• Wilson D Pace, Elias Brandt, Victoria A Carter, Ku-Lang Chang, Chelsea L Edwards, Alexander Evans, Chester Fox, Gabriela Gaona, MeiLan K Han, Alan G Kaplan, Rachel Kent, KocksJanwillem W HJWHObservational & Pragmatic Research Institute, Singapore.General Practitioners Research Institute, Groningen, The Netherlands., Maja Kruszyk, Chantal E Le Lievre, Tessa Li Voti, Cathy Mahle, Barry Make, Amanda R Ratigan, Asif Shaikh, Neil Skolnik, Brooklyn Stanley, Barbara P Yawn, and David B Price.
• DARTNet Institute, Aurora, Colorado.
• Ann Fam Med. 2022 Jul 1; 20 (4): 319-327.

PurposeTo describe demographic and clinical characteristics of chronic obstructive pulmonary disease patients managed in US primary care.MethodsThis was an observational registry study using data from the Chronic Obstructive Pulmonary Disease (COPD) Optimum Patient Care DARTNet Research Database from which the Advancing the Patient Experience COPD registry is derived. Registry patients were aged ≥35 years at diagnosis. Electronic health record data were collected from both registries, supplemented with patient-reported information/outcomes from the Advancing the Patient Experience registry from 5 primary care groups in Texas, Ohio, Colorado, New York, and North Carolina (June 2019 through November 2020).ResultsOf 17,192 patients included, 1,354 were also in the Advancing the Patient Experience registry. Patients were predominantly female (56%; 9,689/17,192), White (64%; 9,732/15,225), current/ex-smokers (80%; 13,784/17,192), and overweight/obese (69%; 11,628/16,849). The most commonly prescribed maintenance treatments were inhaled corticosteroid with a long-acting β2-agonist (30%) and inhaled corticosteroid with a long-acting muscarinic antagonist (27%). Although 3% (565/17,192) of patitents were untreated, 9% (1,587/17,192) were on short-acting bronchodilator monotherapy, and 4% (756/17,192) were on inhaled corticosteroid monotherapy. Despite treatment, 38% (6,579/17,192) of patients experienced 1 or more exacerbations in the last 12 months. These findings were mirrored in the Advancing Patient Experience registry with many patients reporting high or very high impact of disease on their health (43%; 580/1,322), a breathlessness score 2 or more (45%; 588/1,315), and 1 or more exacerbation in the last 12 months (50%; 646/1,294).ConclusionsOur findings highlight the high exacerbation, symptom, and treatment burdens experienced by COPD patients managed in US primary care, and the need for more real-life effectiveness trials to support decision making at the primary care level.© 2022 Annals of Family Medicine, Inc.

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