OUTCOMES OF HIGH FREQUENCY CHEST WALL OSCILLATION (HFCWO) IN COPD PATIENTS WITHOUT BRONCHIECTASIS

Abstract

SESSION TITLE: Tuesday Electronic Posters 4 SESSION TYPE: Original Inv Poster Discussion PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM PURPOSE: High Frequency Chest Wall Oscillation (HFCWO) vests have long been used to assist in airway clearance for patients with cystic fibrosis (CF) and non-CF bronchiectasis (NCFB), but there is limited information on the outcomes of this therapy in COPD patients who are free of radiographic bronchiectasis. METHODS: The hospitalization patterns and self-reported metrics of subjective airway clearance experience were assessed before and after initiation of HFCWO therapy in a data set of COPD patients (ICD-9-CM 496 and ICD-10-CM J44.X) from the HFCWO Outcomes Registry (HFCWO-OR). Patients with evidence of bronchiectasis by high-resolution chest CT were excluded. Variables collected included demographics, radiographic findings, hospitalizations, and respiratory symptoms. RESULTS: 219 COPD patients met inclusion criteria (male/female 46%/54%, average age 65). In the 12-month interval prior to initiating HFCWO therapy, the number of patients with zero self-reported hospitalizations was 39.5% (64/162), compared with 64.4% (29/45) of patients who reported zero hospitalizations in the subsequent 12 months (p=0.005). Conversely, 29.0% (47/162) of patients reported three or more hospitalizations in the prior 12 months, compared with 8.9% (4/45) in the subsequent 12 months. (p=0.001). There was an overall 54.4% reduction in the annualized hospitalization rate after 12 months (0.60 hospitalizations/patient/year at 12 months, compared to 1.31 hospitalizations/patient/year prior to initiating vest therapy) (p=0.001). Those patients who subjectively rated their “overall respiratory health” as good, very good, or excellent increased from 8.0% upon initiation of therapy to 50.0% within 12 months. (p=0.018). Those who rated the “ability to clear your lungs” as good, very good, or excellent increased from 9.5% upon initiation of therapy to 61.4% within 12 months. (p=0.137). CONCLUSIONS: This study shows that outcomes in COPD patients without bronchiectasis, as measured by number of hospitalizations, self-reported respiratory health, and the ability to clear secretions, improved substantially after the initiation of HFCWO therapy. These improvements were sustained for at least one year. CLINICAL IMPLICATIONS: Symptomatic patients with COPD who are free of radiographic bronchiectasis may benefit from the use of HFCWO therapy. DISCLOSURES: no disclosure on file for Tara Barto; No relevant relationships by Sarah Daignault, source=Web Response Employee $100000 Added 03/13/2019 by Gary Hansen, source=Web Response, value=Salary<br Consultant relationship with Sunovion Please note: $1001 - $5000 Added 11/28/2018 by Diego Maselli Caceres, source=Web Response, value=Consulting fee Consultant relationship with Sanofi Regeneron Please note: $5001 - $20000 Added 11/28/2018 by Diego Maselli Caceres, source=Web Response, value=Consulting fee Consultant relationship with AztraZeneca Please note: $1001 - $5000 Added 03/14/2019 by Diego Maselli Caceres, source=Web Response, value=Consulting fee Consultant relationship with Novartis Please note: $1001 - $5000 Added 03/14/2019 by Diego Maselli Caceres, source=Web Response, value=Consulting fee Consultant relationship with GSK Please note: $5001 - $20000 Added 03/14/2019 by Diego Maselli Caceres, source=Web Response, value=Consulting fee