OBJECTIVES

Known guidelines recommend a treatment escalation procedure in case a patient is diagnosed with COPD. The study aimed (1) to assess epidemiology of patients receiving/not receiving long-acting COPD therapy and (2) to assess percentage of patients in need of therapy optimization.

METHODS

This retrospective analysis utilized claims data (AOK PLUS; 2015-2016). Included were patients (i) with ≥1 inpatient and/or ≥2 confirmed outpatient COPD diagnoses [ICD-10 J44%] in 2015-2016; (ii) no asthma diagnosis [ICD‑10 J45%]; (iii) aged ≥40 years; (iv) with enrolment in a COPD-disease management program (DMP).

Based on the second half of the year 2016, patients were assigned to the following subgroups: (A) therapy-naïve starting or in need of a long-acting bronchodilator therapy (LABA/LAMA); (B) therapy-naïve not in need of LABA/LAMA therapy; (C) receiving LABA/LAMA, but in need of therapy optimization; (D) stable on LABA/LAMA.

Therapy optimization need was defined as either >2 prescriptions of antibiotics or oral corticosteroids, or ≥1 inpatient or ≥2 outpatient exacerbation diagnoses (ICD-10 J44.1 and/or documented within DMP), or another DMP documentation indicating additional treatment needs.

RESULTS

We identified 22,839 COPD patients (mean/median age 72.1/73; 37.8% female); 9.7% could not be assigned to one of the subgroups due to COPD treatment in 2015 but no treatment in the observational period. Patient numbers were as follows: therapy-naïve patients:10.5% of patients with 5.2% in need of LABA-therapy initiation (A) and 5.3% not in need (B); patients receiving LABA/LAMA 79.8% of patients with 16.3% in need of therapy optimization (C) and 63.5% being stable on current therapy (D). In group C, 100% had a documentation of at least one exacerbation in the observational period, 39.7% had at least one inpatient exacerbation.

CONCLUSIONS

About 16% of currently treated and additional 5.2% of currently untreated patients are in need of a therapy optimization.