Trends in Chronic Obstructive Pulmonary Disease Prevalence, Incidence, and Mortality in Ontario, Canada, 1996 to 2007

Gershon, Andrea S.; Wang, Chengning; Wilton, Andrew S.; Raut, Roxana; To, Teresa

doi:10.1001/archinternmed.2010.17

Cited by 154 publications

(145 citation statements)

References 21 publications

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“…[10][11][12] However, COPD is primarily managed within the primary care sector. The Canadian Primary Care Sentinel Surveillance Network was established in 2008 to bring together practice-based research networks using diverse EMR systems to generate data on chronic disease in Canadian primary care settings.…”

Section: Cmaj Openmentioning

confidence: 99%

“…16 This may explain in part the significant differences between the rates observed in our data and the prevalence of almost 12% in adults over age 35 reported most recently by Gershon and colleagues. 10,26 The true prevalence is likely found between these levels. A recent study by Muggah and colleagues 27 also showed poor agreement between data from a large population health survey and the administrative data definition used in Ontario (κ = 0.29, prevalence 11.1% health administrative data, 5.6% selfreported).…”

Section: Cmaj Openmentioning

confidence: 99%

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Chronic obstructive pulmonary disease in primary care: an epidemiologic cohort study from the Canadian Primary Care Sentinel Surveillance Network

et al. 2015

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CMAJ OPEN, 3(1) E15Research CMAJ OPEN C hronic obstructive pulmonary disease (COPD) is a substantial source of morbidity and mortality in Canada and globally. Estimates place the worldwide prevalence at 9%-10% from physiologic-based studies and 3%-8% from studies based on physician-or patient-reported diagnosis or symptoms.1,2 Globally, COPD is rated as the fifth leading cause of death, and ninth in contributions to loss of disability-adjusted life years.3,4 A recent systematic review of COPD epidemiology worldwide identified 12 Canadian studies, which produced prevalence estimates that ranged from 3% to 12%, depending on the method used.5 Canadian data from a study using spirometry to screen a populationbased sample suggest a rate of about 10%. 6 There are limited data on COPD either alone or in combination with other chronic diseases from primary care settings.In other countries, the limited reports on COPD prevalence in primary care settings show marked variation depending on the method of identification of illness. A study from the United Kingdom based on electronic records in the Computerized Patient Records Database found the prevalence of physician-diagnosed COPD to be less than 1% for women and only 1.35% for men.7 Another practice-based research network study from the UK that invited participants in a postal survey to come for spirometry if they had either symptoms or a smoking history found a much higher prevalence (4.1% overall, 9.6% in patients over 40 yr).8 A recent Spanish study using data from electronic medical records (EMRs) found a physician-diagnosed prevalence of 3.2%, 90% of whom were also found to have at least 1 comorbid condition. Background: Chronic obstructive pulmonary disease (COPD) is mostly managed within primary care, but there is little Canadian evidence from this setting. This study was undertaken to determine the prevalence of physician-diagnosed COPD in primary care practices, and the degree of comorbidity with other chronic conditions, and to assess patterns of medication prescribing.

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Section: Cmaj Openmentioning

confidence: 99%

Section: Cmaj Openmentioning

confidence: 99%

Chronic obstructive pulmonary disease in primary care: an epidemiologic cohort study from the Canadian Primary Care Sentinel Surveillance Network

et al. 2015

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“…We are unable to comment on whether anxiety or depression had improved substantially for patients after opioids were started, but caregivers often mentioned that their loved one appeared "more relaxed." We did not collect spirometric measures of airflow obstruction (i.e., FEV 1 or FEV 1 /FVC ratio); most of the included patients were housebound, living with high dyspnea burden and had not undergone recent pulmonary function testing.…”

Section: Limitationsmentioning

confidence: 99%

Perspectives of patients, family caregivers and physicians about the use of opioids for refractory dyspnea in advanced chronic obstructive pulmonary disease

Rocker¹,

Young²,

Donahue³

et al. 2012

CMAJ

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Background: A recent national practice guideline recommends the use of opioids for the treatment of refractory dyspnea in patients with advanced chronic obstructive pulmonary disease (COPD). We conducted two qualitative studies to explore the experiences of patients and family caregivers with opioids for refractory COPD-related dyspnea and the perspectives and attitudes of physicians toward opioids in this context. Methods: Patients (n = 8; 5 men, 3 women), their caregivers (n = 12; 5 men, 7 women) and physicians (n = 28, 17 men, 11 women) in Nova Scotia participated in the studies. Semistructured interviews were recorded, transcribed verbatim, coded conceptually and analyzed for emergent themes using interpretive description methodology. Results: Patients reported that opioids provided a sense of calm and relief from severe dyspnea. Family caregivers felt that opioids helped patients to breathe more “normally,” observed improvements in patients’ symptoms of anxiety and depression, and experienced reductions in their own stress. Patients reported substantial improvements in their quality of life. All patients and family caregivers wanted opioid therapy to continue. Most physicians were reluctant to prescribe opioids for refractory dyspnea, describing a lack of related knowledge and experience, and fears related to the potential adverse effects and legal censure. Interpretation: Discrepancies between the positive experiences of patients and family caregivers with opioids and the reluctance of physicians to prescribe opioids for refractory dyspnea constitute an important gap in care. Bridging this gap will require initiatives to improve the uptake of practice guidelines and to increase confidence in prescribing opioids for dyspnea refractory to conventional treatment

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“…Chronic obstructive pulmonary disease is an increasing health issue worldwide [1][2][3][4][5] and is expected to be the third leading cause of death by 2020 [6,7] . Similarly, the World Health Organization [8] reports that COPD is the fifth most common cause of death and the tenth most burdensome disease worldwide.…”

Section: Introductionmentioning

confidence: 99%

Best practice in nursing care of dyspnea: The 6th vital sign in individuals with COPD

Bailey

Boyles

Cloutier

et al. 2013

JNEP

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Aim: The aim of this paper is to highlight evidence and key nursing practice, education, organization and policy recommendations from the original and revised Registered Nurses' Association of Ontario Best Practice Guideline, Nursing Care of Dyspnea: The 6th Vital Sign in Individuals with Chronic Obstructive Pulmonary Disease (COPD). This paper introduces the notion of dyspnea as the sixth vital sign and presents evidence from the RNAO Best Practice Guideline and other relevant literature to support and enhance nursing care of dyspnea in clients with COPD.Background: COPD is an increasingly serious health issue. Nurses have significant opportunity to positively influence client outcomes and quality of life by assessing dyspnea, identifying problems, and applying appropriate evidence-based interventions. Best practice guidelines developed by the RNAO provide a framework to enhance nursing practice and client care.Design: A panel of nurses was assembled for the initial development of the guideline and more recently, the revision to the original guideline.Method: A structured evidence review based on the scope of the original guideline and supported by three clinical questions was conducted to capture the relevant literature and guidelines published since the original publication.Results: As a result of this work recommendations for nursing practice and education are discussed. Organizational and policy recommendations are also outlined. Conclusions:Nurses have opportunity to positively influence client outcomes and quality of life by assessing dyspnea, identifying problems, and applying appropriate evidence-based interventions.Relevance to Clinical Practice: Recommendations made in the best practice guideline will enhance nursing care of dyspnea in clients with COPD and dyspnea should be recognized as the sixth vital sign in individuals with COPD.

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Trends in Chronic Obstructive Pulmonary Disease Prevalence, Incidence, and Mortality in Ontario, Canada, 1996 to 2007

Cited by 154 publications

References 21 publications

Chronic obstructive pulmonary disease in primary care: an epidemiologic cohort study from the Canadian Primary Care Sentinel Surveillance Network

Chronic obstructive pulmonary disease in primary care: an epidemiologic cohort study from the Canadian Primary Care Sentinel Surveillance Network

Perspectives of patients, family caregivers and physicians about the use of opioids for refractory dyspnea in advanced chronic obstructive pulmonary disease

Best practice in nursing care of dyspnea: The 6th vital sign in individuals with COPD

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