Prevalence and management of COPD and heart failure comorbidity in the general practitioner setting

Abstract

this study has evidenced a disparity in performing instrumental diagnosis between COPD and HF groups that persists when both conditions coexist. Moreover, the pharmacological treatment of the two conditions shows a consistent under treatment with bronchodilators in COPD patients and with β-blockers in HF patients.

Danish general practitioners’ management of patients with COPD: a nationwide survey

“…In our study, about half of the GPs stated that they, at least to some degree, needed educational support in COPD management. Similar studies show that some GPs stray from the guideline recommendations [10,11,13,14,27,28]. Our findings suggested variation according to the location; GPs from a rural area reported less need to consult a specialist than city GPs.…”

“…Internationally, a substantial under-treatment of patients with COPD has been reported [8][9][10]. One explanation could be 'therapeutic nihilism' where the GP regards COPD treatment as futile compared to treatment of other chronic diseases [8,9].…”

Herzinsuffizienz, COPD und Betablocker-Therapie

“…Obwohl auch in der chronischen, stabilen Herzinsuffizienz restriktive und obstruktive Ventilationsstörungen beschrieben wurden, bleibt der Tiffeneau-Index FEV 1 / FVC < 70 % bei entsprechender Klinik ein valides diagnostisches Kriterium, wenn er außerhalb der akuten Dekompensation bestimmt wird [14]. Zumindest aus Italien liegen Daten vor, dass in Hausarztpraxen eine Spirometrie überhaupt nur bei 57 % der Patienten durchgeführt wird, die die Diagnose COPD plus Herzinsuffizienz tragen (während 95 % ein EKG erhalten) [32].…”

Pulmonary function predicts mortality and hospitalizations in outpatients with heart failure and preserved ejection fraction

“…Nonetheless, the most important observation of our study is that in these ambulatory patients at an early stage of their heart failure disease, airflow limitation (irrespective of its specific cause) predicts mortality. Yet, it is highly relevant clinically since airflow limitation and respiratory failure are treatable and, as described, only a minority of HFPEF patients with abnormal lung function was receiving appropriate treatment for their respiratory condition [25].…”