A Real-World Study of 30-Day Exacerbation Outcomes in Chronic Obstructive Pulmonary Disease (COPD) Patients Managed with Aerobika OPEP

Abstract

Introduction: Oscillating positive expiratory pressure (OPEP) devices may reduce chronic symptoms in patients with obstructive pulmonary disease (COPD); however, no real-world studies have been performed to evaluate the benefits of these devices. The objective of this study was to measure the rate of early (30-day) moderate-to-severe exacerbations and related costs in COPD patients treated with Aerobika, an OPEP device, vs. a matched control group in a real-world setting. Methods: The study utilized data from the QuintilesIMS’ CDM hospital database. COPD patients treated with Aerobika OPEP between 9/2013 and 8/2015 were propensity score matched to COPD patients who did not use any positive expiratory pressure device. Severe exacerbation was defined as a hospital admission with a diagnosis for chronic bronchitis or COPD. Moderate-to-severe exacerbation was defined as a hospitalization or an ED visit with a diagnosis for chronic bronchitis or COPD. Exacerbations and costs were compared between cohorts at 30 days. A generalized linear model (GLM) was used to estimate the marginal effect of Aerobika OPEP on the cost of ED visits and hospitalizations due to COPD exacerbations. Results: A total of 405 Aerobika OPEP patients were matched to 405 controls. At 30 days, 18.5% of subjects using the Aerobika OPEP vs. 25.7% of controls had a moderate-to-severe exacerbation (p = 0.014); 13.8% of subjects with Aerobika OPEP vs. 19.0% of controls had a severe exacerbation (p = 0.046). The mean per patient cost of moderate-to-severe exacerbations and severe exacerbations in the Aerobika OPEP group was significantly lower than controls ($2975 vs. $6065; p = 0.008, and $2838 vs. $5871; p = 0.009, respectively). In the GLM, the per-patient cost of moderate-to-severe exacerbations in the Aerobika OPEP group was 34% lower (p = 0.012) than the control group. Conclusions: Study findings suggest that using Aerobika OPEP as part of a treatment regimen may help reduce ED visits, hospital re-admissions and related costs in COPD patients who have a history of exacerbations.