Gender and the Diagnosis, Management, and Surveillance of Chronic Obstructive Pulmonary Disease

Camp, Pat G.; Goring, Sarah

doi:10.1513/pats.200706-081sd

Cited by 54 publications

(47 citation statements)

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“…9,10,[16][17][18] Women with COPD tend to be more depressed than men. 19 Nevertheless, Model 2 (adjusted for depression) showed an independent effect for gender, suggesting that, in our data, the higher risk of drug interruptions exhibited by women may not be driven by depression alone.…”

Section: Discussioncontrasting

confidence: 59%

Correlates of adherence to respiratory drugs in COPD patients

Laforest¹,

Denis

Ganse³

et al. 2010

Primary Care Respiratory Journal

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Aims: To identify the correlates of accidental omissions and intentional interruptions of respiratory therapy in COPD.Methods: COPD patients (GOLD stages II-IV) were recruited by general practitioners or respiratory physicians. Patients reported in selfreport questionnaires their adherence to respiratory drugs (over the past three months) and their perception of therapy.Results: 179 patients were included (mean age 63 years, 24% females). 45% forgot their respiratory therapy, while 30% interrupted it in the absence of any perceived benefit. The risks of accidental omissions were significantly higher when patients complained about having too many medications to take on a daily basis (OR=2.35; 95%CI=1.13-4.89), and among current smokers (OR=2.14; 95%CI=1.07-4.29). Females were more likely to interrupt therapy intentionally (OR=2.40; 95%CI=1.04-5.53). Surprisingly, there was no significant relationship with the number of drugs actually taken by patients.Conclusions: Adherence to respiratory drugs is inadequate in COPD patients. In order to improve adherence, patients' perception of the burden of therapy should not be overlooked.

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Section: Discussioncontrasting

confidence: 59%

Correlates of adherence to respiratory drugs in COPD patients

Laforest¹,

Denis

Ganse³

et al. 2010

Primary Care Respiratory Journal

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“…It is not known if females perceive their symptoms differently, seek medical aid more frequently, or are genuinely more prone to exacerbations than men 39,40. Studies have shown both biological and cultural associations between sex and respiratory disease 41.…”

Section: Discussionmentioning

confidence: 99%

Incidence of utilization- and symptom-defined COPD exacerbations in hospital- and population-recruited patients

Erdal

Johannessen

Eagan

et al. 2016

COPD

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ObjectivesThe objectives of this study were to estimate the impact of recruitment source and outcome definition on the incidence of acute exacerbations of COPD (AECOPD) and explore possible predictors of AECOPD.Patients and methodsDuring a 1-year follow-up, we performed a baseline visit and four telephone interviews of 81 COPD patients and 132 controls recruited from a population-based survey and 205 hospital-recruited COPD patients. Both a definition based on health care utilization and a symptom-based definition of AECOPD were applied. For multivariate analyses, we chose a negative binomial regression model.ResultsCOPD patients from the population- and hospital-based samples experienced on average 0.4 utilization-defined and 2.9 symptom-defined versus 1.0 and 5.9 annual exacerbations, respectively. The incidence rate ratios for utilization-defined AECOPD were 2.45 (95% CI 1.22–4.95), 3.43 (95% CI 1.59–7.38), and 5.67 (95% CI 2.58–12.48) with Global Initiative on Obstructive Lung Disease spirometric stages II, III, and IV, respectively. The corresponding incidence rate ratios for the symptom-based definition were 3.08 (95% CI 1.96–4.84), 3.45 (95% CI 1.92–6.18), and 4.00 (95% CI 2.09–7.66). Maintenance therapy (regular long-acting muscarinic antagonists, long-acting beta-2 agonists, inhaled corticosteroids, or theophylline) also increased the risk of AECOPD with both exacerbation definitions (incidence rate ratios 1.65 and 1.73, respectively). The risk of AECOPD was 59%–78% higher in the hospital sample than in the population sample.ConclusionIf externally valid conclusions are to be made regarding incidence and predictors of AECOPD, studies should be based on general population samples or adjustments should be made on account of a likely higher incidence in other samples. Likewise, the effect of different AECOPD definitions should be taken into consideration.

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“…2 Information about gender differences in clinical presentation and disease biology is accumulating, demonstrating that women tend to report more dyspnea and poorer quality of life (QOL) for the same burden of disease and also may be more susceptible to declines in lung function for the same levels of tobacco exposure. [3][4][5][6] Unfortunately, knowledge about gender differences in coping with this chronic illness and interface with the healthcare delivery system is more limited.…”

Section: Introductionmentioning

confidence: 99%

Gender Differences in Symptoms and Care Delivery for Chronic Obstructive Pulmonary Disease

Martínez

Raparla²,

Plauschinat³

et al. 2012

Journal of Women's Health

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Background: Morbidity and mortality for women with chronic obstructive pulmonary disease (COPD) are increasing, and little is known about gender differences in perception of COPD care. Methods: Surveys were administered to a convenience sample of COPD patients to evaluate perceptions about symptoms, barriers to care, and sources of information about COPD. Results: Data on 295 female and 273 male participants were analyzed. With similar frequencies, women and men reported dyspnea and rated their health as poor/very poor. Although more women than men reported annual household income < $30,000, no significant gender differences in frequency of health insurance, physician visits, or ever having had spirometry were detected. In adjusted models (1) women were more likely to report COPD diagnostic delay (odds ratio [OR] 1.66, 95% confidence interval [CI] 1.13-2.45, p = 0.01), although anxiety (OR 1.83, 95% CI 1.10-3.06, p = 0.02) and history of exacerbations (OR 1.60, 95% CI 1.08-2.37, p = 0.01) were also significant predictors, (2) female gender was associated with difficulty reaching one's physician (OR 2.54, 95% CI 1.33-4.86, p = 0.004), as was prior history of exacerbations (OR 2.25, 95% CI 1.21-4.20, p = 0.01), and (3) female gender (OR 2.15, 95% CI 1.10-4.21, p = 0.02) was the only significant predictor for finding time spent with their physician as insufficient. Conclusions: Significant gender-related differences in the perception of COPD healthcare delivery exist, revealing an opportunity to better understand what influences these attitudes and to improve care for both men and women.

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Gender and the Diagnosis, Management, and Surveillance of Chronic Obstructive Pulmonary Disease

Cited by 54 publications

References 54 publications

Correlates of adherence to respiratory drugs in COPD patients

Correlates of adherence to respiratory drugs in COPD patients

Incidence of utilization- and symptom-defined COPD exacerbations in hospital- and population-recruited patients

Gender Differences in Symptoms and Care Delivery for Chronic Obstructive Pulmonary Disease

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