11% (33.90-37.12) smokers diagnosed by cooximetry p < 0.05. 288 active smokers had low motivation (49.80%), high dependence (49.5%), negative attitude (52.60%), low mood (32.05%), with 2.72 (1.74-3.67) attempts to quit smoking, p < 0.0001. The conductive-behavioral therapy (CBT) combined with drug treatment was performed in 55.8% (52.2 to 54.9), p < 0.05; the most effective intervention was CBT combined with varenicline achieving an abstinence of 29.86%. A total of 51.05% (49.49 to 52.70) out of the patients with COPD stopped smoking, p < 0.001. Conclusions: The prevalence of smoking in COPD in our environment remains unacceptably high. Greater involvement is required to reduce its impact on the health of these patients.

Objective: To estimate the prevalence of chronic obstructive pulmonary disease (COPD) phenotypes in the province of Leon. Methods: Multicenter epidemiological cross-sectional study (30 health centers in the province of Leon). It included patients older than 35 years diagnosed and treated for COPD. Study variables: age, sex, habitat, anthropometric data, smoking, postbronchodilator spirometry, dyspnea (mMRC), exacerbations, severity (Bodex Index), hospitalization, treatment, monitoring and characterization of the phenotype (GesEOPC 2014 3) exacerbator with chronic bronchitis, p < 0.05. In the not exacerbator phenotype mild forms predominate and are controlled by general practitioner doctors. In the exacerbator phenotypes severe forms predominate and monitoring is shared by GP doctors and pulmonologists. Exacerbations are more common in exacerbator phenotypes with chronic bronchitis (40%), emphysema (27%) and FMEA (23%), p = 0.004. The exacerbator phenotype with chronic bronchitis have exacerbations an average of 6.4, 4 hospitalitations and 4 drugs prescribed/year. The exacerbator phenotype with emphysema have 5.7 exacerbations, 2.8 hospitalitations and 3.1 drugs prescribed/year. The FMEA have an average of 5 exacerbations, 1 hospitalitation and 2.6 prescribed drugs/year, p < 0.001. Conclusions:The clinical phenotypes are postulated as prognostic and therapeutic targets. Knowing its prevalence enables personalized treatment planning and better reallocation of resources for control and monitoring of COPD. ResumenObjetivo: estimar la prevalencia de los fenotipos de enfermedad pulmonar obstructiva crónica (EPOC) en la provincia de León. Métodos: estudio epidemiológico, transversal, multicéntrico (30 centros de salud de la provincia de León). Incluyó pacientes mayores de 35 años diagnosticados y tratados de EPOC. Variables a estudio: edad, sexo, hábitat, datos antropométricos, tabaquismo, espirometría posbroncodilatadora, disnea (mMRC), reagudizaciones, gravedad (índice Bodex), hospitalizaciones, tratamiento, seguimiento y caracterización del fenotipo (GesEOPC 2014). Los resultados se expresan con sus IC al 95,5%. Resultados: se incluyeron 833 pacientes, el 85,8% varones, edad media: 64,69 (53,66-75,61) años y 20,65 (4,47-36,8) años de evolución de la EPOC. El 86,67% (80,30) habían fumado. Prevalencia de fenotipos: 58,8% (55,2-61,9) no agudizador, 13,6% (11,(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)3) FMEA,10,8% (8,(8)(9)(10)(11)(12)(13)3) agudizador con enfi sema y 16,7% (14,2-19,3) agudizador con bronquitis crónica, p < 0,05. En el fenotipo no reagudizador predominan las formas leves y son controlados por médicos de familia. En los agudizadores predominan las formas graves y el seguimiento es compartido por médicos de familia y neumólogos. Las reagudizaciones son más frecuentes en los fenotipos agudizadores con bronquitis crónica (40%), con enfi sema (27%) y FMEA (23%), p = 0,004. Los fenotipos agudizadores con bronquitis crónica tienen una media de 6 reagudizaciones, 4 ingresos y 4 fármacos prescrit...

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Objectives: To estimate the percentage of patients with COPD trained in the consultation for the management of inhalers in the province of Leon. Methods: Multicenter epidemiological cross-sectional study (30 health centers in the province of Leon). It included patients older than 35 years diagnosed and treated for COPD. Study variables: age, sex, habitat, anthropometric data, nutritional status, smoking, post bronchodilator spirometry, dyspnea (mMRC), exacerbations, severity (Bodex Index), hospitalization, treatment, monitoring and characterization of the phenotype (GesEPOC 2014). Results are expressed with CI 95.5%. Results: Eight hundred and thirty-three patients were included. 85.8% male with an average age of 64.69 (53.66 to 75.61) and 20.65 years (4.47 to 36.8) years course of COPD. An average of 1.88% (1.64 to 2.16) employed inhaler devices, p = 0.006, (57% correctly, 23% regularly ok and 20% incorrectly). 20.9% received no training to use inhalers against 79.1% who were trained to do so, p < 0.001 (9.4% by pneumologists, 20.3% by nurses and 43.5% by family physicians, p = 0.002). Well-trained patients performed better the treatment in 60.60% of the cases (58.91 to 62.29), p = 0.002. There were no signifi cant differences in training by smoking, severity, hospital admissions, or quality of life, resulting in a signifi cant reduction in the number of exacerbations, being 1.59 (1.12 to 2.15) the average of exacerbations in the trained group versus 3.29 (2.50 to 4.11) in the untrained, p = 0.002. Conclusions: The degree of training in the use of inhalers in patients with COPD is poor in our midst. A better training of our professionals and simplifying the inhaler devices contribute to an increased number of patients who fulfi ll the treatment properly. ResumenObjetivos: estimar el porcentaje de pacientes con EPOC adiestrados en la consulta para el manejo de inhaladores en la provincia de León. Métodos: estudio epidemiológico, transversal, multicéntrico (30 centros de salud de la provincia de León). Incluyó pacientes mayores de 35 años diagnosticados y tratados de EPOC. Variables a estudio: edad, sexo, hábitat, datos antropométricos, estado nutricional, tabaquismo, espirometría postboroncodilatadora, disnea (mMRC), reagudizaciones, gravedad (Índice Bodex), hospitalizaciones, tratamiento, seguimiento y caracterización del fenotipo (GesEOPC 2014). Los resultados se expresan con sus IC al 95,5%. Resultados: se incluyeron 833 pacientes, el 85,8% varones, con edad media de 64,69 (53,66-75,61) años y 20,65 (4,47-36,8) años evolución de la EPOC. Empleaban 1,88 (1,64-2,16) dispositivos inhaladores de media, p = 0,006, (57% de forma correcta, 23% regular y el 20% incorrecta). El 20,9% no recibieron adiestramiento para usar inhaladores frente al 79,1% adiestrados, p < 0,001, (9,4% por neumólogos, 20,3% enfermeras y 43,5% médicos familia, p = 0,002). Los pacientes bien adiestrados realizan mejor el tratamiento, en el 60,60% (58,29), p = 0,002. No hubo diferencias signifi cativas en el adiestramiento por tabaquism...