Claims Data Hint at Unmet Needs Among Patients With Severe Asthma, COPD

The wealth of information contained within large claims databases can reveal areas of unmet need for among patients with chronic obstructive pulmonary disease (COPD) and severe asthma, as described in 2 posters presented at the CHEST Annual Meeting 2023.

Doctor holding a health icon on an interface with data points.

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Gaps in optimal care can occur at several points along the disease trajectory, from diagnosis throughout testing, treatment, and adherence. But even once these unmet needs are identified, researchers investigated, how can health care providers be empowered to close the gaps?

In one poster, the investigators reviewed the US IQVIA claims database to identify claims, diagnoses, and treatments for patients with COPD who received treatment between September 2017 and August 2019.¹ They went on to define states of medical unmet needs (MUN) using analysis of “medically measurable moments” combined with clinical input, then prioritized 3 of those states based on the magnitude of the gap and its ability to be addressed.

Of the MUN states including lack of diagnosis, insufficient testing, absence of treatment after diagnosis, suboptimal treatment, and poor therapy adherence and persistence, the 3 prioritized states were (1) lack of therapy escalation when warranted, (2) use of multiple inhalers to deliver triple therapy when single-inhaler options are available, and (3) high use of oral corticosteroids.

To align these gaps with best practices, the researchers tailored educational efforts to health care providers through a wide variety of strategies, including infographics, webinars, podcasts, and online games. After these education and engagement efforts, about 4220 patients with COPD who had been in 1 of the MUN states saw improvement in the prioritized states between June 2020 and March 2022. For instance, providers who took part in the educational programs had a 3.8% increase in patients whose therapy was effectively escalated and a 4.2% increase in patients using single-inhaler triple therapy relative to providers who did not participate.

“Identification of MUN through combined use of real-world data, advanced analytics, and clinical expertise enables understanding of potential medical educational impact at the level of the individual patient,” the investigators wrote.

In another poster, the authors also used the IQVIA claims database but this time focused on patients with severe asthma.² Using similar techniques, they identified MUN states and selected the top 3 to prioritize based on the number of patients in need and the state’s amenability to improvement. For this analysis, the 3 prioritized MUN were (1) lack of testing for eosinophilic phenotype, which is present in about 4 in 5 patients with severe asthma and can determine optimal therapy choice; (2) eligible patients with uncontrolled disease who had not yet tried a biologic drug; and (3) high use of oral corticosteroids.

Interventions to educate health care providers on these caps were deployed both virtually and in person—including an escape room game—in collaboration with the CHEST organization. Again, these efforts appeared to yield improvements, with 4155 patients with severe asthma showing improvement in their respective MUN.

“This novel data-driven approach is allowing Medical Affairs to evolve future medical engagement and evidence, as it has enabled better understanding of individual patient needs,” the researchers noted.

References

1. DiRocco K, Brock C, Espey T, Conlon B, Igboekwe E. Using US healthcare claims database to uncover medical unmet needs in patients with COPD. Poster presented at: CHEST Annual Meeting 2023; October 8-11, 2023; Honolulu, HI. doi:10.1016/j.chest.2023.07.2536

2. Stach-Klysh A, Brock C, Vichiendilokkul A, Espey T, Henshall G, Conlon B, Corbridge TC. Identifying medical unmet needs using US claims database to improve severe asthma patient health outcomes. Poster presented at: CHEST Annual Meeting 2023; October 8-11, 2023; Honolulu, HI. doi:10.1016/j.chest.2023.07.2531