COPD prevalence and the differences between newly and previously diagnosed COPD patients in a spirometry program

Abstract

Aims: To evaluate the prevalence and severity of COPD in a primary care population participating in a spirometry program. Differences between newly and previously diagnosed COPD patients were identified.Methods: A spirometry program was conducted in 15 primary care centres. Visitors aged over 30 years who were willing to perform spirometry were included in this program.Results: A total of 1,526 subjects provided acceptable spirometries. COPD prevalence in our population was 18.4%, of whom 69.0% were newly diagnosed. Most patients were classified as GOLD stages I and II (26.0% and 54.0%, respectively). COPD diagnosis was related to gender (men), age (older subjects), history of repeated respiratory infection in childhood, smoking (>10 pack-years) and presence of symptoms (cough, dyspnoea, wheezing). Variables related to newly diagnosed COPD were younger age and absence of chronic cough. Conclusions:A primary care spirometry program may identify a large proportion of undiagnosed COPD patients especially in the early stages of the disease. Newly diagnosed COPD patients were of younger age and presented with less symptoms. These results support the need for spirometry programs in primary care for early COPD detection.

Impact of the financial crisis on COPD burden: Greece as a case study

“…A number of studies have shown that COPD has been more prevalent among smokers, older adults and males in Greece [31][32][33]35]. COPD patients have displayed this profile both pre-crisis and throughout the crisis period.…”

“…There is a linear increase in COPD prevalence with patients age [25,[31][32][33]. The average age of COPD patients across studies was 71 and 68 years for the pre- [33] and post-crisis period [35], respectively. Comparably, global estimates have reported that 40% of patients are aged 40-60 years and 30% are aged >60 years [25].…”

“…A study published 1 year later, performed in northern Greece and including the population over an extended age range, reported a lower COPD prevalence rate of 5.6% [32]. One of the latest studies conducted before the Greek crisis began (from January 2006 to June 2007) included 15 primary healthcare centres in central Greece and documented a prevalence rate of 18.4% [33]. In contrast, a report from Cyprus found a lower COPD prevalence of 4.9% in 2008 [34].…”

“…Similarly, a study performed after the onset of the economic crisis found that 32.5% of newly diagnosed COPD patients were living in Athens and 32% in other urban areas [35]. A proposed explanation for this geographic variation in COPD rates is the limited access to spirometry in rural areas of Greece, which is strongly evident before and after the crisis [33]. It is well documented that in primary healthcare settings in Greece there are a lack of specialised pulmonologists to perform spirometry, as well as a lack of training and feedback in diagnostic spirometry for general practitioners, both of which are major barriers to spirometry use [38][39][40][41].…”

“…It is well documented that in primary healthcare settings in Greece there are a lack of specialised pulmonologists to perform spirometry, as well as a lack of training and feedback in diagnostic spirometry for general practitioners, both of which are major barriers to spirometry use [38][39][40][41]. Thus, the percentage of undiagnosed patients in primary healthcare settings is estimated to be very high, both pre- [33,39] and post-crisis [38,40,41]. Notably, the study of SPYRATOS et al [38] reported that 52.6% of COPD cases remained undiagnosed.…”