Continuous Improvement and the Expansion of Quality ... - NCQA

C H R o N I C D I S E A S E M A N A G E M E N T
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N AT I o N A l C o M M I T T E E f o R Q U A l I T y A S S U R A N C E
PHARMACoTHERAPy MANAGEMENT
of CoPD ExACERbATIoN
Chronic obstructive pulmonary disease (CoPD) exacerbations are characterized by acute
worsening of clinical symptoms (e.g., breathlessness or sputum production). Exacerbations
may range from temporary decline in functional status to fatal events. 1,2 After an exacerbation,
patients’ symptoms and lung function can take several weeks to recover to baseline, and quality
of life declines drastically. 2 The Pharmacotherapy Management of COPD Exacerbation measure
evaluates whether patients received appropriate medical treatment after an event and assesses
effective outpatient management of the disease.
• CoPD exacerbations are responsible for
the majority of CoPD-related costs from
unscheduled physician and emergency
room visits and hospitalizations. 2
• Exacerbations have contributed to an
increase in CoPD-related mortality, from
21.4 to 43.3 deaths per 100,000 persons
in the U.S. in the last two decades. 1
• According to the Global Initiative for
Chronic obstructive lung Disease
guidelines, inhaled bronchodilators are
a cornerstone of treatment for CoPD
exacerbation. 3,4 Short-term corticosteroid
therapy may also be required. 5,6
the Case for Improvement
• CoPD exacerbations are estimated to
result in approximately 110,000 deaths
and more than 500,000 hospitalizations
annually. More than $18 billion is spent
on direct costs every year. 4 Hospital
admissions for CoPD exacerbations
average a 10-day length of stay, at a cost
of $10,000 per stay. 5,6
• Approximately one-third of patients
discharged from the emergency department
with acute exacerbations have recurrent
symptoms within 14 days, and 17 percent
relapse and require hospitalization—a
good indicator that patients are not getting
the care they require. 3
• benefits of appropriate medical treatment
include decreased duration of hospital
stays and less likelihood of treatment
failure. Patients also exhibit decreased
frequency of exacerbations and maintain
longer disease-free intervals. 5