OUTCOMES WITH HIGH-FREQUENCY CHEST WALL OSCILLATION AMONG PATIENTS WITH COPD USING A LARGE CLAIMS DATABASE

Abstract

SESSION TITLE: Obstructive Lung Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: High-Frequency Chest Wall Oscillation (HFCWO) is increasingly used for airway clearance therapy in patients with bronchiectasis and chronic obstructive pulmonary disease (COPD). Limited evidence currently exists on the relationship between HFCWO therapy and clinical/economic outcomes in patients with COPD who do not have bronchiectasis. Several studies have evaluated the impact of HFCWO but have yielded variable evidence. Without larger and more robust studies, there exists a clinical concern that some patients with COPD and chronic bronchitis are receiving suboptimal therapy. METHODS: A retrospective pre/post-cohort design and data from the Optum healthcare claims repository were employed. The study population included all patients having 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-index continuous medical insurance eligibility from the first usage of HFCWO therapy; no major comorbidities indicating end of life; patients with a COPD diagnosis and no record of bronchiectasis; 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.A retrospective pre/post-cohort design and data from the Optum healthcare claims repository were employed. The study population included all patients having 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-index continuous medical insurance eligibility from the first usage of HFCWO therapy; no major comorbidities indicating end of life; patients with a COPD diagnosis and no record of bronchiectasis; 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 1172 patients with COPD-only who had initiated HFCWO therapy during the study period. Of these, 62% were female; age distribution was 4% age <40, 14% age 40-59, 61% age 60-79, 21% age 80 and over; and the mean Charlson Comorbidity Index was 2.78 + 1.9. Comparing pre and post periods, mean respiratory-related and all-cause hospitalization rates were lowered by 17.1% (0.495 vs. 0.410, p=0.025) and 13.6% (0.873 vs. 0.754, p=0.031) respectively. CONCLUSIONS: For patients with COPD in the absence of bronchiectasis, hospital utilization improved during the 12-month period following initiation of HFCWO therapy. CLINICAL IMPLICATIONS: HFCWO is associated with reduced hospitalizations in patients with COPD-only. 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