Comparing health status between patients with COPD in primary, secondary and tertiary care

Abstract

In this study, we compare health status between COPD patients treated in three different care levels in the Netherlands and assess determinants that influence their health status. We applied the Nijmegen Clinical Screening Instrument to measure eight health status subdomains in primary (n = 289), secondary (n = 184) and tertiary care (n = 433) COPD patient cohorts. Proportions of patients with severe problems in ≥3 subdomains are 47% in primary, 71% in secondary and 94% in tertiary care. Corrected for patient characteristics, differences between the care levels are statistically significant for nearly all health status subdomains. The pooled cohort data show female sex, age, FEV1 % predicted and BMI to be determinants of one or more subdomains. We conclude that the proportion of COPD patients with severe health status problems is substantial, not just in tertiary care but also in primary and secondary care. Use of detailed health status information may support patient-tailored COPD care.

Prevalence of hyperventilation in patients with asthma

“…This might limit the generalizability of the findings for instance to patients treated in primary care. It should be noted however, that disease severity of pulmonary patients treated in the different echelons of the healthcare system show considerable overlap and these differences might be lesser than expected (32). The cross-sectional study design we employed, precludes obviously any conclusions regarding changes over time of the presence of hyperventilation, and this requires additional research.…”