Patterns of Care in the Management of High-Risk COPD in the US (2011-2019): An Observational Study for the CONQUEST Quality Improvement Program

Margee  Kerr; Yasir  Tarabichi; Alexander  Evans; Douglas  Mape; Wilson D. Pace; Victoria Carter; Amy  Couper; M. Bradley  Drummond; Norbert  Feigler; Alex  Federman; Hitesh  Gandhi; Nicola A. Hanania; Alan Kaplan; Konstantinos  Kostikas; Maja Kruszyk; Marije  van Melle; Hana  Müllerová; Ruth B Murray; Jill A.  Ohar; Michael  Pollack; Rachel  Pullen; Dennis M Williams; Juan  Wisnivesky; MeiLan K. Han; Catherine  Meldrum; David Price

doi:10.1016/j.lana.2023.100546

Patterns of Care in the Management of High-Risk COPD in the US (2011-2019): An Observational Study for the CONQUEST Quality Improvement Program

Margee Kerr, Yasir Tarabichi, Alexander Evans, Douglas Mape, Wilson D. Pace, Victoria Carter, Amy Couper, M. Bradley Drummond, Norbert Feigler, Alex Federman , Hitesh Gandhi, Nicola A. Hanania, Alan Kaplan, Konstantinos Kostikas, Maja Kruszyk, Marije van Melle, Hana Müllerová, Ruth B Murray, Jill A. Ohar, Michael PollackRachel Pullen, Dennis M Williams, Juan Wisnivesky, MeiLan K. Han, Catherine Meldrum, David Price

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

Background: In this study, we compare management of patients with high-risk Chronic Obstructive Pulmonary Disease (COPD) in the United States to national and international guidelines and quality standards, including the COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST).
Methods: Patients were identified from the DARTNet Practice Performance Registry and categorized into three high-risk cohorts in each year from 2011 to 2019: newly diagnosed (≤12 months after diagnosis), already diagnosed, and patients with potential undiagnosed COPD. Patients were considered high-risk if
they had a history of exacerbations or likely exacerbations (respiratory consult with prescribed medication).
Descriptive statistics for 2019 are reported, along with annual trends.
Findings: In 2019, 10% (n = 16610/167197) of patients met high-risk criteria. Evidence of spirometry for diagnosis was low; in 2019, 81% (n = 295/1523) of patients newly diagnosed at high-risk had no record of spirometry/peak expiratory flow in the 12 months pre- or post-diagnosis and 43% (n = 872/1523) had no record of COPD symptom review. Among those newly and already diagnosed at high-risk, 52% (n =4830/9350) had no evidence of COPD medication.
Interpretation: Findings suggest inconsistent adherence to evidence-based guidelines, and opportunities to improve identification, documentation of services, assessment, therapeutic intervention, and follow-up of patients with COPD.
Funding: This study was conducted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd and was partially funded by Optimum Patient Care Global and AstraZeneca Ltd. No funding was received by the Observational & Pragmatic Research Institute Pte Ltd (OPRI) for its contribution.

Original language	English
Article number	100546
Number of pages	13
Journal	The Lancet Regional Health - Americas
Volume	24
Early online date	28 Jul 2023
DOIs	https://doi.org/10.1016/j.lana.2023.100546
Publication status	Published - 1 Aug 2023

Bibliographical note

Acknowledgments
We acknowledge Frank Trudo, of AstraZeneca, for his contributions to the development and review of the protocol. We wish to acknowledge Tonya Winders for her valuable contributions to this publication. Writing, editorial support, and/or formatting assistance in the development of this manuscript was provided by Shilpa Suresh, MSc and Andrea Lim, BSc of the Observational and Pragmatic Research Institute, Singapore.
Funding: This study was conducted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd and was partially funded by Optimum Patient Care Global and AstraZeneca Ltd. No funding was received by the Observational & Pragmatic Research Institute Pte Ltd (OPRI) for its contribution.

Data Availability Statement

The dataset supporting the conclusions of this article was derived from DARTNet’s Practice Performance Registry. The authors do not have permission to give public access to the study dataset; researchers may request access to the Registry data for their own purposes via dartnet.info/contact.htm

Keywords

COPD
Exacerbations
Diagnosis
Spirometry
Treatment
Coordination of Care

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© 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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Cite this

Kerr, M., Tarabichi, Y., Evans, A., Mape, D., Pace, W. D., Carter, V., Couper, A., Drummond, M. B., Feigler, N., Federman , A., Gandhi, H., Hanania, N. A., Kaplan, A., Kostikas, K., Kruszyk, M., van Melle, M., Müllerová, H., Murray, R. B., Ohar, J. A., ... Price, D. (2023). Patterns of Care in the Management of High-Risk COPD in the US (2011-2019): An Observational Study for the CONQUEST Quality Improvement Program . The Lancet Regional Health - Americas, 24, Article 100546. https://doi.org/10.1016/j.lana.2023.100546

Kerr, M, Tarabichi, Y, Evans, A, Mape, D, Pace, WD, Carter, V, Couper, A, Drummond, MB, Feigler, N, Federman , A, Gandhi, H, Hanania, NA, Kaplan, A, Kostikas, K, Kruszyk, M, van Melle, M, Müllerová, H, Murray, RB, Ohar, JA, Pollack, M, Pullen, R, Williams, DM, Wisnivesky, J, Han, MK, Meldrum, C & Price, D 2023, 'Patterns of Care in the Management of High-Risk COPD in the US (2011-2019): An Observational Study for the CONQUEST Quality Improvement Program ', The Lancet Regional Health - Americas, vol. 24, 100546. https://doi.org/10.1016/j.lana.2023.100546

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title = "Patterns of Care in the Management of High-Risk COPD in the US (2011-2019): An Observational Study for the CONQUEST Quality Improvement Program ",

abstract = "Background: In this study, we compare management of patients with high-risk Chronic Obstructive Pulmonary Disease (COPD) in the United States to national and international guidelines and quality standards, including the COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST).Methods: Patients were identified from the DARTNet Practice Performance Registry and categorized into three high-risk cohorts in each year from 2011 to 2019: newly diagnosed (≤12 months after diagnosis), already diagnosed, and patients with potential undiagnosed COPD. Patients were considered high-risk ifthey had a history of exacerbations or likely exacerbations (respiratory consult with prescribed medication).Descriptive statistics for 2019 are reported, along with annual trends.Findings: In 2019, 10% (n = 16610/167197) of patients met high-risk criteria. Evidence of spirometry for diagnosis was low; in 2019, 81% (n = 295/1523) of patients newly diagnosed at high-risk had no record of spirometry/peak expiratory flow in the 12 months pre- or post-diagnosis and 43% (n = 872/1523) had no record of COPD symptom review. Among those newly and already diagnosed at high-risk, 52% (n =4830/9350) had no evidence of COPD medication.Interpretation: Findings suggest inconsistent adherence to evidence-based guidelines, and opportunities to improve identification, documentation of services, assessment, therapeutic intervention, and follow-up of patients with COPD.Funding: This study was conducted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd and was partially funded by Optimum Patient Care Global and AstraZeneca Ltd. No funding was received by the Observational & Pragmatic Research Institute Pte Ltd (OPRI) for its contribution.",

keywords = "COPD, Exacerbations, Diagnosis, Spirometry, Treatment, Coordination of Care",

author = "Margee Kerr and Yasir Tarabichi and Alexander Evans and Douglas Mape and Pace, {Wilson D.} and Victoria Carter and Amy Couper and Drummond, {M. Bradley} and Norbert Feigler and Alex Federman and Hitesh Gandhi and Hanania, {Nicola A.} and Alan Kaplan and Konstantinos Kostikas and Maja Kruszyk and {van Melle}, Marije and Hana M{\"u}llerov{\'a} and Murray, {Ruth B} and Ohar, {Jill A.} and Michael Pollack and Rachel Pullen and Williams, {Dennis M} and Juan Wisnivesky and Han, {MeiLan K.} and Catherine Meldrum and David Price",

note = "Acknowledgments We acknowledge Frank Trudo, of AstraZeneca, for his contributions to the development and review of the protocol. We wish to acknowledge Tonya Winders for her valuable contributions to this publication. Writing, editorial support, and/or formatting assistance in the development of this manuscript was provided by Shilpa Suresh, MSc and Andrea Lim, BSc of the Observational and Pragmatic Research Institute, Singapore. Funding: This study was conducted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd and was partially funded by Optimum Patient Care Global and AstraZeneca Ltd. No funding was received by the Observational & Pragmatic Research Institute Pte Ltd (OPRI) for its contribution.",

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day = "1",

doi = "10.1016/j.lana.2023.100546",

language = "English",

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TY - JOUR

T1 - Patterns of Care in the Management of High-Risk COPD in the US (2011-2019)

T2 - An Observational Study for the CONQUEST Quality Improvement Program

AU - Kerr, Margee

AU - Tarabichi, Yasir

AU - Evans, Alexander

AU - Mape, Douglas

AU - Pace, Wilson D.

AU - Carter, Victoria

AU - Couper, Amy

AU - Drummond, M. Bradley

AU - Feigler, Norbert

AU - Federman , Alex

AU - Gandhi, Hitesh

AU - Hanania, Nicola A.

AU - Kaplan, Alan

AU - Kostikas, Konstantinos

AU - Kruszyk, Maja

AU - van Melle, Marije

AU - Müllerová, Hana

AU - Murray, Ruth B

AU - Ohar, Jill A.

AU - Pollack, Michael

AU - Pullen, Rachel

AU - Williams, Dennis M

AU - Wisnivesky, Juan

AU - Han, MeiLan K.

AU - Meldrum, Catherine

AU - Price, David

N1 - Acknowledgments We acknowledge Frank Trudo, of AstraZeneca, for his contributions to the development and review of the protocol. We wish to acknowledge Tonya Winders for her valuable contributions to this publication. Writing, editorial support, and/or formatting assistance in the development of this manuscript was provided by Shilpa Suresh, MSc and Andrea Lim, BSc of the Observational and Pragmatic Research Institute, Singapore. Funding: This study was conducted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd and was partially funded by Optimum Patient Care Global and AstraZeneca Ltd. No funding was received by the Observational & Pragmatic Research Institute Pte Ltd (OPRI) for its contribution.

PY - 2023/8/1

Y1 - 2023/8/1

N2 - Background: In this study, we compare management of patients with high-risk Chronic Obstructive Pulmonary Disease (COPD) in the United States to national and international guidelines and quality standards, including the COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST).Methods: Patients were identified from the DARTNet Practice Performance Registry and categorized into three high-risk cohorts in each year from 2011 to 2019: newly diagnosed (≤12 months after diagnosis), already diagnosed, and patients with potential undiagnosed COPD. Patients were considered high-risk ifthey had a history of exacerbations or likely exacerbations (respiratory consult with prescribed medication).Descriptive statistics for 2019 are reported, along with annual trends.Findings: In 2019, 10% (n = 16610/167197) of patients met high-risk criteria. Evidence of spirometry for diagnosis was low; in 2019, 81% (n = 295/1523) of patients newly diagnosed at high-risk had no record of spirometry/peak expiratory flow in the 12 months pre- or post-diagnosis and 43% (n = 872/1523) had no record of COPD symptom review. Among those newly and already diagnosed at high-risk, 52% (n =4830/9350) had no evidence of COPD medication.Interpretation: Findings suggest inconsistent adherence to evidence-based guidelines, and opportunities to improve identification, documentation of services, assessment, therapeutic intervention, and follow-up of patients with COPD.Funding: This study was conducted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd and was partially funded by Optimum Patient Care Global and AstraZeneca Ltd. No funding was received by the Observational & Pragmatic Research Institute Pte Ltd (OPRI) for its contribution.

AB - Background: In this study, we compare management of patients with high-risk Chronic Obstructive Pulmonary Disease (COPD) in the United States to national and international guidelines and quality standards, including the COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST).Methods: Patients were identified from the DARTNet Practice Performance Registry and categorized into three high-risk cohorts in each year from 2011 to 2019: newly diagnosed (≤12 months after diagnosis), already diagnosed, and patients with potential undiagnosed COPD. Patients were considered high-risk ifthey had a history of exacerbations or likely exacerbations (respiratory consult with prescribed medication).Descriptive statistics for 2019 are reported, along with annual trends.Findings: In 2019, 10% (n = 16610/167197) of patients met high-risk criteria. Evidence of spirometry for diagnosis was low; in 2019, 81% (n = 295/1523) of patients newly diagnosed at high-risk had no record of spirometry/peak expiratory flow in the 12 months pre- or post-diagnosis and 43% (n = 872/1523) had no record of COPD symptom review. Among those newly and already diagnosed at high-risk, 52% (n =4830/9350) had no evidence of COPD medication.Interpretation: Findings suggest inconsistent adherence to evidence-based guidelines, and opportunities to improve identification, documentation of services, assessment, therapeutic intervention, and follow-up of patients with COPD.Funding: This study was conducted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd and was partially funded by Optimum Patient Care Global and AstraZeneca Ltd. No funding was received by the Observational & Pragmatic Research Institute Pte Ltd (OPRI) for its contribution.

KW - COPD

KW - Exacerbations

KW - Diagnosis

KW - Spirometry

KW - Treatment

KW - Coordination of Care

U2 - 10.1016/j.lana.2023.100546

DO - 10.1016/j.lana.2023.100546

M3 - Article

C2 - 37545746

SN - 2667-193X

VL - 24

JO - The Lancet Regional Health - Americas

JF - The Lancet Regional Health - Americas

M1 - 100546

ER -

Patterns of Care in the Management of High-Risk COPD in the US (2011-2019): An Observational Study for the CONQUEST Quality Improvement Program

Abstract

Bibliographical note

Data Availability Statement

Keywords

Access to Document

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Cite this