Gender difference on the knowledge, attitude, and practice of COPD diagnosis and treatment: a national, multicenter, cross-sectional survey in China

Abstract

PurposeTo investigate the gender difference in knowledge, attitude, and practice of COPD diagnosis and treatment in China.Patients and methodsA nationwide, multicenter, cross-sectional questionnaire study was carried out to investigate patients’ understanding and experience of COPD between September 2007 and December 2008.ResultsTwo thousand and seventy-two patients were recruited from eleven centers. The final effective questionnaires were those of 1,698 cases, of which 32% were female. Women were younger, had higher body mass index, were more never smokers, and had lesser pack-years (all P<0.01). More women had under elementary education level and monthly income <1,000 RMB (about 160 USD) (all P<0.01). Women had higher ratio of FEV1/FVC (54.1±10.9 vs 50.2±11.5), FEV1% (50.0±19.1 vs 45.4±29.0), and lower short form-36 mental component summary (57.5±26.8 vs 61.3±25.0) (all P<0.01). Fewer women reported severe exacerbation (defined as an acute worsening of respiratory symptoms that results in patient’s hospitalization) in the previous year (44.5% vs 51.6%, P<0.05). More women reported that they never heard of COPD before (67.0% vs 59.0%, P<0.01). Less women reported that physician had to tell them they had emphysema (50.5% vs 60.4%) or COPD (31.9% vs 37.9%). Less women had pulmonary function test (PFT) done before (65.2% vs 70.4%, P<0.05). More women reported that they would not repeat PFT annually (91.7% vs 87.6%, P<0.05) and did not know the PFT results (78.6% vs 73.1%, P<0.05). More women reported not having had pulmonary rehabilitation before (87.8% vs 83.6%, P<0.05). Fewer women reported knowing that COPD should be given combined therapy (38.3% vs 44.5%) and long-term treatment (46.1% vs 51.9%) (all P<0.05).ConclusionMale and female patients had different experiences on COPD diagnosis and treatment. Physicians should pay more attention to patients’ education on COPD, especially of women.

Sex-differences in factors and outcomes associated with adherence to statin therapy in primary care: Need for customisation strategies

“…Women instead, despite better knowledge of diseases, reported lower satisfaction with social support and lower quality of life. [37][38][39][40] Confirming that, our study has shown that some factors traditionally associated with higher or lower adherence to therapy have a different impact in the two sexes.…”

<p>Clinical Characteristics of Chronic Obstructive Pulmonary Disease in Female Patients: Findings from a KOCOSS Cohort</p>

“…11,14 This was not the case for the PFT results in our study population, in which males had worse FEV 1 and FEV 1 /FVC values than females, a finding consistent with nationwide multicenter studies from Spain and China. 14,15 The discordance between symptom and exacerbation rate on one hand, and the PFT results on the other, may be due to a higher rate of asthma-COPD overlap in females, as observed in this and other studies. 28,29 Several population-based studies have reported steeper annual FEV 1 declines in men than in women.…”

“…[11][12][13] However, despite having better lung function, female COPD patients suffer from a larger number of symptoms and more frequent exacerbations. 3,14,15 These features may be related to the socioeconomic status of each study population and thus its specific risk factors. Korea has rapidly changed from a developing to a developed country, so it may have unique features not only in terms of COPD but also its occurrence in males vs females.…”

No gender-related bias in COPD diagnosis and treatment in Sweden: a randomised, controlled, case-based trial

“…Female patients develop COPD at earlier ages with lower tobacco consumption in comparison to males [4], and their quality of life is more impaired [25]. Females have an increased susceptibility to COPD due to sex-related biological factors [26] and may have different responses to medical treatment, follow-ups, smoking cessation interventions and pulmonary rehabilitation programmes [27][28][29][30][31][32]. Women with COPD exacerbations are younger, smoke more actively and have less comorbidity [33].…”