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

Martínez, Carlos H.; Raparla, Swetha; Plauschinat, Craig; Giardino, Nicholas D.; Rogers, Barbara; Julien, Beresford,; Bentkover, Judith D.; Schachtner-Appel, Amy; Curtis, Jeffrey L.; Martínez, Fernando J.; Han, MeiLan K.

doi:10.1089/jwh.2012.3650

Cited by 64 publications

(50 citation statements)

References 36 publications

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“…Although women have earlier been found to have a longer diagnostic delay and increased difficulties of reaching a physician,21 there are no consistent findings of gender differences in treatments in the earlier studies,22 as we found in the present study. An explanation of the gender differences could be an inherent difference in the appreciation of, for example, rehabilitation efforts.…”

Section: Discussioncontrasting

confidence: 91%

Management of COPD, equal treatment across age, gender, and social situation? A register study

Henoch

Strang

Ekberg-Jansson

2016

COPD

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Chronic obstructive pulmonary disease (COPD) is a progressive chronic disease where treatment decisions should be based on disease severity and also should be equally distributed across age, gender, and social situation. The aim of this study was to determine to what extent patients with COPD are offered evidence-based interventions and how the interventions are distributed across demographic and clinical factors in the sample. Baseline registrations of demographic, disease-related, and management-related variables of 7,810 patients in the Swedish National Airway Register are presented. One-third of the patients were current smokers. Patient-reported dyspnea and health-related quality of life were more deteriorated in elderly patients and patients living alone. Only 34% of currently smoking patients participated in the smoking cessation programs, and 22% of all patients were enrolled in any patient education program, with women taking part in them more than men. Less than 20% of the patients had any contact with physiotherapists or dieticians, with women having more contact than men. Men had more comorbidities than women, except for depression and osteoporosis. Women were more often given pharmacological treatments. With increasing severity of dyspnea, participation in patient education programs was more common. Dietician contact was more common in those with lower body mass index and more severe COPD stage. Both dietician contact and physiotherapist contact increased with deteriorated health-related quality of life, dyspnea, and increased exacerbation frequency. The present study showed that COPD management is mostly equally distributed across demographic characteristics. Only a minority of the patients in the present study had interdisciplinary team contacts. Thus, this data shows that the practical implementation of structured guidelines for treatment of COPD varies, to some extent, with regard to age and gender. Also, disease characteristics influence guideline implementation for each individual patient. Quality registers have the strength to follow-up on compliance with guidelines and show whether an intervention needs to be adapted prior to implementation in health care practice.

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Section: Discussioncontrasting

confidence: 91%

Management of COPD, equal treatment across age, gender, and social situation? A register study

Henoch

Strang

Ekberg-Jansson

2016

COPD

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“…Spirometry testing and referral to a pulmonologist are less common for women [4,14,15]. Women reportedly suffer a delay in the diagnosis of COPD, explainable in part by voluntary postponement of access to a consultation or in some patients by the prevalence of symptoms of fatigue or depression that point to a different type of treatment [16]. Allowing for these reservations, the prevalence of COPD is currently estimated, depending on the country, to range from 4.5% to 10.2% [17,18].…”

Section: Epidemiology Of Copd In Womenmentioning

confidence: 99%

Women and COPD: do we need more evidence?

et al. 2019

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@ERSpublicationsThe face of COPD is increasingly female. We need more evidence and a change in how the disease is managed.ABSTRACT The increasingly female face of chronic obstructive pulmonary disease (COPD) prevalence among women has equalled that of men since 2008, due in part to increased tobacco use among women worldwide and exposure to biomass fuels. This finding is supported by a number of characteristics. There is evidence of susceptibility to smoking and other airborne contaminants, along with epidemiological and phenotypic manifestations. COPD has thus become the leading cause of death in women in the USA. The clinical presentation is characterised by increasingly pronounced dyspnoea with a marked tendency towards anxiety and depression, undernutrition, nonsmall cell lung cancer (especially adenocarcinoma) and osteoporosis. Quality of life is also more significantly impacted. The theories advanced to explain these differences involve the role played by oestrogens, impaired gas exchange in the lungs and smoking habits. While these differences require appropriate therapeutic responses (smoking cessation, pulmonary rehabilitation, long-term oxygen therapy), barriers to the treatment of women with COPD include greater under-diagnosis than in men, fewer spirometry tests and medical consultations. Faced with this serious public health problem, we need to update and adapt our knowledge to the epidemiological changes.

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“…In addition, people who speak a language other than English face significant barriers in access to care and in receiving quality health care (3, 4, 15, 16, 19, 23, 24, 26, 30-34, 50, 54, 86). Health outcomes and care received also vary between men and women (5,18,20,43,51,57,62,75,93,98,102). Finally, people with disabilities frequently cannot access the benefits, services, and information provided by health care systems to the same extent as those without disabilities (29,46,53,55,77,92,95).…”

Section: Introductionmentioning

confidence: 99%

Implementing Health Reform: Improved Data Collection and the Monitoring of Health Disparities

Dorsey

Graham

Glied

et al. 2014

Annu. Rev. Public Health

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The relative lack of standards for collecting data on population subgroups has not only limited our understanding of health disparities, but also impaired our ability to develop policies to eliminate them. This article provides background about past challenges to collecting data by race/ethnicity, primary language, sex, and disability status. It then discusses how passage of the Affordable Care Act has provided new opportunities to improve datacollection standards for the demographic variables of interest and, as such, a better understanding of the characteristics of populations served by the U.S. Department of Health and Human Services (HHS). The new standards have been formally adopted by the Secretary of HHS for application in all HHS-sponsored population health surveys involving self-reporting. The new data-collection standards will not only promote the uniform collection and utilization of demographic data, but also help the country shape future programs and policies to advance public health and to reduce disparities.

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

Cited by 64 publications

References 36 publications

Management of COPD, equal treatment across age, gender, and social situation? A register study

Management of COPD, equal treatment across age, gender, and social situation? A register study

Women and COPD: do we need more evidence?

Implementing Health Reform: Improved Data Collection and the Monitoring of Health Disparities

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