MINNEAPOLIS/ST. PAUL (10/16/2023) — People living in rural areas, those facing longer drive times to specialized care and those seeing multiple providers for full care were more likely to receive suboptimal inhaler regimens after being hospitalized, according to new research published in The Lancet Regional Health - Americas. New insights from this research by University of Minnesota Medical School and Minneapolis VA Health Care System researchers come from a careful study of the impact geographic factors have on the prescription of inhalers for patients recovering from a chronic obstructive pulmonary disease (COPD) exacerbation. 

“To address gaps in the literature, we used the national Veterans Health Administration (VA) electronic health record data to examine receipt of guideline-discordant inhaler regimens among patients discharged from the hospital for COPD exacerbation by rurality, drive time to the closest pulmonary specialty care and fragmented care,” said Arianne Baldomero, MD, MS, an assistant professor at the U of M Medical School.

Their findings reveal that patients in rural areas, facing longer drive times to specialized care and experiencing care fragmentation, were more likely to receive suboptimal inhaler regimens post-hospitalization.

“This work could help tailor health system efforts by contributing to our understanding of how factors such as geographical access to and fragmentation of health care are associated with the delivery of guideline-discordant care for patients with COPD,” Dr. Baldomero said.

The researchers recommend the development of proactive healthcare delivery methods tailored for high-risk COPD patients facing geographic challenges. Dr. Baldomero and her team plan to engage stakeholders, including rural patients and caregivers, primary care providers, clinic staff and VA leadership, to design effective programs for improving care delivery.

The study was funded by the National Institutes of Health National Center for Advancing Translational Sciences (NCATS) grants KL2TR002492 and UL1TR002494.


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