Time to diagnosis of pulmonary hypertension and diagnostic burden: A retrospective analysis of nationwide US healthcare data
Abstract The main aim of this analysis was to investigate time from symptom onset (chronic unexplained dyspnoea [CUD]) to diagnosis of Group 1 pulmonary hypertension (PH)—pulmonary arterial hypertension (PAH)—and to characterize healthcare resource utilization leading up to diagnosis using a nationw...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Pulmonary Circulation |
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| Online Access: | https://doi.org/10.1002/pul2.12188 |
| _version_ | 1827944810727604224 |
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| author | Eva‐Maria Didden Eileen Lee Julie Wyckmans Deborah Quinn Loïc Perchenet |
| author_facet | Eva‐Maria Didden Eileen Lee Julie Wyckmans Deborah Quinn Loïc Perchenet |
| author_sort | Eva‐Maria Didden |
| collection | DOAJ |
| description | Abstract The main aim of this analysis was to investigate time from symptom onset (chronic unexplained dyspnoea [CUD]) to diagnosis of Group 1 pulmonary hypertension (PH)—pulmonary arterial hypertension (PAH)—and to characterize healthcare resource utilization leading up to diagnosis using a nationwide US claims and an electronic health record (EHR) database from Optum©. Eligible patients were ≥18 years old at first CUD diagnosis (index event) and had a PAH diagnosis on or after index date. Based on administrative codes, PAH was defined as right heart catheterization (RHC), ≥ 2 PAH diagnoses (1 within a year of RHC), and ≥1 post‐RHC prescription for PAH treatment. All values are median (1st quartile–3rd quartile) unless otherwise stated. Of 854,722 patients with CUD in the claims database, 582 (0.1%) had PAH. Time from CUD to PAH diagnosis was 2.26 (0.73–4.22) years. PAH patients experienced 3 (2–4) transthoracic echocardiograms (TTEs), 6 (3–12) specialist visits, and 2 (1–4) hospitalizations during the diagnostic interval. Almost one‐third of patients (29%) waited 10 months or more to have a TTE. Findings from the EHR database were broadly similar. Resource utilization during the diagnostic interval was also analyzed in an overall PH cohort: findings were generally similar to the PAH cohort (2 [1–3] TTEs, 4 [2–9] specialist visits and 2 [1–4] hospitalizations). These data indicate a delay in the diagnostic pathway for PAH, and illustrate the burden associated with PAH diagnosis. |
| first_indexed | 2024-03-13T10:35:33Z |
| format | Article |
| id | doaj.art-e781ce805b7b4374b84b41ac9b627cd1 |
| institution | Directory Open Access Journal |
| issn | 2045-8940 |
| language | English |
| last_indexed | 2024-03-13T10:35:33Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj.art-e781ce805b7b4374b84b41ac9b627cd12023-05-18T06:26:29ZengWileyPulmonary Circulation2045-89402023-01-01131n/an/a10.1002/pul2.12188Time to diagnosis of pulmonary hypertension and diagnostic burden: A retrospective analysis of nationwide US healthcare dataEva‐Maria Didden0Eileen Lee1Julie Wyckmans2Deborah Quinn3Loïc Perchenet4Actelion Pharmaceuticals Ltd Allschwil SwitzerlandJanssen Research & Development Spring House Pennsylvania USAActelion Pharmaceuticals Ltd Allschwil SwitzerlandJanssen Pharmaceuticals, Inc Raritan New Jersey USAActelion Pharmaceuticals Ltd Allschwil SwitzerlandAbstract The main aim of this analysis was to investigate time from symptom onset (chronic unexplained dyspnoea [CUD]) to diagnosis of Group 1 pulmonary hypertension (PH)—pulmonary arterial hypertension (PAH)—and to characterize healthcare resource utilization leading up to diagnosis using a nationwide US claims and an electronic health record (EHR) database from Optum©. Eligible patients were ≥18 years old at first CUD diagnosis (index event) and had a PAH diagnosis on or after index date. Based on administrative codes, PAH was defined as right heart catheterization (RHC), ≥ 2 PAH diagnoses (1 within a year of RHC), and ≥1 post‐RHC prescription for PAH treatment. All values are median (1st quartile–3rd quartile) unless otherwise stated. Of 854,722 patients with CUD in the claims database, 582 (0.1%) had PAH. Time from CUD to PAH diagnosis was 2.26 (0.73–4.22) years. PAH patients experienced 3 (2–4) transthoracic echocardiograms (TTEs), 6 (3–12) specialist visits, and 2 (1–4) hospitalizations during the diagnostic interval. Almost one‐third of patients (29%) waited 10 months or more to have a TTE. Findings from the EHR database were broadly similar. Resource utilization during the diagnostic interval was also analyzed in an overall PH cohort: findings were generally similar to the PAH cohort (2 [1–3] TTEs, 4 [2–9] specialist visits and 2 [1–4] hospitalizations). These data indicate a delay in the diagnostic pathway for PAH, and illustrate the burden associated with PAH diagnosis.https://doi.org/10.1002/pul2.12188chronic unexplained dyspnoeapulmonary arterial hypertensionUS electronic health recordsUS insurance claims |
| spellingShingle | Eva‐Maria Didden Eileen Lee Julie Wyckmans Deborah Quinn Loïc Perchenet Time to diagnosis of pulmonary hypertension and diagnostic burden: A retrospective analysis of nationwide US healthcare data Pulmonary Circulation chronic unexplained dyspnoea pulmonary arterial hypertension US electronic health records US insurance claims |
| title | Time to diagnosis of pulmonary hypertension and diagnostic burden: A retrospective analysis of nationwide US healthcare data |
| title_full | Time to diagnosis of pulmonary hypertension and diagnostic burden: A retrospective analysis of nationwide US healthcare data |
| title_fullStr | Time to diagnosis of pulmonary hypertension and diagnostic burden: A retrospective analysis of nationwide US healthcare data |
| title_full_unstemmed | Time to diagnosis of pulmonary hypertension and diagnostic burden: A retrospective analysis of nationwide US healthcare data |
| title_short | Time to diagnosis of pulmonary hypertension and diagnostic burden: A retrospective analysis of nationwide US healthcare data |
| title_sort | time to diagnosis of pulmonary hypertension and diagnostic burden a retrospective analysis of nationwide us healthcare data |
| topic | chronic unexplained dyspnoea pulmonary arterial hypertension US electronic health records US insurance claims |
| url | https://doi.org/10.1002/pul2.12188 |
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