Table 1.
Baseline Characteristics of U.S. Medicare Beneficiaries Prescribed MAC Antibiotic Regimen, 2006–2014
| N (%) or Mean (SD) | N (%) or Mean (SD) | N (%) or Mean (SD) | P Value | P Value | P Value | |
|---|---|---|---|---|---|---|
| 2007 non-GBT (N = 1780) | 2007 GBT (N = 3040) | Macrolide + Ethambutol (2-drug) (N = 682) |
2007 GBT versus non-GBT |
2020 GBT versus non-GBT |
3-drug versus 2-drug |
|
| Demographic characteristics | ||||||
| Age at treatment start (y) | 78.1 (SD 6.4) | 77.6 (SD 6.0) | 78.5 (SD 6.4) | <.01 | .74 | <.01 |
| Female | 1318 (74.0%) | 2351 (77.3%) | 516 (75.7%) | <.01 | <.01 | .34 |
| Race, ethnicity | .27 | .94 | .10 | |||
| White | 1537 (86.4%) | 2686 (88.4%) | 581 (85.2%) | |||
| Asian | 109 (6.1%) | 155 (5.1%) | 45 (6.6%) | |||
| Hispanic | 73 (4.1%) | 102 (3.4%) | 31 (4.6%) | |||
| Black | 40 (2.3%) | 58 (1.9%) | 19 (2.8%) | |||
| Combined Groupa | 21 (1.2%) | 30 (1.3%) | <10 (<0.1%) | |||
| Number of years in Medicare since age 65 | 6.9 (SD 2.3) | 7.1 (SD 2.3) | 7.1 (SD 2.2) | .02 | <.01 | .87 |
| Clinical characteristics b | ||||||
| Chronic obstructive pulmonary disease/emphysema | 1407 (79.0%) | 2207 (72.6%) | 505 (74.1%) | <.01 | <.01 | .45 |
| Oral corticosteroid usec | 1119 (62.9%) | 1686 (55.5%) | 391 (57.3%) | <.01 | <.01 | .40 |
| Gastroesophageal reflux | 994 (55.8%) | 1672 (55.0%) | 344 (50.4%) | .57 | <.01 | .03 |
| Asthma | 564 (31.7%) | 877 (28.9%) | 199 (29.2%) | .04 | <.01 | .88 |
| Diabetes mellitus | 541 (30.4%) | 807 (26.6%) | 206 (30.2%) | <.01 | .03 | .05 |
| Rheumatologic disease | 97 (5.5%) | 110 (3.6%) | 39 (5.7%) | <.01 | .07 | .01 |
| Pseudomonas infection | 191 (10.7%) | 190 (6.3%) | 53 (7.8%) | <.01 | <.01 | .14 |
| Lung cancer | 172 (9.7%) | 266 (8.8%) | 51 (7.5%) | .29 | .01 | .27 |
| Primary immune deficiency | 132 (7.4%) | 144 (4.7%) | 40 (5.9%) | <.01 | <.01 | .23 |
| Allergic bronchopulmonary aspergillosis | 20 (1.1%) | 26 (0.9%) | 9 (1.3%) | .36 | .86 | .26 |
| Alpha-1 antitrypsin deficiency | 7 (0.4%) | 13 (0.4%) | <10 (<0.1%) | .86 | .40 | .58 |
| Primary ciliary dyskinesia | 0 | <10 (<0.1%) | 0 | .13 | .58 | .34 |
| Silicosis | <10 (<0.1%) | <10 (<0.1%) | 0 | .90 | .54 | .50 |
| Chronic kidney disease | 0 | <10 (<0.1%) | 0 | .44 | .78 | .63 |
| Charlson comorbidity index score | 2.4 (SD 1.7) | 2.0 (SD 1.5) | 2.3 (SD 1.6) | <.01 | <.01 | <.01 |
| Healthcare utilization | ||||||
| Number of clinician office visits per year | 5.9 (SD 5.0) | 5.1 (SD 4.4) | 5.6 (SD 4.9) | <.01 | <.01 | <.01 |
| Number of visits to pulmonologist per year | 1.6 (SD 1.6) | 1.4 (SD 1.9) | 1.5 (SD 1.6) | <.01 | <.01 | .13 |
| Number of visits to infectious disease specialists per year | 0.7 (SD 1.1) | 0.5 (SD 0.8) | 0.6 (SD 0.8) | <.01 | <.01 | .15 |
| Number of any hospitalizations per year | 1.2 (SD 1.8) | 0.9 (SD 1.4) | 1.1 (SD 1.5) | <.01 | <.01 | .07 |
| Number of hospitalizations from respiratory illness per year | 0.7 (SD 0.8) | 0.6 (SD 0.7) | 0.6 (SD 0.8) | <.01 | <.01 | .20 |
| Number of acute respiratory exacerbations per yeard | 0.6 (SD 0.9) | 0.8 (SD 0.6) | 0.6 (SD 0.6) | <.001 | <.01 | .62 |
Abbreviations: GBT, guideline-based therapy; MAC, Mycobacterium avium complex; SD, standard deviation.
aBeneficiaries who identify as American Indian, Alaska Native, more than 1 race and ethnicity, or who did identify with any of the provided categories were combined due to low numbers.
bIdentified by International Classification of Diseases, Ninth Revision, Clinical Modification, codes-based Medicare claims made during the baseline period.
cNational Drug Codes for oral corticosteroids were used to identify use of oral corticosteroid during the baseline period (eg, 1 or more oral corticosteroid dispensed within 12 mo before starting MAC-pulmonary disease therapy).
dPrescriptions of antibiotics typically used for acute respiratory exacerbation (erythromycin, azithromycin, clarithromycin, inhaled tobramycin, levofloxacin, moxifloxacin, ciprofloxacin, amoxicillin, amoxicillin/clavulanate, or doxycycline) for ≥7 d but ≤28 d.