel +1-203-791-6409Email David_2.singerBoehringer-Ingelheim.comBackground: Chronic obstructive pulmonary disease (COPD) is often managed with inhaled long-acting muscarinic antagonists (LAMAs), yet real-world data on healthcare resource utilization (HRU) by inhaler type are lacking. This study compared HRU after LAMA initiation with a soft mist inhaler (SMI) versus a dry powder inhaler (DPI).Patients and Methods: Inclusion criteria were COPD diagnosis, age ≥ 40 years, LAMA initiation (index date = first LAMA SMI or DPI claim 9/1/14— 6/30/18), and Medicare Advantage enrollment 1 year pre-index (baseline) to ≥ 30 days post-index (follow-up). Patients were followed to the earliest of discontinuation, switch, disenrollment, 1 year, or study end (7/31/18). Exclusion criteria were asthma, cystic fibrosis, or lung cancer diagnoses, unavailable demographics, multiple index LAMAs, or baseline LAMA use. Cohorts (SMI or DPI) were balanced on baseline characteristics using inverse probability of treatment weighting. Outcomes included per patient per month (PPPM) COPD-related HRU encounters, and exacerbations (defined as moderate [ambulatory visit with corticosteroid or antibiotic within +- 7 days] or severe [emergency visit or inpatient admission]); and 30-day readmissions following COPD-related hospitalizations.Results: After weighting, cohorts (SMI [n=5360] and DPI [n=22,880]) were similar in age (72 and 73 years, respectively), gender (both 52% female), and COPD severity score (31.3 and 31.5, respectively). Cohorts had similar counts of follow-up HRU encounters. However, the SMI cohort had fewer (mean +- standard deviation) COPD-related exacerbations (0.054+- 0.082 vs DPI cohort 0.059+- 0.088 PPPM, p< 0.001) overall. Moreover, the SMI cohort had fewer severe exacerbations (0.030+- 0.058 vs DPI: 0.034+- 0.065 PPPM, p< 0.001). Hospitalizations among SMI patients had a lower adjusted odds of readmission versus hospitalizations among DPI patients (odds ratio: 0.656, 95% confidence interval= 0.460, 0.937; p=0.020).Conclusion: SMI initiators had significantly fewer COPD-related exacerbations than DPI initiators. In addition, lower odds of readmissions were observed following COPD-related hospitalizations among the SMI cohort, as compared with the DPI cohort.Keywords: chronic obstructive pulmonary disease, COPD, long-acting muscarinic antagonist, LAMA, soft mist inhaler, SMI, dry powder inhaler, DPI, healthcare resource utilization, readmissions, exacerbations chronic obstructive pulmonary disease (copd) long-acting muscarinic antagonist (lama) soft mist inhaler (smi) dry powder inhaler (dpi) healthcare resource utilization readmissions exacerbations Diseases of the respiratory system Bengtson LG verfasserin aut Elliott C verfasserin aut Buikema AR verfasserin aut Franchino-Elder J verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2020), Seite 3239-3250 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2020 pages:3239-3250 https://doaj.org/article/84a30f856b2e42959b9c9b39a5096fa4 kostenfrei https://www.dovepress.com/healthcare-resource-utilization-exacerbations-and-readmissions-among-m-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2020 3239-3250
language	English
source	In International Journal of COPD (2020), Seite 3239-3250 year:2020 pages:3239-3250
sourceStr	In International Journal of COPD (2020), Seite 3239-3250 year:2020 pages:3239-3250
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institution	findex.gbv.de
topic_facet	chronic obstructive pulmonary disease (copd) long-acting muscarinic antagonist (lama) soft mist inhaler (smi) dry powder inhaler (dpi) healthcare resource utilization readmissions exacerbations Diseases of the respiratory system
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container_title	International Journal of COPD
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fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">DOAJ052521176</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230503143923.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230227s2020 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ052521176</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJ84a30f856b2e42959b9c9b39a5096fa4</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RC705-779</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">Singer D</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2020</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">David Singer,1 Lindsay GS Bengtson,2 Caitlin Elliott,2 Ami R Buikema,2 Jessica Franchino-Elder1 1Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA; 2Health Economics and Outcomes Research, Optum, Eden Prairie, MN, USACorrespondence: David SingerBoehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USATel +1-203-791-6409Email David_2.singerBoehringer-Ingelheim.comBackground: Chronic obstructive pulmonary disease (COPD) is often managed with inhaled long-acting muscarinic antagonists (LAMAs), yet real-world data on healthcare resource utilization (HRU) by inhaler type are lacking. This study compared HRU after LAMA initiation with a soft mist inhaler (SMI) versus a dry powder inhaler (DPI).Patients and Methods: Inclusion criteria were COPD diagnosis, age &ge; 40 years, LAMA initiation (index date = first LAMA SMI or DPI claim 9/1/14&mdash; 6/30/18), and Medicare Advantage enrollment 1 year pre-index (baseline) to &ge; 30 days post-index (follow-up). Patients were followed to the earliest of discontinuation, switch, disenrollment, 1 year, or study end (7/31/18). Exclusion criteria were asthma, cystic fibrosis, or lung cancer diagnoses, unavailable demographics, multiple index LAMAs, or baseline LAMA use. Cohorts (SMI or DPI) were balanced on baseline characteristics using inverse probability of treatment weighting. Outcomes included per patient per month (PPPM) COPD-related HRU encounters, and exacerbations (defined as moderate [ambulatory visit with corticosteroid or antibiotic within +- 7 days] or severe [emergency visit or inpatient admission]); and 30-day readmissions following COPD-related hospitalizations.Results: After weighting, cohorts (SMI [n=5360] and DPI [n=22,880]) were similar in age (72 and 73 years, respectively), gender (both 52% female), and COPD severity score (31.3 and 31.5, respectively). Cohorts had similar counts of follow-up HRU encounters. However, the SMI cohort had fewer (mean +- standard deviation) COPD-related exacerbations (0.054+- 0.082 vs DPI cohort 0.059+- 0.088 PPPM, p&lt; 0.001) overall. Moreover, the SMI cohort had fewer severe exacerbations (0.030+- 0.058 vs DPI: 0.034+- 0.065 PPPM, p&lt; 0.001). Hospitalizations among SMI patients had a lower adjusted odds of readmission versus hospitalizations among DPI patients (odds ratio: 0.656, 95% confidence interval= 0.460, 0.937; p=0.020).Conclusion: SMI initiators had significantly fewer COPD-related exacerbations than DPI initiators. In addition, lower odds of readmissions were observed following COPD-related hospitalizations among the SMI cohort, as compared with the DPI cohort.Keywords: chronic obstructive pulmonary disease, COPD, long-acting muscarinic antagonist, LAMA, soft mist inhaler, SMI, dry powder inhaler, DPI, healthcare resource utilization, readmissions, exacerbations</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">chronic obstructive pulmonary disease (copd)</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">long-acting muscarinic antagonist (lama)</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">soft mist inhaler (smi)</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">dry powder inhaler (dpi)</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">healthcare resource utilization</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield 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callnumber-first	R - Medicine
author	Singer D
spellingShingle	Singer D misc RC705-779 misc chronic obstructive pulmonary disease (copd) misc long-acting muscarinic antagonist (lama) misc soft mist inhaler (smi) misc dry powder inhaler (dpi) misc healthcare resource utilization misc readmissions misc exacerbations misc Diseases of the respiratory system Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers
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topic_title	RC705-779 Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers chronic obstructive pulmonary disease (copd) long-acting muscarinic antagonist (lama) soft mist inhaler (smi) dry powder inhaler (dpi) healthcare resource utilization readmissions exacerbations
topic	misc RC705-779 misc chronic obstructive pulmonary disease (copd) misc long-acting muscarinic antagonist (lama) misc soft mist inhaler (smi) misc dry powder inhaler (dpi) misc healthcare resource utilization misc readmissions misc exacerbations misc Diseases of the respiratory system
topic_unstemmed	misc RC705-779 misc chronic obstructive pulmonary disease (copd) misc long-acting muscarinic antagonist (lama) misc soft mist inhaler (smi) misc dry powder inhaler (dpi) misc healthcare resource utilization misc readmissions misc exacerbations misc Diseases of the respiratory system
topic_browse	misc RC705-779 misc chronic obstructive pulmonary disease (copd) misc long-acting muscarinic antagonist (lama) misc soft mist inhaler (smi) misc dry powder inhaler (dpi) misc healthcare resource utilization misc readmissions misc exacerbations misc Diseases of the respiratory system
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title	Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers
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title_full	Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers
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author_browse	Singer D Bengtson LG Elliott C Buikema AR Franchino-Elder J
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title_sort	healthcare resource utilization, exacerbations, and readmissions among medicare patients with chronic obstructive pulmonary disease after long-acting muscarinic antagonist therapy initiation with soft mist versus dry powder inhalers
callnumber	RC705-779
title_auth	Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers
abstract	David Singer,1 Lindsay GS Bengtson,2 Caitlin Elliott,2 Ami R Buikema,2 Jessica Franchino-Elder1 1Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA; 2Health Economics and Outcomes Research, Optum, Eden Prairie, MN, USACorrespondence: David SingerBoehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USATel +1-203-791-6409Email David_2.singerBoehringer-Ingelheim.comBackground: Chronic obstructive pulmonary disease (COPD) is often managed with inhaled long-acting muscarinic antagonists (LAMAs), yet real-world data on healthcare resource utilization (HRU) by inhaler type are lacking. This study compared HRU after LAMA initiation with a soft mist inhaler (SMI) versus a dry powder inhaler (DPI).Patients and Methods: Inclusion criteria were COPD diagnosis, age ≥ 40 years, LAMA initiation (index date = first LAMA SMI or DPI claim 9/1/14— 6/30/18), and Medicare Advantage enrollment 1 year pre-index (baseline) to ≥ 30 days post-index (follow-up). Patients were followed to the earliest of discontinuation, switch, disenrollment, 1 year, or study end (7/31/18). Exclusion criteria were asthma, cystic fibrosis, or lung cancer diagnoses, unavailable demographics, multiple index LAMAs, or baseline LAMA use. Cohorts (SMI or DPI) were balanced on baseline characteristics using inverse probability of treatment weighting. Outcomes included per patient per month (PPPM) COPD-related HRU encounters, and exacerbations (defined as moderate [ambulatory visit with corticosteroid or antibiotic within +- 7 days] or severe [emergency visit or inpatient admission]); and 30-day readmissions following COPD-related hospitalizations.Results: After weighting, cohorts (SMI [n=5360] and DPI [n=22,880]) were similar in age (72 and 73 years, respectively), gender (both 52% female), and COPD severity score (31.3 and 31.5, respectively). Cohorts had similar counts of follow-up HRU encounters. However, the SMI cohort had fewer (mean +- standard deviation) COPD-related exacerbations (0.054+- 0.082 vs DPI cohort 0.059+- 0.088 PPPM, p< 0.001) overall. Moreover, the SMI cohort had fewer severe exacerbations (0.030+- 0.058 vs DPI: 0.034+- 0.065 PPPM, p< 0.001). Hospitalizations among SMI patients had a lower adjusted odds of readmission versus hospitalizations among DPI patients (odds ratio: 0.656, 95% confidence interval= 0.460, 0.937; p=0.020).Conclusion: SMI initiators had significantly fewer COPD-related exacerbations than DPI initiators. In addition, lower odds of readmissions were observed following COPD-related hospitalizations among the SMI cohort, as compared with the DPI cohort.Keywords: chronic obstructive pulmonary disease, COPD, long-acting muscarinic antagonist, LAMA, soft mist inhaler, SMI, dry powder inhaler, DPI, healthcare resource utilization, readmissions, exacerbations
abstractGer	David Singer,1 Lindsay GS Bengtson,2 Caitlin Elliott,2 Ami R Buikema,2 Jessica Franchino-Elder1 1Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA; 2Health Economics and Outcomes Research, Optum, Eden Prairie, MN, USACorrespondence: David SingerBoehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USATel +1-203-791-6409Email David_2.singerBoehringer-Ingelheim.comBackground: Chronic obstructive pulmonary disease (COPD) is often managed with inhaled long-acting muscarinic antagonists (LAMAs), yet real-world data on healthcare resource utilization (HRU) by inhaler type are lacking. This study compared HRU after LAMA initiation with a soft mist inhaler (SMI) versus a dry powder inhaler (DPI).Patients and Methods: Inclusion criteria were COPD diagnosis, age ≥ 40 years, LAMA initiation (index date = first LAMA SMI or DPI claim 9/1/14— 6/30/18), and Medicare Advantage enrollment 1 year pre-index (baseline) to ≥ 30 days post-index (follow-up). Patients were followed to the earliest of discontinuation, switch, disenrollment, 1 year, or study end (7/31/18). Exclusion criteria were asthma, cystic fibrosis, or lung cancer diagnoses, unavailable demographics, multiple index LAMAs, or baseline LAMA use. Cohorts (SMI or DPI) were balanced on baseline characteristics using inverse probability of treatment weighting. Outcomes included per patient per month (PPPM) COPD-related HRU encounters, and exacerbations (defined as moderate [ambulatory visit with corticosteroid or antibiotic within +- 7 days] or severe [emergency visit or inpatient admission]); and 30-day readmissions following COPD-related hospitalizations.Results: After weighting, cohorts (SMI [n=5360] and DPI [n=22,880]) were similar in age (72 and 73 years, respectively), gender (both 52% female), and COPD severity score (31.3 and 31.5, respectively). Cohorts had similar counts of follow-up HRU encounters. However, the SMI cohort had fewer (mean +- standard deviation) COPD-related exacerbations (0.054+- 0.082 vs DPI cohort 0.059+- 0.088 PPPM, p< 0.001) overall. Moreover, the SMI cohort had fewer severe exacerbations (0.030+- 0.058 vs DPI: 0.034+- 0.065 PPPM, p< 0.001). Hospitalizations among SMI patients had a lower adjusted odds of readmission versus hospitalizations among DPI patients (odds ratio: 0.656, 95% confidence interval= 0.460, 0.937; p=0.020).Conclusion: SMI initiators had significantly fewer COPD-related exacerbations than DPI initiators. In addition, lower odds of readmissions were observed following COPD-related hospitalizations among the SMI cohort, as compared with the DPI cohort.Keywords: chronic obstructive pulmonary disease, COPD, long-acting muscarinic antagonist, LAMA, soft mist inhaler, SMI, dry powder inhaler, DPI, healthcare resource utilization, readmissions, exacerbations
abstract_unstemmed	David Singer,1 Lindsay GS Bengtson,2 Caitlin Elliott,2 Ami R Buikema,2 Jessica Franchino-Elder1 1Health Economics and Outcomes Research, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USA; 2Health Economics and Outcomes Research, Optum, Eden Prairie, MN, USACorrespondence: David SingerBoehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, USATel +1-203-791-6409Email David_2.singerBoehringer-Ingelheim.comBackground: Chronic obstructive pulmonary disease (COPD) is often managed with inhaled long-acting muscarinic antagonists (LAMAs), yet real-world data on healthcare resource utilization (HRU) by inhaler type are lacking. This study compared HRU after LAMA initiation with a soft mist inhaler (SMI) versus a dry powder inhaler (DPI).Patients and Methods: Inclusion criteria were COPD diagnosis, age ≥ 40 years, LAMA initiation (index date = first LAMA SMI or DPI claim 9/1/14— 6/30/18), and Medicare Advantage enrollment 1 year pre-index (baseline) to ≥ 30 days post-index (follow-up). Patients were followed to the earliest of discontinuation, switch, disenrollment, 1 year, or study end (7/31/18). Exclusion criteria were asthma, cystic fibrosis, or lung cancer diagnoses, unavailable demographics, multiple index LAMAs, or baseline LAMA use. Cohorts (SMI or DPI) were balanced on baseline characteristics using inverse probability of treatment weighting. Outcomes included per patient per month (PPPM) COPD-related HRU encounters, and exacerbations (defined as moderate [ambulatory visit with corticosteroid or antibiotic within +- 7 days] or severe [emergency visit or inpatient admission]); and 30-day readmissions following COPD-related hospitalizations.Results: After weighting, cohorts (SMI [n=5360] and DPI [n=22,880]) were similar in age (72 and 73 years, respectively), gender (both 52% female), and COPD severity score (31.3 and 31.5, respectively). Cohorts had similar counts of follow-up HRU encounters. However, the SMI cohort had fewer (mean +- standard deviation) COPD-related exacerbations (0.054+- 0.082 vs DPI cohort 0.059+- 0.088 PPPM, p< 0.001) overall. Moreover, the SMI cohort had fewer severe exacerbations (0.030+- 0.058 vs DPI: 0.034+- 0.065 PPPM, p< 0.001). Hospitalizations among SMI patients had a lower adjusted odds of readmission versus hospitalizations among DPI patients (odds ratio: 0.656, 95% confidence interval= 0.460, 0.937; p=0.020).Conclusion: SMI initiators had significantly fewer COPD-related exacerbations than DPI initiators. In addition, lower odds of readmissions were observed following COPD-related hospitalizations among the SMI cohort, as compared with the DPI cohort.Keywords: chronic obstructive pulmonary disease, COPD, long-acting muscarinic antagonist, LAMA, soft mist inhaler, SMI, dry powder inhaler, DPI, healthcare resource utilization, readmissions, exacerbations
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title_short	Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers
url	https://doaj.org/article/84a30f856b2e42959b9c9b39a5096fa4 https://www.dovepress.com/healthcare-resource-utilization-exacerbations-and-readmissions-among-m-peer-reviewed-article-COPD https://doaj.org/toc/1178-2005
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This study compared HRU after LAMA initiation with a soft mist inhaler (SMI) versus a dry powder inhaler (DPI).Patients and Methods: Inclusion criteria were COPD diagnosis, age &ge; 40 years, LAMA initiation (index date = first LAMA SMI or DPI claim 9/1/14&mdash; 6/30/18), and Medicare Advantage enrollment 1 year pre-index (baseline) to &ge; 30 days post-index (follow-up). Patients were followed to the earliest of discontinuation, switch, disenrollment, 1 year, or study end (7/31/18). Exclusion criteria were asthma, cystic fibrosis, or lung cancer diagnoses, unavailable demographics, multiple index LAMAs, or baseline LAMA use. Cohorts (SMI or DPI) were balanced on baseline characteristics using inverse probability of treatment weighting. Outcomes included per patient per month (PPPM) COPD-related HRU encounters, and exacerbations (defined as moderate [ambulatory visit with corticosteroid or antibiotic within +- 7 days] or severe [emergency visit or inpatient admission]); and 30-day readmissions following COPD-related hospitalizations.Results: After weighting, cohorts (SMI [n=5360] and DPI [n=22,880]) were similar in age (72 and 73 years, respectively), gender (both 52% female), and COPD severity score (31.3 and 31.5, respectively). Cohorts had similar counts of follow-up HRU encounters. However, the SMI cohort had fewer (mean +- standard deviation) COPD-related exacerbations (0.054+- 0.082 vs DPI cohort 0.059+- 0.088 PPPM, p&lt; 0.001) overall. Moreover, the SMI cohort had fewer severe exacerbations (0.030+- 0.058 vs DPI: 0.034+- 0.065 PPPM, p&lt; 0.001). Hospitalizations among SMI patients had a lower adjusted odds of readmission versus hospitalizations among DPI patients (odds ratio: 0.656, 95% confidence interval= 0.460, 0.937; p=0.020).Conclusion: SMI initiators had significantly fewer COPD-related exacerbations than DPI initiators. In addition, lower odds of readmissions were observed following COPD-related hospitalizations among the SMI cohort, as compared with the DPI cohort.Keywords: chronic obstructive pulmonary disease, COPD, long-acting muscarinic antagonist, LAMA, soft mist inhaler, SMI, dry powder inhaler, DPI, healthcare resource utilization, readmissions, exacerbations</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">chronic obstructive pulmonary disease (copd)</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">long-acting muscarinic antagonist (lama)</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">soft mist inhaler (smi)</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">dry powder inhaler (dpi)</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">healthcare resource utilization</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield 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Healthcare Resource Utilization, Exacerbations, and Readmissions Among Medicare Patients with Chronic Obstructive Pulmonary Disease After Long-Acting Muscarinic Antagonist Therapy Initiation with Soft Mist versus Dry Powder Inhalers

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