A RETROSPECTIVE REAL-WORLD COHORT STUDY DEMONSTRATING THE IMPACT OF HIGH FREQUENCY CHEST WALL OSCILLATION THERAPY ON HEALTHCARE COSTS IN PATIENTS WITH NEUROMUSCULAR DISORDERS

Abstract

SESSION TITLE: Respiratory Care Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: The progressive muscle weakness caused by neuromuscular makes it challenging for patients to get mucus out of the lungs leading to either mucus plugging in the airways and/or chest congestion. Mucus secretion clearing and mobilization techniques play a critical role and can be helpful in maintaining well-being, to minimize breathing problems, and prevent further decay of health status. Currently, there is limited evidence on the relationship between utilization of high frequency chest wall oscillation (HFCWO) therapy with clinical and economic outcomes. To address this, the aim of this study was to characterize hospitalization rate data before and after initiation of HFCWO with air-powered vests. METHODS: A retrospective pre/post-cohort design and data from the Optum healthcare claims repository were employed. The study population included all patients at least one medical claim with HCPCS code E0483 for the use of air-powered HFCWO devices on or between January 1, 2008 and April 30, 2018. Of these, the cohort was limited to those with >= 12 months pre- and >=12 months post from the first usage of HFCWO therapy; no major comorbidities indicating end of life; patients with neuromuscular disorders (e.g., muscular dystrophies, cerebral palsy, and/or multiple sclerosis, and selected other conditions); and patients >= age 18. Statistical comparisons were made using a paired-samples t-test of the 12-month pre and 12-month post periods, examining both respiratory-related and all-cause hospitalizations. RESULTS: The study population included 1080 diagnosed with neuromuscular disorders. Of these, 62% were female; age distribution was 27% age 18-39, 15% age 40-59, 44% age 60-79, 14% age 80 and over; and the mean Charlson Comorbidity Index was 2.12 + 1.179. Our analysis comparing pre and post periods indicate a reduction in all-cause and respiratory-related hospitalization in the year after initiating HFCWO therapy. Specifically, the average all-cause hospitalization rates were reduced by 21.7% (1.008 vs. 0.790, p<0.005) while the respiratory-related hospitalizations were reduced by 24.7% (0.498 vs. 0.375, p<0.005). CONCLUSIONS: In a retrospective analysis of claims data, hospitalization rates were reduced for one year after initiation of HFCWO therapy in a blended group of patients with neuromuscular conditions. CLINICAL IMPLICATIONS: HFCWO is associated with reduced hospitalizations in patients with neuromuscular disorders. DISCLOSURES: Employee relationship with RespirTech Please note: >$100000 Added 04/06/2020 by Gary Hansen, source=Web Response, value=Salary Scientific Medical Advisor relationship with Respirtech a Philips Company Please note: $5001 - $20000 Added 04/10/2020 by Charlene McEvoy, source=Web Response, value=Grant/Research Support Employee relationship with RespirTech, A Philips Company Please note: >$100000 Added 04/08/2020 by PRITESH PANDYA, source=Web Response, value=Salary Consultant relationship with RespirTech, A Philips Company Please note: $1001 - $5000 Added 04/08/2020 by Derek Weycker, source=Web Response, value=Grant/Research Support