A Real-World Study of 30-Day Exacerbation Outcomes in Chronic Obstructive Pulmonary Disease (COPD) Patients Managed with Aerobika OPEP

Abstract

Oscillating positive expiratory pressure (OPEP) devices may reduce chronic symptoms in patients with obstructive pulmonary disease (COPD); however, no real-world studies have been performed to evaluate the benefits of these devices. The objective of this study was to measure the rate of early (30-day) moderate-to-severe exacerbations and related costs in COPD patients treated with Aerobika, an OPEP device, vs. a matched control group in a real-world setting. The study utilized data from the QuintilesIMS’ CDM hospital database. COPD patients treated with Aerobika OPEP between 9/2013 and 8/2015 were propensity score matched to COPD patients who did not use any positive expiratory pressure device. Severe exacerbation was defined as a hospital admission with a diagnosis for chronic bronchitis or COPD. Moderate-to-severe exacerbation was defined as a hospitalization or an ED visit with a diagnosis for chronic bronchitis or COPD. Exacerbations and costs were compared between cohorts at 30 days. A generalized linear model (GLM) was used to estimate the marginal effect of Aerobika OPEP on the cost of ED visits and hospitalizations due to COPD exacerbations. A total of 405 Aerobika OPEP patients were matched to 405 controls. At 30 days, 18.5% of subjects using the Aerobika OPEP vs. 25.7% of controls had a moderate-to-severe exacerbation (p = 0.014); 13.8% of subjects with Aerobika OPEP vs. 19.0% of controls had a severe exacerbation (p = 0.046). The mean per patient cost of moderate-to-severe exacerbations and severe exacerbations in the Aerobika OPEP group was significantly lower than controls ($2975 vs. $6065; p = 0.008, and $2838 vs. $5871; p = 0.009, respectively). In the GLM, the per-patient cost of moderate-to-severe exacerbations in the Aerobika OPEP group was 34% lower (p = 0.012) than the control group. Study findings suggest that using Aerobika OPEP as part of a treatment regimen may help reduce ED visits, hospital re-admissions and related costs in COPD patients who have a history of exacerbations.