Disease Onset and Burden in Patients With Chronic Bronchitis and COPD: A Real-World Evidence Study.

Chronic bronchitis (CB), classically defined as having cough and sputum production for at least three months per year for two consecutive years, is frequently associated with COPD. This retrospective cohort study using the Optum® de-identified Electronic Health Record data set (Optum® EHR) aimed to identify patients with CB, COPD and both CB and COPD through application of the classical definition of CB, and to compare the characteristics of these populations, timing of diagnosis as well as their healthcare resource utilization (HCRU). Scanning of the EHRs was performed electronically using a specially developed algorithm. Of 104,633,876 patients in the study period between January 2007 to September 2020, 628,545 patients had CB only (i.e., non-obstructive disease),129,084 had COPD only (COPD cohort) and 77,749 had both COPD and CB (COPD-CB cohort). 75.9% of patients (59,009/77,749) fulfilled the criteria for CB diagnosis before their first diagnosis with COPD, compared with 24.1% who had COPD before being diagnosed with CB. HCRU over five years was highest in the COPD-CB cohort, whereas the COPD cohort and CB cohorts had similar HCRU over five years. The COPD-CB cohort had a greater percentage of common COPD comorbidities and exposure to more drug classes than the other cohorts. These results highlight the importance of increased attention to CB. CB often precedes the diagnosis of COPD and subsequently leads to high HCRU. Interventions to better manage CB and prevent progression of CB to COPD could improve morbidity in this population.