Respiratory medicine · 2026
Sex Differences in Delivery of Guideline-Recommended COPD Care: A National U.S. Cohort.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hamann Kayla M, Wendt Chris H, Baldomero Arianne K
Аннотация
BACKGROUND: Sex-based differences in chronic obstructive pulmonary disease (COPD) outcomes are well documented, but sex disparities in the delivery of evidence-based, guideline-recommended care remain insufficiently understood. We aimed to compare the receipt of guideline-recommended COPD care between females and males in a national U.S.
METHODS: We performed a retrospective cohort study using national Veterans Health Administration data among individuals with ≥2 encounters with ICD-9 or ICD10 for COPD between 2012-2020. We compared receipt of guideline-recommended COPD care among females vs. males. Outcomes included diagnostic confirmation via spirometry, maintenance inhaler prescription and tobacco cessation interventions. Females and males were age-matched at a 1:4 ratio. We used multivariable logistic regression to assess the associations between odds of receiving guideline-recommended COPD care for females vs males, adjusting for age, race/ethnicity, Charlson Comorbidity Index, and Social Vulnerability Index.
RESULTS: Among 882,292 individuals with COPD, 34,645 (3.9%) were females. After 1:4 age matching, the final analytic cohort included 173,225 individuals (34,645 females and 138,580 males). In adjusted analyses, females had higher odds of receiving confirmatory spirometry (aOR 1.24 [95%CI: 1.21-1.27]) and tobacco cessation intervention (aOR 1.23 [95%CI: 1.20-1.27]) compared to males; females had lower odds of receiving maintenance inhaler prescriptions (aOR 0.86 [95%CI: 0.84-0.89).
CONCLUSION: Both female and male patients experience suboptimal receipt of guideline-recommended COPD care in this national cohort. However, females more frequently received spirometry and tobacco cessation but less maintenance inhaler therapy than males, underscoring the need for targeted strategies to address these gaps and ensure equitable, guideline-based care for all.
METHODS: We performed a retrospective cohort study using national Veterans Health Administration data among individuals with ≥2 encounters with ICD-9 or ICD10 for COPD between 2012-2020. We compared receipt of guideline-recommended COPD care among females vs. males. Outcomes included diagnostic confirmation via spirometry, maintenance inhaler prescription and tobacco cessation interventions. Females and males were age-matched at a 1:4 ratio. We used multivariable logistic regression to assess the associations between odds of receiving guideline-recommended COPD care for females vs males, adjusting for age, race/ethnicity, Charlson Comorbidity Index, and Social Vulnerability Index.
RESULTS: Among 882,292 individuals with COPD, 34,645 (3.9%) were females. After 1:4 age matching, the final analytic cohort included 173,225 individuals (34,645 females and 138,580 males). In adjusted analyses, females had higher odds of receiving confirmatory spirometry (aOR 1.24 [95%CI: 1.21-1.27]) and tobacco cessation intervention (aOR 1.23 [95%CI: 1.20-1.27]) compared to males; females had lower odds of receiving maintenance inhaler prescriptions (aOR 0.86 [95%CI: 0.84-0.89).
CONCLUSION: Both female and male patients experience suboptimal receipt of guideline-recommended COPD care in this national cohort. However, females more frequently received spirometry and tobacco cessation but less maintenance inhaler therapy than males, underscoring the need for targeted strategies to address these gaps and ensure equitable, guideline-based care for all.