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Vol 78, No 2 (2010)
ORIGINAL PAPERS
Published online: 2010-03-19
Submitted: 2013-02-22
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Patients with chronic obstructive pulmonary disease in the primary care setting

Hanna Siatkowska, Jerzy Kozielski, Dariusz Ziora
Pneumonol Alergol Pol 2010;78(2):112-120.

open access

Vol 78, No 2 (2010)
ORIGINAL PAPERS
Published online: 2010-03-19
Submitted: 2013-02-22

Abstract


Introduction: Chronic obstructive pulmonary disease (COPD) is one of the most important public health problems due to its high prevalence, progressive nature, and costs of treatment and care.
Material and methods: We enrolled 1026 patients in our study (86.3% of the registered patients) to assess the incidence and severity of COPD, the degree of underdiagnosis, the association with smoking, and the presence of co-morbidities.
Results: COPD was diagnosed in 8.1% of the subjects over the age of 40, most of whom were current or former smokers (90.3%). More than half of the subjects (61.3%) presented with mild disease, 35.5% with moderate disease, and 3.2% with severe disease. The development of COPD is most affected by the number of pack-years and age. In women, the development of COPD is associated with a smaller number of pack-years.
Conclusions: We found that COPD is underdiagnosed in the primary care setting, as only 1% of the subjects carried the correct diagnosis. One of the reasons why COPD goes underdiagnosed is that doctors do not perform spirometry often enough. Cardiovascular disease is significantly more prevalent in patients with COPD.
Pneumonol. Alergol. Pol. 2010; 78, 2: 112–120

Abstract


Introduction: Chronic obstructive pulmonary disease (COPD) is one of the most important public health problems due to its high prevalence, progressive nature, and costs of treatment and care.
Material and methods: We enrolled 1026 patients in our study (86.3% of the registered patients) to assess the incidence and severity of COPD, the degree of underdiagnosis, the association with smoking, and the presence of co-morbidities.
Results: COPD was diagnosed in 8.1% of the subjects over the age of 40, most of whom were current or former smokers (90.3%). More than half of the subjects (61.3%) presented with mild disease, 35.5% with moderate disease, and 3.2% with severe disease. The development of COPD is most affected by the number of pack-years and age. In women, the development of COPD is associated with a smaller number of pack-years.
Conclusions: We found that COPD is underdiagnosed in the primary care setting, as only 1% of the subjects carried the correct diagnosis. One of the reasons why COPD goes underdiagnosed is that doctors do not perform spirometry often enough. Cardiovascular disease is significantly more prevalent in patients with COPD.
Pneumonol. Alergol. Pol. 2010; 78, 2: 112–120
Get Citation

Keywords

COPD; epidemiology; spirometry; early diagnosis; cardiovascular diseases; family doctor

About this article
Title

Patients with chronic obstructive pulmonary disease in the primary care setting

Journal

Advances in Respiratory Medicine

Issue

Vol 78, No 2 (2010)

Pages

112-120

Published online

2010-03-19

Bibliographic record

Pneumonol Alergol Pol 2010;78(2):112-120.

Keywords

COPD
epidemiology
spirometry
early diagnosis
cardiovascular diseases
family doctor

Authors

Hanna Siatkowska
Jerzy Kozielski
Dariusz Ziora

References (46)
  1. World Bank/WHO Global Burden of Disease Study. http:www.who.int/topics/global burden_of_ disease (11.2007).
  2. Lopez AD, Shibuya K, Rao C, et al. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J. 2006; 27(2): 397–412.
  3. Prescott E. Tobacco-related diseases: the role of gender. Dan Med Bull. 2000; 47: 115–131.
  4. Antó JM, Vermeire P, Vestbo J, et al. Epidemiology of chronic obstructive pulmonary disease. Eur Respir J. 2001; 17(5): 982–994.
  5. Rozpoznawanie i leczenie przewlekłej obturacyjnej choroby płuc. Wytyczne Światowej Inicjatywy Zwalczania Przewlekłej Obturacyjnej Choroby Płuc (GOLD 2006). Med Prakt. 2007; 2: 13–16.
  6. Meek PA, Schwartzstein RM, Adams L, et al. Dyspnea. Mechanisms, assessment and management: a consensus statement. Am. J. Respir. Crit. Care Med. 1999; 159: 321–340.
  7. Zalecenia skiego Towarzystwa Chorób Płuc dotyczące wykonywania badań spirometrycznych. Pneumonol Alergol Pol. 2006; 74(supl. 1): 6–44.
  8. Quanier PH, Tammeling G, Cotes E, et al. Lung volumes and forced expiratory flows. Eur Respir J. 1993(supl. 6): 5–49.
  9. Enright PL, Kaminsky DA. Strategies for screening for chronic obstructive pulmonary disease. Respir. Care 2003; 48: 1194–1201. 10. Europejskie Towarzystwo ogiczne. Europejskie wytyczne dotyczące prewencji chorób układu krążenia w praktyce klinicznej. Kardiol Pol. 2004; 61(supl. 1): 1–92.
  10. Europejskie Towarzystwo ogiczne. Europejskie wytyczne dotyczące prewencji chorób układu krążenia w praktyce klinicznej. Kardiol Pol. 2004; 61(supl. 1): 1–92.
  11. Rennard S, Decramer M, Calverley PMA, et al. Impact of COPD in North America and Europe in 2000: subjects' perspective of Confronting COPD International Survey. Eur Respir J. 2002; 20(4): 799–805.
  12. Zieliński J. Profilaktyka POChP. Nowe zadanie dla lekarza rodzinnego. Lekarz Rodz. 2005; 7-8: 748–756.
  13. Chapman KR. Chronic obstructive pulmonary disease: are women more susceptible than men? Clin Chest Med. 2004; 25(2): 331–341.
  14. Soriano JB, Maier WC, Egger P, et al. Recent trends in physician diagnosed COPD in women and men in the UK. Thorax. 2000; 55(9): 789–794.
  15. Krawczyk K, Skucha W. Częstość występowania przewlekłej obturacyjnej choroby płuc wśród przewlekle palących tytoń mieszkańców Krakowa i Proszowic. Przegl Lek. 2000; 57: 617–618.
  16. Menzin J, Brown JS, Guadagno L, et al. Care-seeking behavior among subjects with early chronic obstructive lung disease identified through a community spirometry screening program: findings from the respiratory health promotion study (RHPS). Chest. 2006; 130: 170.
  17. Price DB, Tinkelman DG, Nordyke RJ, et al. COPD Questionnaire Study Group. Scoring system and clinical application of COPD diagnostic questionnaires. Chest. 2006; 129(6): 1531–1539.
  18. Halbert RJ, Isonaka S. International Primary Care Respiratory Group (IPCRG) Guidelines: integrating diagnostic guidelines for managing chronic respiratory diseases in primary care. Prim Care Respir J. 2006; 15(1): 13–19.
  19. Halbert RJ, Natoli JL, Gano A, et al. Global burden of COPD: systematic review and meta-analysis. Eur Respir J. 2006; 28(3): 523–532.
  20. Stratelis G, Jakobsson P, Molstad S, et al. Early detection of COPD in primary care: screening by invitation of smokers aged 40 to 55 years. Br J Gen Pract. 2004; 54(500): 201–206.
  21. Bednarek M, Pływaczewski R, Górecka D, et al. Wczesne rozpoznawanie POChP badaniem spirometrycznym u palących papierosy mieszkańców Warszawy. Pneumonol Alergol Pol. 2002; 70: 139–147.
  22. Lubiński W, Płusa T, Mierzejewska-Zawisza M, et al. Early detection of COPD in mass spirometry. Eur Respir J. 2002; 20(supl. 38): 123.
  23. Maciejewski J. Częstość występowania POChP w praktyce lekarza rodzinnego. Rozprawa doktorska, Instytut Gruźlicy i Chorób Płuc 2007.
  24. Grassi FT, Stafford C. The use of spirometry to screen patients with chronic obstructive pulmonary disease risk factors at a military treatment facility. Chest. 2006; 130: 174.
  25. Glaab T, Banik N, Singer C, et al. [Guideline conformance for outpatient management of COPD in Germany]. Dtsch Med Wochenschr. 2006; 131(21): 1203–1208.
  26. Bashford S, Chadwick S, et al. Identifying chronic obstructive pulmonary disease in the community — a primary care survey. Eur Respir J. 2002; 20(supl. 38): 413S.
  27. Damarla M, Celli BR, Mullerova HX, et al. Discrepancy in the use of confirmatory tests in patients hospitalized with the diagnosis of chronic obstructive pulmonary disease or congestive heart failure. Respir Care. 2006; 51(10): 1120–1124.
  28. Walker PP, Mitchell P, Diamantea F, et al. Effect of primary-care spirometry on the diagnosis and management of COPD. Eur Respir J. 2006; 28(5): 945–952.
  29. Zieliński J, Roszkowski-Śliż K. Narodowy program wczesnego rozpoznawania i profilaktyki POChP. Pneumonol Alergol Pol. 2002; 70: 125–129.
  30. Faulconer ER, de Lusignan S. An eight-step method for assessing diagnostic data quality in practice: chronic obstructive pulmonary disease as an exemplar. Inform Prim Care. 2004; 12(4): 243–254.
  31. Lindberg A, Bjerg A, Bjerg-Bäcklund A, et al. Prevalence and underdiagnosis of COPD by disease severity and the attributable fraction of smoking Report from the Obstructive Lung Disease in Northern Sweden Studies. Respir Med. 2006; 100(2): 264–272.
  32. Niepsuj G, Kozielski J, Niepsuj K, et al. Przewlekła obturacyjna choroba płuc wśród mieszkańców miasta Zabrze. Wiad Lek. 2002; 55(supl. 1): 354–359.
  33. Menezes AM, Perez-Padilla R, Jardim JR, et al. PLATINO Team. Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): a prevalence study. Lancet. 2005; 366(9500): 1875–1881.
  34. WordHealthOrganization.TobaccoAtlas. http://www.who.int/tobacco/global_data/country_profiles/amro/en/ (11.2007).
  35. Buist AS, McBurnie MA, Vollmer WM, et al. BOLD Collaborative Research Group. International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet. 2007; 370(9589): 741–750.
  36. Fukuchi Y, Nishimura M, Ichinose M, et al. COPD in Japan: the Nippon COPD Epidemiology study. Respirology. 2004; 9(4): 458–465.
  37. Peña VS, Miravitlles M, Gabriel R, et al. Geographic variations in prevalence and underdiagnosis of COPD: results of the IBERPOC multicentre epidemiological study. Chest. 2000; 118(4): 981–989.
  38. Sin DD, Man SF. Systemic inflamation and mortality in chronic obstructive pulmonary disease. Can J Physiol Pharmacol. 2007; 85: 141–147.
  39. Lee JH, Lee DS, Kim EK, et al. Simvastatin inhibits cigarette smoking-induced emphysema and pulmonary hypertension in rat lungs. Am J Respir Crit Care Med. 2005; 172(8): 987–993.
  40. Dhungel S, Paudel B, Shah S. Study of prevalence of hypertension in Chronic Obstructive Pulmonary Disease patients admitted at ical ege and Teaching Hospital. Nepal Med Coll J. 2005; 7: 90–92.
  41. Hozawa A, Billings JL, Shahar E, et al. Lung function and ischemic stroke incidence: the Atherosclerosis Risk in Communities study. Chest. 2006; 130(6): 1642–1649.
  42. Löfdahl CG, Postma DS, Pride NB, et al. Possible protection by inhaled budesonide against ischaemic cardiac events in mild COPD. Eur Respir J. 2007; 29(6): 1115–1119.
  43. Sidney S, Sorel M, Quesenberry CP, et al. COPD and incident cardiovascular disease hospitalizations and mortality: Kaiser Permanente Medical Care Program. Chest. 2005; 128(4): 2068–2075.
  44. Rascon-Aguilar IE, Pamer M, Wludyka P, et al. Role of gastroesophageal reflux symptoms in exacerbations of COPD. Chest. 2006; 130(4): 1096–1101.
  45. Phulpoto MA, Qayyum S, Rizvi N, et al. Proportion of gastroesophageal reflux symptoms in patients with chronic obstructive pulmonary disease. J Pak Med Assoc. 2005; 55(7): 276–279.
  46. Casanova C, Baudet JS, del Valle Velasco M, et al. Increased gastro-oesophageal reflux disease in patients with severe COPD. Eur Respir J. 2004; 23(6): 841–845.

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