Outcomes with High-Frequency Chest Wall Oscillation Among Patients with Non-CF
Bronchiectasis or COPD
Download PDF Derek Weycker Ph.D.1, Gary L. Hansen Ph.D.2, Frederic D. Seifer M.D.3 1Policy Analysis Inc. (PAI), Brookline, MA, 2RespirTech, St Paul, MN, 3St. Lawrence Health System, Potsdam, NY
The poster was presented at the American Thoracic Society (ATS) meeting in Washington, DC, May 21, 2017
Abstract
High-frequency chest wall oscillation (HFCWO) has gained acceptance for treating airway clearance issues in patients with non-CF bronchiectasis (BE), either by itself or combined with chronic obstructive pulmonary disease (COPD). Little is known about the effectiveness of HFCWO for patients with COPD who lack a diagnosis of BE (COPD-only).
Using a large commercial database of healthcare claims, patients who had an initial claim for HFCWO and a diagnosis of BE or COPD-only (865 and 135, respectively). Mean healthcare utilization for any reason was calculated for the three months prior to and the three months after initiating HFCWO therapy.
Number of hospitalizations, physician office visits, emergency department visits, and prescriptions were lower during the period following start of HFCWO therapy. These findings were true for both BE and COPD-only groups.
Method
- A retrospective pre/post-cohort design and data from a healthcare claims repository were employed:
- Data were deidentified and thus exempt from IRB approval.
- The study population included all patients who had ≥1 encounter for HFCWO therapy between January 2010 and December 2012 and, at any time on or before the first encounter for HFCWO therapy, had evidence of BE (irrespective of COPD) or COPD-only (i.e., without BE).
- Study outcomes–including selected measures of all-cause healthcare utilization–were evaluated during the three-month period before and three-month period after initiation of HFCWO therapy.
- Statistical comparisons were undertaken using a dependent-samples t-test, and were adjusted for differential follow-up.

Table 1. All-cause healthcare utilization for patients with BE (with or without COPD) and COPD (without BE). Mean values for utilization are provided for the three-month periods before and after initiation of HFCWO therapy. (NS) indicates not statistically significant.

Figure 1. The change in all-cause healthcare utilization for patients with BE (with or without COPD) and COPD (without BE), comparing the three-month periods before and after initiation of HFCWO therapy. (NS) indicates not statistically significant.
Discussion
- HFCWO has found increasing acceptance in treating adults with non-CF bronchiectasis.
- Studies have found HFCWO to be effective for non-CF bronchiectasis1 and also for COPD when the status of BE was unknown.2-4
- The paucity of published results for COPD-only patients may be due, in part, to the lack of reimbursement for this condition.
- These data suggest that HFCWO is effective in COPD patients without recognized bronchiectasis.
- More research is needed to confirm these findings.