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International Journal of Chronic Obstructive Pulmonary Disease Volume 16, 2021 - Issue
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Original Research

Healthcare, Medication Utilization and Outcomes of Patients with COPD by GOLD Classification in England

Leah B Sansbury1 Value Evidence and Outcomes, GlaxoSmithKline, Research Triangle Park, Durham, NC, USAView further author information
,
Kieran J Rothnie2 Value and Evidence Outcomes, GlaxoSmithKline, Uxbridge, UKView further author information
,
Chanchal Bains3 Real World Evidence and Epidemiology, GlaxoSmithKline, Uxbridge, UKView further author information
,
Chris Compton4 Global Respiratory Franchise, GlaxoSmithKline, Brentford, UKView further author information
,
Glenn Anley2 Value and Evidence Outcomes, GlaxoSmithKline, Uxbridge, UKView further author information
&
Afisi S Ismaila5 Value Evidence and Outcomes, GlaxoSmithKline, Collegeville, PA, USA;6 Department of Health Research Methods, McMaster University, Hamilton, ON, CanadaCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0002-2876-8308View further author information
ORCID Icon
Pages 2591-2604 | Published online: 15 Sep 2021

Figures & data

Figure 1 Study design. aConfirmed by spirometry, FEV1/FVC <0.7 (any time). bFuture outcomes ascertained from the database from the defined index date until 90 days post index date for treatment and the day after the defined index date and 12 months post index date, until December 31, 2017, for categorical exacerbations per year and health outcomes of interest.

Note: Healthcare utilization and longitudinal outcomes (GP visits, hospitalizations, and COPD exacerbations per year) were analyzed in patients who had at least 12 months of follow-up data after the index date in the CPRD database.
Abbreviations: COPD, chronic obstructive pulmonary disease; CPRD, Clinical Practice Research Datalink; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; GP, general practitioner; MRC, Medical Research Council.
Figure 1 Study design. aConfirmed by spirometry, FEV1/FVC <0.7 (any time). bFuture outcomes ascertained from the database from the defined index date until 90 days post index date for treatment and the day after the defined index date and 12 months post index date, until December 31, 2017, for categorical exacerbations per year and health outcomes of interest.

Table 1 Patient Demographics and Clinical Characteristics, Overall and Stratified by GOLD 2017 Group

Table 2 Longitudinal Outcomes and Healthcare Utilization of Patients in the 12 Months After the Index Date, Overall and Stratified by GOLD 2017 Group

Table 3 Time-to-Event Analysis for COPD Exacerbations and Death in the 12 Months After the Index Date According to GOLD 2017 Group

Figure 2 Univariate Cox proportional hazards model for time to the following events according to GOLD classification during the 12 months following the index date, (A) moderate COPD exacerbations; (B) severe COPD exacerbations; (C) death. aPatients were followed up for death from 90 days post index date until 12 months post index date.

Note: P values were generated from a single Log rank test comparing all groups.
Abbreviations: COPD, chronic obstructive pulmonary disease; GOLD, Global Initiative for Chronic Obstructive Lung Disease.
Figure 2 Univariate Cox proportional hazards model for time to the following events according to GOLD classification during the 12 months following the index date, (A) moderate COPD exacerbations; (B) severe COPD exacerbations; (C) death. aPatients were followed up for death from 90 days post index date until 12 months post index date.

Table 4 Time-to-Event Analysis for COPD Exacerbations and Death in the 12 Months After the Index Date According to MRC Dyspnea Grade

Figure 3 Univariate Cox proportional hazards model for time to the following events according to MRC dyspnea grade during the 12 months following the index date, (A) moderate COPD exacerbations; (B) severe COPD exacerbations; (C) death. aPatients were followed up for death from 90 days post index date until 12 months post index date. Note: P values were generated from a single Log rank test comparing all groups.

Abbreviations: COPD, chronic obstructive pulmonary disease; MRC, Medical Research Council.
Figure 3 Univariate Cox proportional hazards model for time to the following events according to MRC dyspnea grade during the 12 months following the index date, (A) moderate COPD exacerbations; (B) severe COPD exacerbations; (C) death. aPatients were followed up for death from 90 days post index date until 12 months post index date. Note: P values were generated from a single Log rank test comparing all groups.

Figure 4 Maintenance therapy use, during the 90 days on or after the index date, overall and stratified by GOLD 2017 group.

Note: Patients may be included in more than one treatment category if they changed their maintenance therapy during the 90-day period.
Abbreviations: GOLD, Global Initiative for Chronic Obstructive Lung Disease; ICS, inhaled corticosteroid; LABA, long-acting β2-agonist; LAMA, long-acting muscarinic antagonist; MITT, multiple-inhaler triple therapy.
Figure 4 Maintenance therapy use, during the 90 days on or after the index date, overall and stratified by GOLD 2017 group.

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