RT Journal Article
SR Electronic
T1 Different methods to classify COPD patients into the ABCD severity groups – Preliminary results of the LQ-DMP project
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA2495
DO 10.1183/13993003.congress-2019.PA2495
VO 54
IS suppl 63
A1 Boglárka Szentes
A1 Larissa Schwarzkopf
A1 Florian Kirsch
A1 Manuel Huber
A1 Anja Schramm
A1 Reiner Leidl
YR 2019
UL http://erj.ersjournals.com/content/54/suppl_63/PA2495.abstract
AB Background: Guidelines for COPD suggest treatment according to the ABCD classification system, which measures symptom burden and risk of exacerbations. Symptom burden can be assessed via COPD assessment test (CAT) or modified British Medical Research Council (mMRC) scale. Exacerbation might be self-reported or ambulatory/hospital documented. Evidence if the different methods deliver congruent results is sparse.Methods: We assessed CAT, mMRC and self-reported exacerbations from participants of a COPD disease management program of a German statutory health insurance fund. Furthermore, we extracted physician documented exacerbation history from insurance claims data. We assigned the patients to the ABCD groups by applying all different combinations of CAT and mMRC, with self-reported or claims data documented exacerbations.Results: Of the 12,270 participants (Øage 69.1, 58.8% male) CAT placed 11.9% in the low symptom group (A,C), whereas mMRC placed 49.6%. Self-reported exacerbations placed 17.5% in the low risk group (A,B) and claims data documented ones 21.7%. Comparing CAT vs mMRC based on self-reported exacerbations yielded A 10.3% vs 43.9%, B 67.9% vs 34.2%, C 0.6% vs 5.8% and D 21.3% vs 16.0%. Depending on methodological approach, 1,011 (8.2%) patients were assigned to four different groups and 5,094 (41.5%) always to the same.Conclusion: CAT and mMRC result in different group assignment, whereas use of self-reported and physician documented exacerbations show similar pattern. The choice of method an data could alter the classification of the patients and their proposed treatment and thus may impact treatment outcomes.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA2495.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).