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CAT score as the primary outcome used to investigate the association between IDM intervention duration and improvement in CAT score. Change in CAT score from baseline to each follow-up visit determined by using least-squares means (LSMeans) approach. The cut-off value of IDM duration for improving the CAT score was determined by the Youden index. Logistic regression was used to analyze the relationship between IDM intervention duration and MCID (the minimal clinically important difference) improvement in CAT score and the factor associated CAT improvement. Risks of COPD exacerbation events (COPD-related ED visit and COPD-related hospitalization) were estimated by using the cumulative incidence curve and Cox proportional hazards models.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Result<\/jats:title>\n                <jats:p>Among 3771 enrolled COPD patients, the majority of the study cohort were males (91.51%) and 42.7% of patients had CAT score of\u2009\u2265\u200910 at baseline. The mean of age was 71.47\u00a0years and the mean CAT at baseline were 10.49. The mean change from baseline in CAT score was \u2212\u00a00.87, \u2212\u00a01.19, \u2212\u00a01.23 and \u2212\u00a01.40 at 3-, 6-, 9- and 12\u00a0month follow-up (p\u2009&lt;\u20090.0001 for all visits), respectively. Statistically significantly lower likelihood of achieving MCID improvement in CAT were observed at 3- and 6\u00a0month compared to 9\u00a0month (at 3\u00a0month: OR: 0.720, 95% CI 0.655\u20130.791; at 6\u00a0month: OR: 0.905, 95% CI 0.825\u20130.922). And only a modest increase likelihood of achieving MCID improvement in CAT at 12\u00a0month (OR: 1.097, 95% CI 1.001\u20131.201) compared with 9-month follow-up. In logistic regression on the entire cohort, CAT MCID improvement was most associated with baseline CAT scores\u2009\u2265\u200910, followed by frequent exacerbation in previous year (&gt;\u20092 episodes\/year), wheezing, and GOLD B or D at baseline. In baseline CAT\u2009\u2265\u200910 group, patients were more likely to achieve CAT MCID improvement and had greater decreases from baseline in CAT score observed at 3-, 6-, 9-, and 12\u00a0month compared with baseline CAT score\u2009&lt;\u200910 group (all p\u2009&lt;\u20090.0001). Moreover, in CAT\u2009\u2265\u200910 groups, patients who achieved CAT MCID improvement had lower risk of subsequent COPD exacerbation events (COPD-related ED visit: aHR: 1.196, 95% CI 0.985\u20131.453, p\u2009=\u20090.0713; COPD-related hospitalization: aHR: 1.529, 95% CI 1.215\u20131.924, p\u2009=\u20090.0003) when compared to those without.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This is the first real-world study indicating the association between COPD IDM intervention duration and COPD-related outcomes. From 3 to 12\u00a0month follow-up results showed that continued improvement over time in COPD-specific health status, particularly in patients with baseline CAT score of\u2009\u2265\u200910. Furthermore, a reduction of the risk of subsequent COPD exacerbations were observed in patients with CAT MCID improvement.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40001-023-01136-0","type":"journal-article","created":{"date-parts":[[2023,5,23]],"date-time":"2023-05-23T07:02:22Z","timestamp":1684825342000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The impact of the duration of the integrated disease management program on COPD-related outcomes"],"prefix":"10.1186","volume":"28","author":[{"given":"Ching-Hsiung","family":"Lin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Rong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bing-Yen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng-Hao","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuo-Yang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Hsiung","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chew-Teng","family":"Kor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,5,23]]},"reference":[{"issue":"10342","key":"1136_CR1","doi-asserted-by":"publisher","first-page":"2227","DOI":"10.1016\/S0140-6736(22)00470-6","volume":"399","author":"SA Christenson","year":"2022","unstructured":"Christenson SA, Smith BM, Bafadhel M, Putcha N. 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