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Observational Study
. 2025 Feb 14:20:325-334.
doi: 10.2147/COPD.S479853. eCollection 2025.

Real-World Evaluation of an EHR-Enabled Chronic Obstructive Pulmonary Disease Assessment Test

Nathaniel Gaeckle  1 , Edward Corazalla  2 , Judy S Kelloway  3 , Joshua N Liberman  4 , Jonathan David Darer  4 , Kristin Kahle-Wrobleski  5 , Rosirene Paczkowski  5 , Purva Parab  4 , Charles Ruetsch  4
Affiliations
Observational Study

Real-World Evaluation of an EHR-Enabled Chronic Obstructive Pulmonary Disease Assessment Test

Nathaniel Gaeckle et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: The Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) measures COPD's impact on well-being and daily activities and is a recommended assessment by the Global Initiative for Obstructive Lung Disease (GOLD). Our research objective was to describe a real-world CAT implementation, including the association of CAT scores with subsequent treatment and clinical outcomes.

Patients and methods: A retrospective, observational, comparative cohort study was conducted among adults with COPD who received care from M Health Fairview, a US healthcare delivery system. Eligible patients had an initial electronic health record (EHR) enabled CAT administration (index) between 8/2017 and 12/2021. Patients were grouped by score (<10 [low impact]; 11-20 [moderate]; and 21-40 [high]). Demographics, comorbidities, provider specialty, and exacerbation history were derived from EHR data in the 12 months preceding index.

Results: Of 11,194 eligible individuals, 821 (7.3%) were administered CAT (cases). Compared to individuals with no documented CAT scores (comparators), cases were older (66.7 vs 63.9 years; p < 0.05) and had higher rates of comorbidities (93.9% vs 79.2%, p < 0.05) and exacerbations (0.31 vs 0.14 PPPY). A total of 61.5% of pulmonologists and 11.5% of primary care providers (PCPs) administered the CAT at least once. Repeated use was more common among pulmonologists (55.7%) than PCPs (7.0%). Medication intensification was most common (28.1%) among individuals with high CAT scores, followed by moderate (21.6%), and low (10.0%). Post-index exacerbations were experienced by 24.2%, 17.4%, and 7.7% of patients with high, moderate, and low CAT scores.

Conclusion: In a real-world practice setting, few patients with COPD received a CAT, although pulmonologists demonstrated repeated use. Higher CAT scores were associated with COPD medication regimen intensification and exacerbations. Further investigation on how to incorporate the CAT into routine care and optimize its impact on medical decision making and evaluation is warranted.

Keywords: COPD Assessment Test; Clinical Relevance, MeSH; Patient Reported Outcome Measures, MeSH; Pulmonary Disease, Chronic Obstructive, MeSH.

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Conflict of interest statement

All authors are either employed by GSK or supported by a contracted research services agreement to support this initiative. Nathaniel Gaeckle and Edward Corazalla received grant funding from GSK. Judy Kelloway, Kristin Kahle-Wrobleski and Rosirene Paczkowski are employees of, and hold financial equities in, GSK. Joshua N Liberman, Purva Parab, Jonathan Darer and Charles Ruetsch have received personal compensation for serving as an employee of Health Analytics, LLC. The Institution of Health Analytics has received research support from GSK. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study Schematic.
Figure 2
Figure 2
Monthly percentage of COPD visits with CAT administration, by provider specialty.
See this image and copyright information in PMC

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