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Sleep and Respiratory

Clinical study

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Study suggests positive airway pressure therapy could reduce COPD patient hospitalization

However, 92% of the COPD patients studied did not receive PAP therapy 

Percentage of COPD studied did not receive PAP therapy

Hospitalization of patients with COPD creates a huge burden on the healthcare system―to the tune of an estimated $50 billion in associated costs1, 2. And hospitalizations are at an all-time high – with the 30-day readmission rate for patients with chronic COPD ranging from 20-39%3-5. A recent Philips-funded study revealed that while positive airway pressure (PAP) therapy was associated with a reduction in hospitalization, a staggering 92% of patients studied were not receiving it in any form.

 

The retrospective study led by Dr. Sairam Parthasarathy, professor of medicine and interim chief of Division of Pulmonary, Allergy, Critical Care and Sleep Medicine with University of Arizona College of Medicine, revealed that only 7.5 percent of some 1,881,652 COPD patients analyzed were receiving any form of PAP therapy.

 

There are multiple modes of PAP treatment which can be administered at home to help people alleviate symptoms of respiratory illness. The study reviewed administrative claims data suggesting that individuals receiving either Bi-level (BiPAP), continuous (CPAP) or noninvasive positive pressure ventilation (NIV) therapy in the home (n = 48,856) experienced lower hospitalization risk than before therapy initiation, as well as lower hospitalization risk than those who did not receive any positive airway pressure therapy at all.

“Frequent readmissions of COPD patients not only disrupt their quality of life, but are costing our health systems billions,” said Dr. Parthasarathy. “This analysis revealed that there is a solution already accessible within our toolbox that can keep patients out of the hospital, but it is significantly underutilized.”

Patients with multiple chronic medical conditions were analyzed as part of the study. Comorbidities such as sleep apnea, chronic respiratory failure and heart failure were associated with greater benefits from PAP therapy, though ultimately, results showed that further clinical study into a causal connection between PAP therapy and reduced hospital readmissions of COPD patients is indicated.

 

Noted Dr. Parthasarath: “With improved awareness and implementation of PAP therapy as a treatment for COPD, we can lower the cost burden for health systems while allowing patients to recover in the comfort of their own homes.”

“With improved awareness and implementation of PAP therapy … we can lower the cost burden for health systems while allowing patients to recover in the comfort of their own homes.”

-Dr. Sairam Parthasarathy,

Professor of medicine and interim chief of Division of Pulmonary, Allergy, Critical Care and Sleep Medicine with University of Arizona College of Medicine

1 American Lung Association. Trends in COPD (Chronic Bronchitis and Emphysema):Morbidity and Mortality. Available at: http://www.lung.org/assets/documents/research/copd-trend-report.pdf. ALA, 2013. Accessed November 23, 2016.

 

2 American Lung Association. COPD Prevalence in Adults by State 2013. Available at: http://www.lung.org/lung-disease/copd/resources/facts-figures/COPD-Fact-Sheet.html#Sources. Accessed November 23, 2016.

 

3 Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med.2009;360:1418-1428.

 

4 Chris K, Terra S, Andrew P. A propensity-matched retrospectiveanalysis to identify predictors of r hospitalization for patients with chronic obstructive pulmonary disease (COPD). C51. Hospitalization and readmission in chronic obstructive pulmonary disease: Am J Respir Crit Care Med. 2013;187:A4387.

 

5 Elixhauser A, Au D, Podulka J. Readmissions for chronic obstructive pulmonary disease, 2008. HCUP Statistical Brief #121 (AHRQ) 2011; #121. Available at: https://www.hcup-us.ahrq.gov/reports/statbriefs/sb121.pdf. Accessed March 1, 2017.