Table 1.
Demographic and clinical characteristics
| DPI (N=1,960) | pMDI (N=1,086) | P-value | |||
|---|---|---|---|---|---|
| n/mean | %/SD | n/mean | %/SD | ||
| Demographicsa | |||||
| Age (years), mean, SD | 67.7 | 12.1 | 67.5 | 11.9 | 0.60 |
| Age (years) (n, %) | |||||
| 40–44 | 27 | 1.4% | 14 | 1.3% | 0.74 |
| 45–49 | 84 | 4.3% | 40 | 3.7% | |
| 50–54 | 145 | 7.4% | 94 | 8.7% | |
| 55–59 | 280 | 14.3% | 161 | 14.8% | |
| 60–64 | 379 | 19.3% | 197 | 18.1% | |
| 65+ | 1,045 | 53.3% | 580 | 53.4% | |
| Male (n, %) | 903 | 46.1% | 509 | 46.9% | 0.67 |
| Geographic region (n, %) | |||||
| Northeast | 381 | 19.4% | 160 | 14.7% | <0.0001 |
| North Central | 696 | 35.5% | 443 | 40.8% | |
| South | 638 | 32.6% | 408 | 37.6% | |
| West | 226 | 11.5% | 65 | 6.0% | |
| Unknown | 19 | 1.0% | 10 | 0.9% | |
| Insurance plan type (n, %) | |||||
| Comprehensive/indemnity | 636 | 32.4% | 371 | 34.2% | <0.01 |
| EPO/PPO | 874 | 44.6% | 457 | 42.1% | |
| POS/POS with capitation | 120 | 6.1% | 47 | 4.3% | |
| HMO | 194 | 9.9% | 129 | 11.9% | |
| CDHP/HDHP | 62 | 3.2% | 54 | 5.0% | |
| Unknown | 74 | 3.8% | 28 | 2.6% | |
| Payer (n, %) | |||||
| Commercial | 884 | 45.1% | 487 | 44.8% | 0.89 |
| Medicare supplemental | 1,076 | 54.9% | 599 | 55.2% | |
| Rural residence indicator (n, %) | |||||
| Urban | 1,551 | 79.1% | 849 | 78.2% | 0.80 |
| Rural | 390 | 19.9% | 227 | 20.9% | |
| Unknown | 19 | 1.0% | 10 | 0.9% | |
| Clinical characteristicsb | |||||
| Deyo–Charlson comorbidity index, mean, SD | 2.4 | 1.8 | 2.4 | 1.8 | 0.62 |
| Comorbid conditions (n, %) | |||||
| Acute bronchitis and bronchiolitis | 654 | 33.4% | 370 | 34.1% | 0.69 |
| Anxiety | 234 | 11.9% | 139 | 12.8% | 0.49 |
| Cardiovascular disease | 509 | 26.0% | 286 | 26.3% | 0.83 |
| Acute myocardial infarction | 78 | 4.0% | 25 | 2.3% | 0.01 |
| Congestive heart failure | 462 | 23.6% | 250 | 23.0% | 0.73 |
| Ischemic stroke | 33 | 1.7% | 30 | 2.8% | 0.045 |
| Depression | 301 | 15.4% | 151 | 13.9% | 0.28 |
| Diabetes (type I or II) | 524 | 26.7% | 310 | 28.5% | 0.28 |
| Gastroesophageal reflux disease | 233 | 11.9% | 147 | 13.5% | 0.19 |
| Hypertension | 1,282 | 65.4% | 734 | 67.6% | 0.22 |
| Osteoarthritis | 304 | 15.5% | 159 | 14.6% | 0.52 |
| Osteoporosis | 92 | 4.7% | 41 | 3.8% | 0.23 |
| Pneumonia | 681 | 34.7% | 378 | 34.8% | 0.97 |
| Antihypertensive medication (n, %) | 1,332 | 68.0% | 768 | 70.7% | 0.12 |
| Diabetes medication (n, %) | 411 | 21.0% | 240 | 22.1% | 0.47 |
| Lipid-lowering medication (n, %) | 916 | 46.7% | 534 | 49.2% | 0.20 |
| Respiratory treatments (n, %) | |||||
| Oxygen therapy | 384 | 19.6% | 191 | 17.6% | 0.18 |
| Nebulizer use | 208 | 10.6% | 127 | 11.7% | 0.36 |
| Maintenance medicationsa | |||||
| ICS | 92 | 4.7% | 58 | 5.3% | 0.43 |
| LABA | 21 | 1.1% | 15 | 1.4% | 0.45 |
| Long-acting muscarinic antagonist | 118 | 6.0% | 66 | 6.1% | 0.95 |
| Methylxanthines | 20 | 1.0% | 18 | 1.7% | 0.13 |
| Phosphodiesterase-4 inhibitors | 2 | 0.1% | 2 | 0.2% | 0.55 |
| SABA | 714 | 36.4% | 436 | 40.1% | 0.04 |
| Short-acting muscarinic antagonist | 73 | 3.7% | 50 | 4.6% | 0.24 |
| Systemic corticosteroids | 842 | 43.0% | 505 | 46.5% | 0.06 |
| Macrolide antibiotics | 686 | 35.0% | 406 | 37.4% | 0.19 |
| Single fill of a macrolide | 464 | 67.6% | 271 | 66.7 | 0.76 |
| Multiple fills of a macrolide | 222 | 32.4 | 135 | 33.3 | |
| Leukotriene modifiers | 76 | 3.9% | 42 | 3.9% | 0.99 |
| Preindex use of index ICS/LABA inhaler type,c,d N, % | 95 | 4.8% | 411 | 37.8% | <0.0001 |
| COPD severity, mean, SD | |||||
| Number of hospitalization days due to AECOPD | 3.7 | 2.5 | 4.0 | 2.9 | 0.01 |
| Number of pulmonologist visits | 1.6 | 3.8 | 1.9 | 4.1 | 0.03 |
| Number of SABA fills | 1.0 | 2.4 | 1.2 | 2.6 | 0.09 |
| Number of oral corticosteroid fills | 0.9 | 1.8 | 1.0 | 1.7 | 0.22 |
Notes:
a
Assessed on the index date.
b
Assessed during the 12-month preindex period.
c
All patients with a preindex ICS + LABA had an index date in 2010.
d
Any ICS + LABA, ICS alone, LABA alone, or SABA medication delivered via DPI/pMDI.
Abbreviations: AECOPD, acute exacerbation of COPD; CDHP, consumer-driven health plan; DPI, dry powder inhaler; EPO, exclusive provider organization; HDHP, high deductible health plan; HMO, health maintenance organization; ICS, inhaled corticosteroid; LABA, long-acting β2-agonist; pMDI, pressurized metered-dose inhaler; POS, point of service; PPO, preferred provider organization; SABA, short-acting β-agonist.