SHM Converge Scientific Abstract ePoster Gallery-How Are Azithromycin and Roflumilast Being Used in the Real World for Treatment of Chronic Obstructive Pulmonary Disease?

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This retrospective cohort study examined how azithromycin and roflumilast are used in real-world COPD care and whether outcomes differ after discharge. Using Vizient Clinical Data Base records from 206 U.S. hospitals between January 2017 and June 2023, researchers identified 225,944 COPD hospitalizations. Only 7,068 hospitalizations (3.1%) involved a new start of azithromycin or roflumilast on the day before or day of discharge.<br /><br />Azithromycin was much more commonly prescribed than roflumilast: 87% of patients received azithromycin (6,164 cases) and 13% received roflumilast (904 cases). The main outcome was readmission within 60 days. Across unadjusted analyses and multiple adjusted statistical approaches, patients discharged on roflumilast had a higher risk of readmission than those discharged on azithromycin. The difference in marginal readmission probability for roflumilast versus azithromycin ranged from 6.4% to 8.6%, depending on the propensity-score method used.<br /><br />The authors note that these findings may reflect differences in patient selection, since roflumilast is typically indicated for a narrower group of COPD patients, especially those with chronic bronchitis, which was infrequently coded in this dataset. Other limitations include lack of outpatient data, limited detail on disease severity, and possible misclassification because azithromycin can be used for both infection treatment and COPD prophylaxis.<br /><br />Overall, the study suggests that in routine practice azithromycin is used far more often than roflumilast at discharge for COPD, and roflumilast recipients had worse short-term readmission outcomes, though residual confounding may influence the results.

Asset Subtitle

Priya A. Prasad

Meta Tag

Author List Alyssa Harris, Andrew D. Auerbach, Brooks T. Kuhn, Colin Hubbard, Jerry Krishnan, Priya A. Prasad, Vivek Rudrapatna

Category Research

Concept Chronic Obstructive Pulmonary Disease

Concept 60-Day Readmission

Concept Hospital Readmission

Concept Confounding

Concept Computable Phenotype

Distinguished Non-Finalist

Presenter Organization University of California San Francisco

Presenting Author Priya A. Prasad

Track Outcomes Research

Keywords

COPD

azithromycin

roflumilast

hospital discharge

readmission

retrospective cohort

real-world care

propensity score

chronic bronchitis

Vizient Clinical Data Base

Chronic Obstructive Pulmonary Disease

60-Day Readmission

Hospital Readmission

Confounding

Computable Phenotype