Elderly patients with idiopathic pulmonary fibrosis (IPF) have high morbidity and mortality, and experience a variety of comorbidities both before and after receiving their diagnosis, a study finds.
The findings of the study, “Characterizing idiopathic pulmonary fibrosis patients using US Medicare-advantage health plan claims data,” were published in the journal BMC Pulmonary Medicine.
In the study, researchers from Optum Epidemiology, with investigators from Boehringer Ingelheim, set out to document the demographic characteristics, healthcare utilization, incidence of comorbidities, and disease outcomes of elderly patients with IPF.
The cohort study was based on a large U.S. health insurance database — the Optum’s Medicare Advantage plan — and analyzed a total of 4,716 medical records dated between 2008 and 2014 from IPF patients, 65 years and older, who were followed up until their health plan disenrollment, death, or claim for a known cause of the disease, or the end of the study.
Data showed that the median age of the cohort was 77.5 years, with 50.3% men. The median follow-up time was 0.8 years.
More than half of the participants (53.4%) underwent diagnostic tests for IPF, of which 97.7% had high-resolution computed tomography (HRCT) scans.
Healthcare utilization data showed 50.8% of the patients were hospitalized, and 82.9% received prescriptions for at least three different types of medications. The median number of doctor visits over the course of the study was 12, and the median medical cost was $11,865, with nearly half of the total arising from facility charges.
Comorbidity incidence rates ranged from 1 per 1,000 person-years (a measure of probability) for lung transplant, to 374.3 per 1,000 person-years for high blood pressure (arterial hypertension).
The higher comorbidity incidence rates seen in the cohort included acute myocardial infarction, pulmonary hypertension, lung cancer, and mortality. Other comorbidities especially affecting this population were chronic renal failure, congestive heart failure, and intracranial hemorrhage.
In general, baseline characteristics and incidence rates were identical for all IPF patients, regardless of whether or not they had undergone specific diagnostic tests for IPF.
The results suggest that “elderly IPF patients experience a variety of comorbidities before and after IPF diagnosis,” the researchers wrote.
The team emphasized that “therapies for IPF and for the associated comorbidities may reduce morbidity and associated health care utilization of these patients.”