Management of chronic obstructive pulmonary disease in the Middle East and North Africa: Results of the BREATHE study

Abstract

Chronic obstructive pulmonary disease (COPD) is a potentially severe chronic progressive respiratory condition requiring long-term treatment and frequently involving episodic hospitalisations to manage exacerbations. The objective of this analysis was to document diagnosis, evaluation, treatment and management of COPD-related respiratory symptoms in 1,392 subjects fulfilling an epidemiological definition of COPD identified in a general population sample of 62,086 individuals aged ≥ 40 years in ten countries in the Middle East and North Africa region (Algeria, Egypt, Jordan, Lebanon, Morocco, Saudi Arabia, Syria, Tunisia, Turkey and United Arab Emirates), together with Pakistan. 442 subjects (31.8%) claimed to have received a diagnosis of COPD from a physician and 287 (20.6%) had undergone spirometry in the previous year. Use of specific treatments for respiratory symptoms was reported by 218 subjects (15.7%). Use of inhaled long-acting bronchodilators together with corticosteroids (53 subjects; 3.8%) and use of oxygen therapy (31 subjects; 2.3%) was very low. 852 subjects (61.2%) had consulted a physician about their respiratory condition at least once in the previous year, with a mean number of consultations of 3.4 ± 3.6. Moreover, 284 subjects (20.4%) had been hospitalised overnight for their COPD, with a mean of 2.3 ± 3.7 hospitalisations per year. Use of all healthcare resources was significantly higher (p < 0.001) in subjects with CAT scores ≥ 10 than in those with scores < 10, and greater in those with exacerbations than in those without. In conclusion, COPD in the region is under-diagnosed, inadequately evaluated and inadequately treated. Nonetheless, COPD symptoms are responsible for considerable healthcare consumption, with high levels of physician consultation and hospitalisation.

The COPD assessment test: a systematic review

“…The number of physician consultations was associated with total CAT scores in one study (p,0.001) [34], but not in the others [15,39]. The number of hospitalisations was directly associated with total CAT scores, irrespective of using the total CAT score (p,0.001) [15] or arbitrarily dichotomising the CAT score (e.g.…”

“…Three studies measured concurrent validity by comparing the total CAT score to healthcare utilisation [15,34,39]. The number of physician consultations was associated with total CAT scores in one study (p,0.001) [34], but not in the others [15,39].…”

“…The number of hospitalisations was directly associated with total CAT scores, irrespective of using the total CAT score (p,0.001) [15] or arbitrarily dichotomising the CAT score (e.g. ,10 and o10) (p,0.001 [34] and p,0.032 [39] : reported population characteristics for face-to-face questionnaire group only, where the CAT was completed in a face-to-face interview.…”

Prevalence of chronic obstructive respiratory diseases amongst fishermen

“…In France, among adults, the prevalence of asthma is estimated between 6% and 7% [3] and that of COPD between 7.5% and 10% [4]. In developing countries, there are few studies assessing the burden of COPD [5][6][7].…”

Effect of Implementation of Teaching Modules about Physiological and Psychological Parameters on Expected Clinical Outcomes of Patients with Chronic Obstructive Pulmonary Disease

“…It was anticipated that 80 million people worldwide have moderate to severe COPD. COPD are responsible for extensive healthcare utilization, with physician follow up and hospitalization [6]. exchange, exercise tolerance and quality of life.…”