BACKGROUND: People with known risk factors for chronic obstructive pulmonary disease (COPD) are important targets for screening and early intervention. We sought to measure the prevalence of COPD among such individuals visiting a primary care practitioner for any reason. We also evaluated the accuracy of prior diagnosis or nondiagnosis of COPD and identified associated clinical characteristics. METHODS: We recruited patients from three primary care sites who were 40 years or older and had a smoking history of at least 20 pack-years. Participants were asked about respiratory symptoms and underwent postbronchodilator spirometry. COPD was defined as a ratio of forced expiratory volume in the first second of expiration to forced vital capacity (FEV(1)/FVC) of less than 0.7 and an FEV(1) of less than 80% predicted. RESULTS: Of the 1459 patients who met the study criteria, 1003 (68.7%) completed spirometry testing. Of these, 208 were found to have COPD, for a prevalence of 20.7% (95% confidence interval 18.3%-23.4%). Of the 205 participants with COPD who completed the interview about respiratory symptoms before spirometry, only 67 (32.7%) were aware of their diagnosis before the study. Compared with patients in whom COPD had been correctly diagnosed before the study, those in whom COPD had been over-diagnosed or undiagnosed were similar in terms of age, sex, current smoking status and number of visits to a primary care practitioner because of a respiratory problem. INTERPRETATION: Among adult patients visiting a primary care practitioner, as many as one in five with known risk factors met spirometric criteria for COPD. Underdiagnosis of COPD was frequent, which suggests a need for greater screening of at-risk individuals. Knowledge of the prevalence of COPD will help plan strategies for disease management.
BACKGROUND:People with known risk factors for chronic obstructive pulmonary disease (COPD) are important targets for screening and early intervention. We sought to measure the prevalence of COPD among such individuals visiting a primary care practitioner for any reason. We also evaluated the accuracy of prior diagnosis or nondiagnosis of COPD and identified associated clinical characteristics. METHODS: We recruited patients from three primary care sites who were 40 years or older and had a smoking history of at least 20 pack-years. Participants were asked about respiratory symptoms and underwent postbronchodilator spirometry. COPD was defined as a ratio of forced expiratory volume in the first second of expiration to forced vital capacity (FEV(1)/FVC) of less than 0.7 and an FEV(1) of less than 80% predicted. RESULTS: Of the 1459 patients who met the study criteria, 1003 (68.7%) completed spirometry testing. Of these, 208 were found to have COPD, for a prevalence of 20.7% (95% confidence interval 18.3%-23.4%). Of the 205 participants with COPD who completed the interview about respiratory symptoms before spirometry, only 67 (32.7%) were aware of their diagnosis before the study. Compared with patients in whom COPD had been correctly diagnosed before the study, those in whom COPD had been over-diagnosed or undiagnosed were similar in terms of age, sex, current smoking status and number of visits to a primary care practitioner because of a respiratory problem. INTERPRETATION: Among adult patients visiting a primary care practitioner, as many as one in five with known risk factors met spirometric criteria for COPD. Underdiagnosis of COPD was frequent, which suggests a need for greater screening of at-risk individuals. Knowledge of the prevalence of COPD will help plan strategies for disease management.
Authors: M R Miller; J Hankinson; V Brusasco; F Burgos; R Casaburi; A Coates; R Crapo; P Enright; C P M van der Grinten; P Gustafsson; R Jensen; D C Johnson; N MacIntyre; R McKay; D Navajas; O F Pedersen; R Pellegrino; G Viegi; J Wanger Journal: Eur Respir J Date: 2005-08 Impact factor: 16.671
Authors: R Antonelli-Incalzi; C Imperiale; V Bellia; F Catalano; N Scichilone; R Pistelli; F Rengo Journal: Eur Respir J Date: 2003-09 Impact factor: 16.671
Authors: Francesca Polverino; Maria E Laucho-Contreras; Hans Petersen; Vanesa Bijol; Lynette M Sholl; Mary E Choi; Miguel Divo; Victor Pinto-Plata; Alfredo Chetta; Yohannes Tesfaigzi; Bartolomé R Celli; Caroline A Owen Journal: Am J Respir Crit Care Med Date: 2017-06-01 Impact factor: 21.405
Authors: Truls S Ingebrigtsen; Jacob L Marott; Børge G Nordestgaard; Peter Lange; Jesper Hallas; Morten Dahl; Jørgen Vestbo Journal: J Gen Intern Med Date: 2014-09-23 Impact factor: 5.128
Authors: Wouter van Dijk; Wan Tan; Pei Li; Best Guo; Summer Li; Andrea Benedetti; Jean Bourbeau Journal: Ann Fam Med Date: 2015 Jan-Feb Impact factor: 5.166
Authors: Kylie Hill; Richard Hodder; Maria Blouin; Diane Heels-Ansdell; Gordon Guyatt; Roger Goldstein Journal: Can Fam Physician Date: 2011-02 Impact factor: 3.275
Authors: Paul Hernandez; Meyer S Balter; Jean Bourbeau; Charles K Chan; Darcy D Marciniuk; Shannon L Walker Journal: Can Respir J Date: 2013 Mar-Apr Impact factor: 2.409