Retrospective observational study of asthma and chronic obstructive pulmonary disease prevalence and associated healthcare resource utilization in a large, integrated healthcare system

Ashley W Collinsworth; Andrew L Masica; Rustam Kudyakov; Valentina Bayer; Mark W Millard; Asif Shaikh

doi:10.1080/08998280.2022.2096370

Retrospective observational study of asthma and chronic obstructive pulmonary disease prevalence and associated healthcare resource utilization in a large, integrated healthcare system

Proc (Bayl Univ Med Cent). 2022 Jul 19;35(6):737-745. doi: 10.1080/08998280.2022.2096370. eCollection 2022.

Authors

Ashley W Collinsworth¹, Andrew L Masica^{1

2}, Rustam Kudyakov¹, Valentina Bayer³, Mark W Millard⁴, Asif Shaikh³

Affiliations

¹ Baylor Scott & White Health, Dallas, Texas.
² Texas Health Resources, Arlington, Texas.
³ Boehringer Ingelheim Pharmaceuticals, Ridgefield, Connecticut.
⁴ Baylor University Medical Center, Dallas, Texas.

Abstract

Limited data exist on asthma and chronic obstructive pulmonary disease (COPD) management-major drivers of healthcare resource utilization (HCRU) in the USA. We describe prevalence and exacerbation rates, therapeutic interventions, and HCRU for asthma and/or COPD within a large, integrated healthcare system. Patients with asthma, COPD, and asthma + COPD were identified from retrospective electronic health record data (2016-2018) of >1.7 million patients. Descriptive analysis of disease prevalence and exacerbation frequencies, pharmacotherapies, and HCRU was performed. Time-to-event analysis of time to first exacerbation was performed in patients with asthma and/or COPD. Exacerbation rates, pharmacotherapies, and HCRU were examined by exploratory analysis in an outpatient subset. Overall, 149,086 unique patients (8.6%) had encounters for asthma, COPD, or asthma + COPD. Acute care utilization was high, including emergency department visits (asthma, 52.9%; COPD, 35.1%) and hospitalizations (asthma, 26.7%; COPD, 65.7%). Many patients were prescribed short-acting therapies (asthma, 45.3%; COPD, 40.0%; asthma + COPD, 54.7%). Prescription rates for maintenance therapies were low (17.1%, 20.8%, 31.7%) and annual exacerbation rates were 0.65, 0.80, and 1.33. This analysis showed a substantive prevalence of pulmonary disease, variability between documented prescriptions and pharmacotherapy guidelines, and high HCRU. Appropriate tailoring of pharmacotherapies and management of asthma and COPD over a continuum are opportunities to improve patient care.

Keywords: Asthma; chronic obstructive pulmonary disease; electronic health record; healthcare resource utilization; retrospective.

Grants and funding

Drs. Collinsworth, Masica, Kudyakov, and Millard received a research contract paid by Boehringer Ingelheim (BI) to the Baylor Scott & White Research Institute to support this work. Dr. Millard also reports being on the speaker’s bureau for BI and having received payments from BI for services rendered. Drs. Bayer and Shaikh are employees of BI. Representatives from the funding source were involved in the study design, data interpretation, critical review of the manuscript, and the decision to submit the article for publication and have been included as authors.