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

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL Pragmatic and Observational Research Pub Date : 2022-04-01 DOI:10.2147/POR.S342736
C. Fox, W. Pace, E. Brandt, V. Carter, Ku-Lang Chang, C. Edwards, Alexander Evans, Gabriela Gaona, M. Han, A. Kaplan, R. Kent, J. Kocks, Maja Kruszyk, Ledoux Chantal, Tessa LiVoti, Cathy Mahle, B. Make, A. Ratigan, A. Shaikh, N. Skolnik, Brooklyn Stanley, B. Yawn, D. Price
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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.
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在美国接受初级保健治疗的COPD患者的人口统计学和临床特征的变化:来自COPD登记处推进患者体验(APEX)的数据
引言对美国不同医疗系统中慢性阻塞性肺病(COPD)管理的可变性以及患者特征对其的影响知之甚少。本研究旨在描述COPD患者的人口统计学和临床特征,并比较美国五个初级保健医疗组的管理。方法这是一项回顾性观察性登记研究,利用存储在促进患者体验(APEX)COPD登记中的电子健康记录。APEX注册表包含来自德克萨斯州、俄亥俄州、科罗拉多州、纽约州和北卡罗来纳州的五个美国医疗保健组织的数据。提取并比较了2019年12月至2020年1月期间COPD初级保健患者的人口统计学和临床特征数据。结果共有17192名COPD患者被纳入分析:德克萨斯州(n=811)、俄亥俄州(n=8722)、科罗拉多州(n=472)、纽约州(n=1149)和北卡罗来纳州(n=6038)。每个位置的大多数患者为女性(>54%)和超重/肥胖(>60%)。注意到年龄、种族/民族、恶化频率、治疗模式和共病患病率方面的地区间差异。来自科罗拉多州的患者每年的病情恶化次数最少,而来自纽约州的患者报告的病情加重次数最多。在纽约发病率最高的5个地区中,有4个地区的高血压是最常见的合并发病率。抑郁症是俄亥俄州最常见的并发症。治疗模式也因地点而异;科罗拉多州没有接受任何治疗的患者比例最高。ICS/LABA是最常见的处方治疗方法,但俄亥俄州除外,那里的ICS/LABA/LAMA最常见。结论和相关性我们的数据显示,在美国不同医疗机构的初级保健中,被诊断为COPD的患者在人口统计学、临床和治疗特征方面存在异质性。
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Pragmatic and Observational Research
Pragmatic and Observational Research MEDICINE, GENERAL & INTERNAL-
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期刊介绍: Pragmatic and Observational Research is an international, peer-reviewed, open-access journal that publishes data from studies designed to closely reflect medical interventions in real-world clinical practice, providing insights beyond classical randomized controlled trials (RCTs). While RCTs maximize internal validity for cause-and-effect relationships, they often represent only specific patient groups. This journal aims to complement such studies by providing data that better mirrors real-world patients and the usage of medicines, thus informing guidelines and enhancing the applicability of research findings across diverse patient populations encountered in everyday clinical practice.
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