Journal article
A 4-Year Retrospective Claims Analysis of Oral Corticosteroid Use and Health Conditions in Newly Diagnosed Medicare FFS Patients with COPD
International journal of chronic obstructive pulmonary disease, Vol.17, pp.2635-2652
01/01/2022
DOI: 10.2147/COPD.S373590
PMCID: PMC9585959
PMID: 36274995
Abstract
Purpose: We analyzed population-level administrative claims data for Medicare fee-for-service (FFS) beneficiaries to provide insights on systemic oral corticosteroid (OCS) use patterns and associated health conditions and acute events among patients newly diagnosed with chronic obstructive pulmonary disease (COPD). Background: COPD is a progressive inflammatory disease of the lungs, characterized by acute exacerbations that may lead to increased mortality. Short courses of systemic corticosteroids (SCS) are recommended to reduce recovery time from exacerbations, although SCS use has been associated with increased risk of adverse events. Methods: This study used 2013-2019 Medicare 100% FFS research identifiable files, which contain all Medicare Parts A, B, and D paid claims incurred by 100% of Medicare FFS beneficiaries. Descriptive statistics for patients newly diagnosed with COPD were analyzed, including OCS use, select health conditions and acute events, and COPD exacerbations. Statistical models were used to analyze the relationship between the incidence of select health conditions and events and cumulative OCS dosage. Results: Of Medicare FFS patients newly diagnosed with COPD, 36% received OCS in the 48 months following diagnosis, and 38% of OCS episodes lasted longer than the recommended 5-7 days. Patients had a variety of health conditions or acute events in the 24month period prior to new COPD diagnosis, such as hypertension, depression/anxiety, type 2 diabetes, or osteoporosis, that could heighten the risks of OCS use. Patients treated with >1000 mg of prednisolone equivalent OCS in the 48 months following COPD diagnosis had a higher incidence of new conditions or events, including cardiovascular disease, heart failure, hypertension, obesity, dyspepsia, infections, and depression/anxiety, than patients with no OCS use. Conclusion: These results highlight the potential risks of OCS in COPD treatment, including prolonged use among complex Medicare patients, and reinforce the importance of preventive treatment strategies and therapy optimization early in the disease course.
Details
- Title: Subtitle
- A 4-Year Retrospective Claims Analysis of Oral Corticosteroid Use and Health Conditions in Newly Diagnosed Medicare FFS Patients with COPD
- Creators
- Carol Bazell - Milliman (United States)Michael Pollack - AstraZeneca, US Med Affairs, BioPharmaceut, Wilmington, DE USAAlejandro P. Comellas - Univ Iowa, Carver Coll Med, Dept Internal Med, Iowa City, IA USASanjay Sethi - University at Buffalo, State University of New YorkMaggie Alston - Milliman (United States)Bruce Pyenson - Milliman (United States)Dane Hansen - Milliman (United States)Melissa Caplen - Milliman (United States)Anthony Staresinic - AstraZeneca, US Med Affairs, BioPharmaceut, Wilmington, DE USAJohn Styczynski - AstraZeneca, US Med Affairs, BioPharmaceut, Wilmington, DE USANorbert Feigler - AstraZeneca, US Med Affairs, BioPharmaceut, Wilmington, DE USA
- Resource Type
- Journal article
- Publication Details
- International journal of chronic obstructive pulmonary disease, Vol.17, pp.2635-2652
- DOI
- 10.2147/COPD.S373590
- PMID
- 36274995
- PMCID
- PMC9585959
- NLM abbreviation
- Int J Chron Obstruct Pulmon Dis
- ISSN
- 1178-2005
- eISSN
- 1178-2005
- Publisher
- Dove Medical Press Ltd
- Number of pages
- 18
- Language
- English
- Date published
- 01/01/2022
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; ICTS; Internal Medicine
- Record Identifier
- 9984359869602771
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