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PubMed2006

The cost of treating patients with COPD in Denmark--a population study of COPD patients compared with non-COPD controls.

This paper describes a population-based study of health care resource use of patients with chronic obstructive pulmonary disease (COPD) compared to non-COPD controls. Through a screening of the Danish Patient Registry for patients admitted with COPD diagnoses for a 5-year period, 1998-2002, 66,000 individuals with COPD still alive at the beginning of 2002 were identified. Their use of health care resources in 2002 were compared with equivalent data, stratified for age, sex and mortality rates, for a control population without COPD based on data for the 300,000 remaining patients on the Danish Patient Registry in 2002. Results indicated that the gross cost of treating patients with COPD in the Danish somatic hospital and primary health care sector corresponded to 10% of the total cost of treating patients of 40 years or more. The net cost for COPD patients was 1.9 billion DKK (256 million euro), 6% of the total annual costs of treating the population of 40 years or more. The gross cost related to any disease and the net cost reflected the resource use which could be attributed to COPD and its related diagnoses. The incidence of inpatient hospital admissions was almost four times higher in the COPD population than in the control group. COPD patients contacted their general practitioner 12 times more per year than non-COPD controls, but for specialist and paramedic treatment in the primary care sector there was no significant difference between COPD patients and non-COPD controls. Only one third of the COPD costs were due to treatment of COPD as the primary diagnosis. The remaining two-thirds of the COPD-related costs were mainly due to admissions for other diseases such as cardio-vascular diseases, other respiratory diseases, and cancer.

Adult↗

PubMed2002

[Chronic obstructive pulmonary disease (COPD) in the elderly: analysis from questionnaire about attitudes to the COPD guideline of the Japanese Respiratory Society and actual therapy for COPD used by physicians].

We have conducted a survey of attitudes to chronic obstructive pulmonary disease (COPD) in the elderly, a survey of attitudes to the COPD guideline prepared by the Japanese Respiratory Society, and a survey of the therapies actually used for this disease among physicians belonging to the Yokohama Medical Association. The results showed that most respondents thought that physicians, mainly except for respiratory physicians, miss the COPD patients because of failure to recognize COPD. The spread of the COPD guideline among physicians and the amount of therapy conducted according to this guideline were also insufficient. However, most physicians who know this guideline have used it well, and have also appreciated the contents. Thus, the results of our surveys suggested that this COPD guideline, with its step-by-step pharmacologic therapy, should be more widely disseminated, mainly among clinics and physicians that are not respiratory specialists. This would enable them to follow the guideline and improve their treatment of COPD. In addition, it was also supposed that the comprehensive respiratory rehabilitation should be more executed in the hospitals.

Aged↗

PubMed2005

Physician and patient perceptions in COPD: the COPD Resource Network Needs Assessment Survey.

PURPOSE: Chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the United States, has received disproportionately little attention from physicians and institutions. National data are lacking on patient and physician perceptions of and patterns of care for COPD. METHODS: Linked surveys were administered to national samples of patients with COPD, primary care physicians, and pulmonologists to evaluate perceptions of COPD severity and quality of life, attitudes about COPD, health insurance barriers to COPD care, sources of information, and knowledge about COPD diagnosis and treatment. RESULTS: Overall, 1023 patients with COPD and 1051 primary care physicians and pulmonologists responded to the surveys. Despite experiencing significant symptoms and high health care use, the majority of patients were satisfied with their care. Eighty-eight percent of physicians agreed with the statement that COPD is a "self-inflicted" disease, and more than one third were nihilistic about the treatment of patients who continued to smoke. Patients and physicians reported that insurance problems impeded access to therapies. Patients were generally uninformed about COPD; 54% of primary care physicians were aware of any COPD guidelines. Both patient and physician surveys demonstrated continued confusion about the diagnosis of COPD and treatment choices. There was frequent use of regular oral steroids despite demonstrated lack of efficacy and under-use of pulmonary rehabilitation despite proven efficacy. CONCLUSIONS: Patients with COPD have a high prevalence of activity limitations. Although most physicians believed that proper treatment can slow progression, inadequate knowledge and poor adherence to practice guidelines, together with insurance impediments, negatively impact COPD care.

Adult↗

PubMed2001

[The impact of COPD on hospital resources: the specific burden of COPD patients with high rates of hospitalization].

OBJECTIVES: 1) To know the impact of chronic obstructive pulmonary disease (COPD) on hospital care (visits to the emergency room and admission); and 2) to identify and describe COPD patients whose use of health care is high (COPD-HC), also assessing the costs generated by such patients. METHOD: We reviewed the files of all patients with COPD receiving care at our hospital in 1998, looking at age, sex, smoking, simple spirometry, arterial gases at rest, number of admissions, duration of hospital stay, and number of visits to the emergency room. After describing the sample, patients were stratified in three groups by use of hospital care: group A, patients not requiring hospital care; group B, patients requiring less care than the COPD-HC group; and group C, COPD-HC. The criteria used to define the COPD-HC group were 1) >= 2 admissions in one year, 2) >= 3 visits to the emergency room, without admission in one year, or 3) 1 admission and 2 visits to the emergency room for COPD exacerbation in one year. RESULTS: Three hundred twenty cases were studied, 3 women (0.9%) and 317 men (99.1%), mean age 71 9 years. One hundred twenty-six patients (39.4%) made 263 visits in 1998, accounting for 1.1% of all emergencies (n = 23,750) and 4.05% of all medical emergencies (n = 6,489). Ninety-two patients (28.7%) were admitted for exacerbation of COPD. One hundred twenty-six admissions were made over the course of the year, accounting for 9.6% of all admissions to the internal medicine wards (n = 1,309). The 39 patients (12.2%) who were classified COPD-HC generated 160 emergency visits (60.8%) and 72 admissions due to COPD (57.1%). The analysis of variation revealed statistically significant differences among the 3 groups for age, FEV1, FVC and PaO2, but not for PaCO2. COPD-HC patients had the lowest values for FEV1, FVC and PaO2 and were older. CONCLUSIONS: COPD generates high demand for hospital care. A small group of COPD patients (12.2%) accounts for nearly 60% of hospital visits for this disease. The group requiring greater care generally has more severe disease (older, more severe bronchial obstruction and hypoxemia).

Adult↗

PubMed2003

The burden of COPD in Italy: results from the Confronting COPD survey.

Chronic obstructive pulmonary disease (COPD) is a disease state characterized by airflow limitation that is not fully reversible, and progressive lung function decline. In Italy, an estimated 2.6 million men and women have COPD, and the disease causes around 18 000 deaths each year. In addition to mortality, morbidity from COPD results in substantial use of secondary healthcare resources. The burden of COPD in Italy may be due to the underdiagnosis of the disease by healthcare professionals, particularly in the early stages of the disease, and a lack of awareness among physicians of recommended treatment practices. In an attempt to address the need for information on the burden of COPD, a large-scale international survey, Confronting COPD in North America and Europe, assessed clinical outcomes, use of healthcare resources and loss of productivity in the workplace, and the economic cost of this disease in Italy and six other countries. In Italy, the economic analysis of the survey data showed that the mean annual cost of COPD to the healthcare system was Euro 1261.25 per patient Indirect costs were estimated at Euro 47.29 per patient, bringing the societal cost of the disease to Euro 1308.54 per patient. Three-quarters of the direct per patient cost of COPD in Italy were accounted for by inpatient hospitalizations (Euro 963.10), suggesting that interventions aimed at preventing exacerbations could alleviate the burden of COPD in Italy. The high impact of COPD on the Italian healthcare system is also likely to be a consequence of the underdiagnosis and undertreatment of the disease, suggesting that costs may be reduced by increasing the utilization of spirometry as a diagnostic tool, and improving physician adherence to treatment guidelines. Patients with severe COPD and other comorbidities showed higher costs (Euro 6366 and Euro 1861, respectively) than patients with mild disease (Euro 441) or no comorbidities (Euro 1021), underlying the importance of smoking cessation interventions to prevent disease progression.

Absenteeism↗

PubMed2003

The burden of COPD in The Netherlands: results from the Confronting COPD survey.

Chronic obstructive pulmonary disease (COPD) is a disabling condition associated with progressive airflow limitation that is largely irreversible, with symptoms of dyspnoea, cough and sputum production. In The Netherlands, COPD tends to be underpresented to physicians, underdiagnosed and undertreated by healthcare professionals, and poorly recognized among the general population. Improving the diagnosis and management of COPD in this country may require raised awareness of the impact of the disease on society. This may be achieved by providing detailed information on the burden of COPD on the patient, healthcare system and the economy. This information has now become available from Confronting COPD in North America and Europe, the first international survey to quantify the country-specific impact of the disease. An economic analysis of the results of the Dutch survey revealed the high cost of COPD to the healthcare system and society, with direct costs estimated at Euro 614 per patient Indirect costs amounted to Euro 410, bringing the annual per patient cost of COPD to Euro 1024. Around 50% of the cost of COPD to the healthcare system was for prescription medication, including symptomatic medication and treatment for underlying airway inflammation. This contributed to effective symptom control in many patients, as shown by the low utilization of unscheduled healthcare (inpatient hospitalizations, emergency room visits, or contacts with healthcare professionals). However, the survey suggested that there was scope for improvement in the understanding of the origin and consequences of this disease among the general public, and the way COPD is managed by healthcare professionals, in order to increase the proportion of patients who are diagnosed with COPD and treated in accordance with management guidelines. In addition, smoking cessation intervention at the early stages of the disease could help to reduce the high costs associated with severe COPD in this country.

Absenteeism↗

PubMed2003

The burden of COPD in France: results from the Confronting COPD survey.

Chronic obstructive pulmonary disease (COPD) is an obstructive lung disorder characterized by progressive airflow limitation that is not reversible or only partially reversible, including chronic bronchitis and emphysema. Confronting COPD in North America and Europe was the first large-scale international survey to attempt to quantify the country-specific burden of the disease, collecting data on clinical outcomes, healthcare resource utilization, and lost productivity, from patients and physicians in France and seven other countries. The economic analysis of the French survey results showed that patients with COPD required considerable utilization of healthcare resources, with annual direct costs estimated at Euro 530 per patient In addition, COPD-related illness or disability prevented many patients from working, with an estimated annual indirect cost of Euro 1078 per patient The survey suggested underdiagnosis and undertreatment of COPD by healthcare professionals, and patients reported poor symptom control. The cost of unscheduled care (Euro 151) was almost double the cost of scheduled visits to healthcare professionals (Euro 82). This suggests that improving the long-term management of chronic symptoms by healthcare professionals could reduce the burden of disease. As in other countries, the clinical management of COPD in France may be improved by following guideline recommendations for COPD treatment. These include smoking cessation at all stages of the disease, regular treatment of chronic symptoms with bronchodilators in dyspnoeic patients, and pulmonary rehabilitation. The results of the survey also showed that the societal cost of COPD was considerably greater in patients with severe disease (Euro 2882) compared with mild COPD (Euro 289). This suggests that interventions that could help delay the progression of COPD to the advanced stages of the disease (such as smoking cessation) could be of economic benefit.

Absenteeism↗

PubMed2005

Difficulties identifying and targeting COPD and population-attributable risk of smoking for COPD: a population study.

STUDY OBJECTIVES: Respiratory public health interventions depend on accurate identification of the target group, yet this may vary depending on the diagnostic criteria used. We therefore compared the relative performance of various international criteria in identifying COPD cases. The burden of COPD due to smoking can only be determined from population-attributable risk (PAR) studies. These studies, lacking in the COPD literature, are necessary research in support of public health initiatives for COPD. In this representative population study, we also assessed the PAR for current and ex-smokers. DESIGN: A representative biomedical population sample of 2,501 South Australians aged > or = 18 years (The Northwest Adelaide Health [Cohort] Study). COPD diagnosis and severity were determined according to various FEV1/FVC and FEV1 percentage of predicted criteria recommended by international respiratory authorities. Demographic, health behavior, and quality-of-life data were obtained by telephone interview and self-completed questionnaire. SETTING: Northwest Adelaide. MEASUREMENTS AND RESULTS: The PAR of smoking (smokers and ex-smokers) for COPD ranged from 51 to 70% depending on the diagnostic respiratory criteria used. COPD prevalence varied depending on the criteria used: American Thoracic Society, 5.4%; British Thoracic Society, 3.5%; European Respiratory Society (ERS), 5.0%; Global Initiative for Chronic Obstructive Lung Disease, 5.4%. There was also substantial disagreement in the cases identified. An alternative approach using ERS reference values one residual SD from the mean produced a COPD prevalence estimate of 6.9%, with improved level of agreement with the established respiratory criteria suggesting their potential as screening criteria. CONCLUSIONS: The COPD risks associated with smoking and ex-smoking history were quantifiable using PAR, but PAR also suggests other, yet unquantified, risks. Targeting COPD cases for public health interventions is difficult given the range of spirometry criteria and the associated high level of underdiagnosis.

Adult↗

PubMed2003

COPD prevalence in 12 Asia-Pacific countries and regions: projections based on the COPD prevalence estimation model.

OBJECTIVE: COPD is a leading cause of mortality and morbidity worldwide. Despite the high rates of cigarette smoking, and the wide use of biomass fuels, there is very little objective data on the prevalence of COPD in Asia. METHODOLOGY: We used a COPD prevalence model to estimate the prevalence of COPD in 12 Asian countries. This model is a validated, computerized tool that uses epidemiological relationships and risk factor prevalence to project the prevalence of COPD within a given population aged 30 years and older. RESULTS: The total number of moderate to severe COPD cases in the 12 countries of this region, as projected by the model, is 56.6 million with an overall prevalence rate of 6.3%. The COPD prevalence rates for the individual countries range from 3.5% (Hong Kong and Singapore) to 6.7% (Vietnam). CONCLUSIONS: The COPD prevalence rates projected by the model reflect the high prevalence of the risk factors for the disease in Asia. The combined prevalence of 6.3% for these countries is considerably higher than the overall rate of 3.8% as extrapolated from WHO data for this region. These estimates highlight the need for further epidemiological studies to support appropriate allocation of resources for the prevention and management of COPD.

Asia↗

PubMed2006

Exercise and the inflammatory response in chronic obstructive pulmonary disease (COPD)--Does training confer anti-inflammatory properties in COPD?

There is increasing evidence that systemic inflammation plays an important role in the pathogenesis of COPD. Inflammatory markers show relationships with exercise performance, health related quality of life and breathlessness. These are important clinical outcomes in the management of COPD. Even more so is the consideration that systemic inflammation in COPD may be directly associated with mortality and deterioration of disease. Long-term exercise training clearly has beneficial properties in healthy subjects, whether the same is true in COPD remains to be seen. This review discusses aspects of the anti-inflammatory effects of exercise in relation to patients with COPD. There is intriguing evidence that the exercise-induced cytokine response differs in COPD patients compared with healthy subjects. We consider the role of IL-6 in the manifestation of fatigue in COPD and consider the implications of raised CRP- and TNF-alpha. Early data suggests beneficial effects of polyunsaturated fatty acid PUFA supplementation and exercise training in combination with appropriate nutritional support may yield rewarding therapeutic benefits. This review raises the hypothesis that physical training in COPD is associated with immunological changes that may confer anti-inflammatory benefits and in part, explain changes seen after pulmonary rehabilitation in COPD patients.

Exercise↗

PubMed2003

The burden of COPD in Spain: results from the Confronting COPD survey.

Chronic obstructive pulmonary disease is a smoking-related condition of progressive airflow obstruction, with disabling symptoms of chronic dyspnoea, cough and sputum production. In Spain, as in other countries worldwide, only a limited number of studies have attempted to quantify the impact of COPD on the patient, healthcare system and society. To obtain comprehensive information about the burden of this disease, an economic analysis of a large international survey, Confronting COPD in North America and Europe, was conducted. The results of the economic analysis of data from the Spanish survey sample estimated that the annual cost of COPD to the healthcare system was Euro 3238 per patient, with indirect costs amounting to Euro 300 per patient bringing the total societal cost of the disease to Euro 3538 per patient per year. A significant proportion of the economic burden of COPD on the Spanish healthcare system was associated with inpatient hospitalization (Euro 2708), which accounted for almost 84% of the total direct cost of the disease. As the major cause of inpatient hospitalization for COPD is acute exacerbations, these results highlight the need for interventions in the outpatient setting to prevent exacerbations in Spain. The impact of COPD on the healthcare system may also be due to the underdiagnosis and treatment of COPD, suggesting that costs may be reduced by improving the diagnosis and treatment of the disease in primary care. The sub-analysis of costs from the survey showed that patients with severe COPD were associated with considerably higher total societal costs than patients with mild disease (Euro 9850 versus Euro 1316 per patient). Therefore, introducing interventions to reduce the progression to severe COPD could also reduce the impact of the disease.

Absenteeism↗

PubMed2000

[Development and results of a screening program for COPD in primary care. The PADOC Project(Program for the Increase in the Diagnosis of COPD in Primary Care].

Several studies have shown that up to 75% of patients with chronic obstructive pulmonary disease (COPD) remain undiagnosed. Early diagnosis of such individuals will allow appropriate preventive and therapeutic measures to be prescribed. The PADOC project aimed to determine the efficacy of a COPD screening program for Spanish primary care settings. The participating primary care physicians were required to administer a spirometric test (forced expiratory volume) to all individuals who had not previously been given a diagnosis of COPD, who visited the clinic for any reason over a period of three months and who met the following enrollment criteria: a) age over 35 years and b) smoker of more than 10 cigarettes per day or ex-smoker of more than 10 packs per year. Individuals meeting the criteria for suspicion of COPD (FEV1 < 90% of predicted and FEV1/FVC < 70%) were referred to a pneumologist for confirmation of the diagnosis. One hundred ninety-four primary care physicians participated, administering 3,209 valid spirometric tests. The physicians identified 723 likely cases of COPD (22.5%). Pneumologists examined 278 patients (38.4% of the likely cases) and the final diagnosis was COPD in 153 of the 278 (55%) and asthma in 28 (10%). Therefore, 4.3% of all patients given spirometric tests received a diagnosis of COPD and 0.8% received a diagnosis of asthma. Agreement between spirometric measurements taken by the primary care physicians and those taken by pneumologists was low for FVC and FVC (%) (intra-class correlation coefficient ICC = 0.38 and 0.45, respectively) but good for FEV1 and FEV1 (%) (ICC = 0.78 and 0.67, respectively). We conclude that primary care screening for COPD is possible and would allow us to detect up to 22% of possible cases. Patient flow from one level of clinical care to another should be improved, given that most of the possible cases detected (61.6%) were not seen by the referral pneumologist. Agreement between spirometric measurements taken by primary care physicians and pneumologists was low for FVC but good for FEV1.

Adult↗

PubMed2003

The burden of COPD in Canada: results from the Confronting COPD survey.

Chronic obstructive pulmonary disease (COPD) is a condition characterized by progressive airflow limitation, with symptoms of dyspnoea, cough, and sputum production. Aside from information on prevalence, mortality and hospital resource utilization arising from COPD in Canada, there is a lack of data on the impact of the disease on primary care healthcare resource utilization and the economic burden of the disease (i.e. direct and indirect costs). Canada is not unusual in this respect, as surprisingly few studies have attempted to quantify the impact of COPD on the healthcare system and society in other countries. In an attempt to address the need for information on the burden of COPD, an economic analysis of data from a large-scale international survey, Confronting COPD in North America and Europe, was conducted in Canada and six other countries. The results of the Canadian survey estimated the direct cost of the disease at CA dollar 1997.81 per patient, with over half of this due to inpatient hospitalizations. COPD also had an impact on the economy, with indirect costs amounting to CA dollar 1198.18, a third of the total per patient cost of COPD to society (CA dollar 3195.97). Reducing the impact of this disease will necessitate improvements to the way the disease is managed in primary care, as poor symptom control and frequent exacerbations are key drivers of hospital and other unscheduled care costs. Early diagnosis and the application of available but underused interventions (e.g. smoking cessation, inhaled drug therapies and pulmonary rehabilitation) could reduce the morbidity and costs of COPD in this country.

Absenteeism↗

PubMed2003

The burden of COPD in the U.K.: results from the Confronting COPD survey.

Chronic obstructive pulmonary disease (COPD) is a condition characterized by progressive airflow limitation and decline in lung function. As seen in other developed countries throughout the world, COPD in the U.K is associated with considerable mortality, and morbidity from the disease places a significant burden on the healthcare system and society. Despite the obvious burden of COPD in this country, there is a lack of recognition of COPD among the general public. Healthcare professionals may also fail to recognize the burden of disease, as shown by underdiagnosis and inadequate managemen. A key step in increasing awareness of the burden of COPD is obtaining comprehensive information about the impact of the disease on patients, the health service and society. The large-scale international survey, Confronting COPD in North America and Europe, aimed to address this need for information, by interviewing patients and physicians in eight countries. An economic analysis of patient responses to the survey in the U.K showed that COPD places a high burden on the healthcare system and society with annual direct costs estimated at pounds 819.42 per patient, and indirect cost at pound 819.66 per patient resulting in total per patient costs of pound 1639.08. The cost impact of the disease was particularly marked in secondary care, as a result of inpatient hospitalizations, amounting to 54% of direct costs. These results suggest that reducing patient requirement for hospital care could alleviate the burden of COPD on the U.K. healthcare system. This will require considerable improvements to the way the disease is managed by healthcare professionals in primary care, with earlier diagnosis and the use of interventions aimed at preventing exacerbations and delaying the progression of disease.

Absenteeism↗

PubMed2005

Circulating levels of soluble Fas ligand in cachexic patients with COPD are higher than those in non-cachexic patients with COPD.

OBJECTIVE: Apoptosis may be involved in the pathophysiology of cachexia in patients with chronic obstructive pulmonary disease (COPD). The purpose of this study is to assess the potential role of the Fas-Fas ligand (FasL) system in cachexic patients with COPD. PATIENTS AND METHODS: We measured the circulating levels of soluble FasL (sFasL), with a newly developed, highly sensitive enzyme-linked immunosorbent assay system in seventy patients with COPD and forty-seven control subjects. RESULTS: The levels of sFasL in the COPD patients were significantly lower than those in the control subjects (46+/-29 vs. 55+/-28 pg/ml; p<0.05), whereas the levels of soluble Fas (sFas) remained unchanged between the two groups. The significant correlation between the levels of sFasL and sFas, observed in the control subjects (r=0.304; p<0.05), was absent in the COPD patients. Cachexic COPD patients with a relatively lower BMI (BMI <20 kg/m(2), n=45) and %fat (%fat <20%, n=34), showed significantly increased levels of sFasL compared to non-cachexic COPD patients with a relatively higher BMI (BMI > or =20 kg/m(2), n=25) and %fat (%fat > or =20%, n=36) (BMI; 51+/-33 vs. 36+/-15 pg/ml; p<0.05. %fat; 55+/-33 vs. 37+/-21 pg/ml; p<0.01), due to the inverse relationships between the body composition measurements and the levels of sFasL observed exclusively in the patients (BMI; r=-0.307; p<0.05. %fat; r=-0.283; p<0.05). CONCLUSION: These results may suggest that the Fas-FasL system does not play a significant role in the potential triggers of enhanced apoptosis leading to skeletal muscle wasting and adipose tissue depletion in cachexic patients with COPD.

Adipose Tissue↗

PubMed2003

The burden of COPD in the U.S.A.: results from the Confronting COPD survey.

Chronic obstructive pulmonary disease (COPD) is a progressive disorder of airflow limitation that is not fully reversible, with disabling symptoms including chronic cough and dyspnoea. Although a number of studies in the U.S.A. have assessed the impact of COPD on the healthcare system and society, data on healthcare resource utilization (particularly outpatient services and medication use) in patients with mild to moderate COPD, or patients who meet symptom criteria for COPD but have not received this diagnosis, are limited or unavailable. To fill gaps in current knowledge about the impact of this disease, an economic analysis was conducted on the data collected from patients enrolled in the U.S.A. sample of Confronting COPD in North America and Europe, the first large-scale international survey of the burden of the disease. The annual cost of healthcare resource utilization was estimated at US dollar 4119 per patient with COPD, with indirect (non-medical care) costs amounting to US dollar 1527 per patient. The annual estimated societal cost was therefore US dollar 5646 per patient. The majority of disease costs in the survey were associated with inpatient hospitalizations (US dollar 2891). The results of the survey suggest that interventions that improve COPD outcomes by decreasing symptoms and preventing acute exacerbations could substantially decrease the costs associated with this disease.

Absenteeism↗

PubMed2004

[Prevalence of chronic obstructive pulmonary disease (COPD) and other pulmonary diseases among participants of the program of early detection and prevention of COPD].

Chronic obstructive pulmonary disease (COPD) is one of the most frequent chronic diseases and the sixth leading cause of death in the world. The cigarette smoking is the most important cause of the disease and therefore, that COPD is preventable. Programmes detecting COPD in its preclinical phase using spirometry with successful smoking cessation prevent disease progression. The aim of the study was to assess the prevalence of COPD and other pulmonary diseases among participants of the program of early detection and prevention of COPD. The program was held in 2002 and carried out by eleven health care institutions. Active smokers over 40 insured in the Fund were offered free spirometry, chest x ray, individual and group behavioural therapy to stop smoking, and chest physician's examination for patients with diagnosed pathology. The results confirm high detection of COPD and other diseases and confirm the efficacy of targeted screening for early detection of COPD and other diseases.

Adult↗

PubMed2004

[The "COPD emergency 2003" study: a description of the hospital management of exacerbations of COPD].

CURRENT SITUATION: Despite its impact on public health and numerous recommendations COPD remains under-diagnosed and its care pathways are not well known. Exacerbations are common presentations of the illness and contribute greatly to its impact on the health of the individual and the community. Despite this the methods of their management in hospital have not been precisely described. The purpose of the prospective study "COPD emergency 2003" is to describe these different aspects of the management of COPD and to study their determining factors. MATERIALS AND METHODS: It is a prospective, multicentre observational study of all the exacerbations of COPD managed as emergencies in public and private hospitals during a two-month period. Enrolment takes place between October 2003 and January 2004. The analysis will begin when the last patient has been discharged from hospital. EXPECTED RESULTS: The data obtained will allow identification of those aspects of the management of COPD and its exacerbations that are heterogeneous or in conflict with the current guidelines as well as the patient care pathways. In the future this study should help target the approaches aimed at improving the outcomes of patients suffering from COPD.

Adult↗