Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 12

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


Checked for plagiarism Yes

Review by Single anonymous peer review

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.
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

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]