Variation in demographic and clinical characteristics of Patients with COPD receiving care in U.S. primary care: data from the Advancing the Patient EXperience (APEX) in COPD registry

Chester Fox, Wilson D. Pace, Elias Brandt, Ku-Lang Chang, Chelsea L. Edwards, Alexander Evans, Gabriela Gaona , MeiLan K. Han, Alan Kaplan, Rachel Kent, Janwillem WH Kocks, Maja Kruszyk BEng, Chantal E. Le Lievre, Tessa Li Voti, Cathy Mahle, Barry Make, Amanda R. Ratigan, Asif Shaikh, Neil Skolnik, Brooklyn StanleyBarbara P Yawn, David Price* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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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 U.S.

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 U.S 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=8,722), Colorado (n=472), New York (n=1,149) and North Carolina (n=6,038). 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 U.S.
Original languageEnglish
Pages (from-to)17-31
Number of pages15
JournalPragmatic and Observational Research
Issue number13
Early online date29 Apr 2022
Publication statusPublished - 29 Apr 2022

Bibliographical note

Medical writing support was provided by Dr. Antony Hardjojo of Jaya Medical Writing Pte Ltd, Singapore. Writing, editorial support, and/or formatting assistance in the development of this manuscript was provided by Andrea Teh, BSc (Hons) and Shilpa Suresh, MSc of the Observational and Pragmatic Research Institute, Singapore. We wish to acknowledge Kidane Gebremariam for his contribution to protocol development. BIPI was given the opportunity to review the manuscript for
medical and scientific accuracy as well as intellectual property considerations.


  • Quality of Care
  • Observational Study
  • Research Database
  • Patient-Reported Outcomes


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