COPD in Taiwan: a National Epidemiology Survey

Abstract

ObjectivesTo determine the prevalence of COPD in Taiwan and to document the disease characteristics and associated risk factors.MethodsWe conducted a random cross-sectional national survey of adults older than 40 years in Taiwan. Respiratory health screening questions identified subjects with diagnosed COPD or whose reported symptoms also fulfilled an epidemiological case definition; these were eligible to complete the survey, which also included indices of symptom severity and disability and questions on comorbidities, medical treatments, smoking habits, and occupations potentially harmful to respiratory health. Subjects with diagnosed COPD were subdivided by smoking status. Subjects who fulfilled the case definition of COPD and smoked were designated as “possible COPD”. Participants who did not fit the case definition of COPD were asked only about their personal circumstances and smoking habits. Data from these groups were analyzed and compared.ResultsOf the 6,600 participants who completed the survey, 404 (6.1%) fulfilled the epidemiological case definition of COPD: 137 with diagnosed COPD and 267 possible COPD. The most common comorbidities of COPD were hypertension or cardiovascular diseases (36.1%). Subjects with definite COPD had significantly higher COPD Assessment Test scores than the possible COPD group (14.6±8.32 vs 12.6±6.49, P=0.01) and significantly more comorbid illnesses (P=0.01). The main risk factors contributing to health care utilization in each COPD cohort were higher COPD Assessment Test scores (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.04–1.26), higher modified Medical Research Council Breathlessness Scale scores (OR 1.97, 95% CI 1.11–3.51), and having more than one comorbidity (OR 5.19, 95% CI 1.05–25.61).ConclusionWith estimated prevalence of 6.1% in the general population, COPD in Taiwan has been underdiagnosed. Symptoms and comorbidities were independent risk factors for health care utilization in subjects with definite or possible COPD. There is an urgent need to raise awareness of the importance of early evaluation and prompt treatment for subjects with chronic airway symptoms.

Trends in health care resource utilization and pharmacological management of COPD in Taiwan from 2004 to 2010

“…A previous study that used a population-based questionnaire survey has reported a COPD prevalence rate of 6.1% among adults who were 40 years or older in Taiwan. 10 The frequency of exacerbation and unplanned health care utilization and the delivery format of the prescribed medication have also been reported. 11 However, detailed health care resource utilization, pharmacologic management, and medical costs of the COPD patients were not reported.…”

Association of asthma–chronic obstructive pulmonary disease overlap syndrome with coronary artery disease, cardiac dysrhythmia and heart failure: a population-based retrospective cohort study

“…In the study by Cheng et al , patients with COPD underwent chest X-ray (84.7%), PFT (58.4%) and CT (39.4%) in a hospital; the results of those examinations support the diagnosis of COPD in the NHIRD. 25 The non-ACOS 26 cohort included patients without either asthma or COPD. 27 …”

Associations among chronic obstructive pulmonary disease with asthma, pneumonia, and corticosteroid use in the general population

“…Shantakumar et al reported that ICSs and OSs use were 46.1% and 85.5% during 1-year follow-up in the COPD with asthma cohort, respectively [25]. A study of the prevalence of COPD in Taiwan revealed that patients with COPD received examinations such as CXR (84.7%), CT (39.4%), and PFT (58.44%) and were ever-smokers (82.9%) [36]. In our study, the non-ACO cohort was derived from the pure COPD cohort.…”

“…Forth, cytokine data were not retrieved from the NHIRD. Fifth, the COPD patients have the frequency of ever-smoker up to 82.9% in another Taiwan study [36]. We derived this COPD with asthma cohort from the COPD patients, therefore the largely portion of COPD with asthma cohort have the smoking history in this study.…”