Prevalence and quality of care among patients using medication targeting obstructive lung disease: a cross-sectional study in the five regions of Greenland

Abstract

The aim of this study was to estimate the age-and gender-specific prevalence and quality of care among patients using medication targeting obstructive lung disease in the five regions of Greenland. The study was designed as a cross-sectional study. Data on patients using medication targeting obstructive lung disease was obtained from the electronically medical record used in Greenland. The prevalence was calculated using the population of Greenland as background population. The quality of care was determined using indicators proposed by international literature and the Steno Diabetes Center Greenland guidelines. The total prevalence of patients using medication targeting obstructive lung disease was 7.5%. The prevalence was significantly higher among women compared to men and differed significantly between the five regions. Smoking status, blood pressure and spirometry were registered within one/two years for 29.8%/ 43.2%, 29.2%/41.1% and 15.9%/26.0% of the patients, respectively. Regional differences were observed for all indicators.The use of medication targeting obstructive lung disease is common in Greenland. Yet, the quality of care was low and interventions improving the quality of care is recommended.

Low prevalence of diagnosed asthma in Greenland – a call for increased focus on diagnosing

“…The very rapid increase seen in the aftermath of a diagnostic intervention also suggests that a proportion of the population has undiagnosed asthma, as not all patients receiving lung medication have been examined yet. On this basis, we believe that the actual prevalence is higher than the prevalence of 1.9% reported in our study, and lower than the 7.5% receiving lung medication reported earlier [ 12 ]. The latter proportion, however, includes both asthmatic patients, but also patients treated for other lung diseases than asthma, such as COPD, while others might be treated for respiratory symptoms such as shortness of breath symptoms, triggered by other causes than asthma.…”

“…In total, we found 870 patients with diagnosed asthma, which is significantly more than the 102 diagnosed patients with asthma found at the end of 2019 [ 12 ]. The very rapid increase seen in the aftermath of a diagnostic intervention also suggests that a proportion of the population has undiagnosed asthma, as not all patients receiving lung medication have been examined yet.…”

“…This could be obesity, which is very common in Greenland and is seen in more than one-third of all adult women [ 18 ]. Only 26.0% of the patients treated with lung medication had had a spirometry performed within the last two years, which is a part of the screening procedure for asthma [ 12 ]. Symptoms from the respiratory airways are frequent in a population with a large prevalence of obesity and many smokers, so the respiratory symptoms can also be explained by other conditions than asthma.…”

“…In 2012, a study from Canada reported a prevalence of asthma of 9.7% among Inuit aged 15–64 years [ 11 ]. In 2021, a study from Greenland found the prevalence of patients using medication for obstructive lung disease (asthma or chronic obstructive pulmonary disease (COPD)) to be 7.5% (2,855/38,164) [ 12 ]. Of those, only 101 patients were registered with a medical diagnosis code for asthma in the electronic medical record (EMR), while 152 patients were registered with a medical diagnosis code for COPD.…”

Prevalence of Chronic Obstructive Pulmonary Disease and Chronic Bronchitis Among Predominantly Smoking Workers in the Seafood Industry in Greenland

“…Yet, less than a third of those had been tested with spirometry over the past two years, indicating low diagnostic activity and limited monitoring of COPD in Greenland. 9 …”