Physical Therapy in Patients With Pulmonary Arterial Hypertension (PAH): Results From a German Claims Data Analysis

OBJECTIVES: Pulmonary arterial hypertension (PAH) is a rare, life-threatening, and progressive disease characterized by remodeling and progressive narrowing of the pulmonary vessels. Medical guidelines recommend supervised physical therapy (PT) for clinically stable patients on PAH-specific agents. To date, no data exists on the utilization of PT in PAH patients in Germany. We aimed to close this gap.

METHODS: A retrospective claims database analysis using anonymized data from the InGef research database was conducted. The database contains data on insured individuals from more than the half of German statutory health insurances and is representative for the German population.

The study population comprised PAH patients identified by ≥ 1 inpatient or ≥ 2 outpatient diagnosis codes for PAH (ICD-10-GM I27.0) in 2021. Thereof, patients with a prescription of pre-defined PAH-specific agents in 2021 were assessed. To determine patients on PT, a list of all aids and remedies recorded between 2016-2021 was generated. Thereafter, PAH-related aids and remedies (incl. supervised PT such as breathing exercises) were defined based on provided data and medical expertise.

RESULTS: Our study identified 403 PAH patients with PAH-specific agents in 2021. The average age was 71 years (SD: 15 years), 63.8% were female. Valid aids and remedies data was available for 383 patients, of which 45.4% (n=174) had a prescription for PAH-related aids and remedies in 2021 and 67.4% (n=258) between 2016-2021. PT was prescribed to 25.6% (n=98) of patients in 2021 and 47.8% (n=183) of patients between 2016-2021.

CONCLUSIONS: One in four of the diagnosed PAH patients treated with PAH-specific agents received PT as part of their aids and remedies prescription in 2021. When considering a more extended timeframe, up to half of identified patients had a PT prescription. Further research is needed to evaluate the patterns of PT prescriptions in PAH patients in Germany.