Higher chronic obstructive pulmonary disease (copd) assessment test scores are associated with pulmonary rehabilitation and pulmonology visits among patients with copd

SESSION TITLE: Novel Biomarkers of Asthma and COPD Severity SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/09/2023 12:00 pm - 12:45 pm PURPOSE: The chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) is a validated 8-item questionnaire that measures the impact of COPD on a patient’s well-being and daily activities. Designed for use in clinical practice, the CAT is a component of Global Initiative for Obstructive Lung Disease (GOLD) strategy for COPD care. The objective of this study was to determine if higher CAT scores are associated with increased utilization of pulmonary rehabilitation and pulmonary clinic visits. METHODS: A retrospective cohort study was conducted using electronic medical records of adults with COPD receiving care at M Health Fairview outpatient clinics. Eligible patients had an initial CAT score (index) entered between 8/2017 and 12/2021. Patients were grouped by index CAT score (<10 [limited impact], 10–20 [moderate], 21–40 [high]). Patient demographics (age, sex, race), comorbidities, and history of exacerbations were measured in the 12 months preceding index (baseline). Proportional hazards models were constructed for two outcomes 60 days after the index visit: time to next pulmonary rehabilitation service and pulmonology visit. RESULTS: Of 11,194 individuals with COPD, 813 (7.3%) had an index CAT recorded. Most eligible patients were female (55.7%) and Caucasian (86.7%), with a mean age of 66.7 years (standard deviation 9.5) and mean FEV1/FVC ratio of 59.0%. A total of 3.2% and 4.7% of patients had pulmonary rehabilitation and pulmonology visit, respectively, post-index. CAT scores for 304 (37.4%), 380 (46.7%), and 129 (15.9%) individuals met criteria for high, moderate, and limited impact, respectively. Compared to the limited impact group, unadjusted hazard ratios for time to pulmonary rehabilitation for moderate and high impact groups were 3.3 (p<0.05) and 6.3 (p<0.05) and after adjustment for baseline exacerbations and pulmonary rehabilitation were 3.2 (n.s.) and 5.4 (p<0.05), respectively. Unadjusted hazard ratios for time to pulmonology visit for moderate and high impact were 2.7 (p<0.05) and 4.2 (p<0.05) and after adjustment for baseline pulmonology visit and exacerbations were 2.4 (n.s.) and 3.6 (p<0.05), respectively. CONCLUSIONS: Only a small percentage of the population (7.3%) received a CAT test. However, higher CAT scores were associated with increased participation in pulmonary rehabilitation and pulmonology visits. Further investigation into how the CAT influences medical decision-making and practice patterns is warranted. CLINICAL IMPLICATIONS: Implementation of the CAT into routine clinical practice has the potential to systematically identify patients with higher COPD symptom burden, leading to earlier referral to pulmonary rehabilitation and evaluation by a pulmonologist. DISCLOSURES: No relevant relationships by Edward Corazalla No relevant relationships by Nathaniel Gaeckle No relevant relationships by Judy Kelloway Employee relationship with Health Analytics, LLC Please note: 5/1/2019 -3/29/2023 Added 03/29/2023 by Joshua Liberman, source=Web Response, value=Salary Employee relationship with GSK Please note: 09/16/2022 - present Added 04/07/2023 by Rosirene Paczkowski, source=Web Response, value=Salary Stock owner relationship with GSK Please note: 09/16/2022- present Added 04/07/2023 by Rosirene Paczkowski, source=Web Response, value=Stock Employee relationship with Eli Lilly and Company Please note: 2008 - 09/15/2022 Added 04/07/2023 by Rosirene Paczkowski, source=Web Response, value=Salary Stock owner relationship with Eli Lilly and Company Please note: 2008 - 09/15/2022 Added 04/07/2023 by Rosirene Paczkowski, source=Web Response, value=Stock Employee relationship with Health Analytics, LLC. Please note: 02/01/2021 -CURRENT Added 03/29/2023 by Purva Parab, source=Web Response, value=Salary No disclosure on file for Charles Ruetsch Employee relationship with GSK Please note: October 21-Present Added 04/06/2023 by Kristin Wrobleski, source=Web Response, value=Salary