How can time to COPD exacerbation be delayed? A real-world study comparing two oscillating positive expiratory pressure (OPEP) devices in patients with chronic obstructive pulmonary disease (COPD) or chronic bronchitis

Abstract

Rationale: Acute COPD exacerbations are common and a main driver of hospitalizations. This retrospective study compared disease-related hospital readmission in COPD/chronic bronchitis patients using two OPEP devices. Methods: Patients were identified on either the Aerobika (Trudell Medical International) or Acapella (Smiths Medical) OPEP devices from September 2013 to April 2018 in IQVIAs hospital claims data linked to medical (Dx) and prescription claims (LRx); the first COPD/chronic bronchitis hospital visit with an OPEP device being index. Patients were ≥18 years old, had ≥1 hospital, LRx, Dx record within 12 months before and after index, and had no asthma diagnosis before index or post-operative OPEP device use within 30 days before index. Kaplan-Meier survival analysis was used to compare time from discharge to disease-related readmission, and readmission rates were determined at 30 days and 12 months post-discharge for 1:3 propensity score (PS)-matched Aerobika and Acapella users. Results: 619 Aerobika users were matched to 1,857 Acapella users (mean age 72 years). Aerobika users had a significantly longer time to readmission than Acapella users (p=0.01). Readmission rates (proportion of patients having at least one) were lower for Aerobika users at 30 days (11% vs 17%) and 12 months (40% vs 45%). Conclusions: Patients given an Aerobika device compared to an alternative OPEP device had delayed time to readmission. This supports use of the Aerobika* OPEP device as an add-on to usual care post-exacerbation and highlights differences in OPEP devices effectiveness.