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

Authors Stephenson JJ, Wertz D, Gu T, Patel J, Dalal AA

Received 16 February 2017

Accepted for publication 23 May 2017

Published 4 July 2017 Volume 2017:12 Pages 1947—1959

DOI https://doi.org/10.2147/COPD.S134618

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Richard Russell

Judith J Stephenson,1 Debra Wertz,1 Tao Gu,1 Jeetvan Patel,2 Anand A Dalal2

1HealthCore, Inc., Wilmington, DE, 2GlaxoSmithKline, Research Triangle Park, NC, USA

Purpose: 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.
Methods: 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).
Results: 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.
Conclusion:
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.

Keywords: COPD, dyspnea, health status, symptoms, health care resource utilization, health care costs

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