title: Implications of chronic obstructive pulmonary disease (COPD) on patients' health status: a western view.
abstract: OBJECTIVE
  To assess and compare health status among chronic obstructive pulmonary disease (COPD) patients presenting for treatment in six countries and in two healthcare settings using a generic health status instrument.
  
  
  METHODS
  A population based cross-sectional survey was conducted among 2703 patients and their physicians (1381 in primary and 1322 in specialty care) in five EU countries and the USA. Information was collected on demographic and clinical characteristics, exacerbations and health status estimated using EQ-5D.
  
  
  RESULTS
  The mean EQ-5D score for COPD patients was similar between primary and specialty settings in all countries except Italy. Approximately, half of the patients indicated some impairment in health status on mobility, usual activities, pain/discomfort and anxiety/depression domains of EQ-5D. Approximately, 5% of patients in EU countries except UK had health status valued as worse than death based on valuations of the general population. Patients suffering from severe breathlessness, experiencing > or =3 exacerbations in the previous year, categorised as severe according to GOLD criteria, and experiencing day-time and night-time symptoms had significantly impaired health status.
  
  
  CONCLUSIONS
  COPD patients classified as moderate/severe in clinical practice have worse health status compared to mild patients. This impairment is similar in primary and specialty setting across western countries.
authors.affiliation: Global Health Outcomes, GlaxoSmithKline Research and Development, Greenford Road, Greenford, Middlesex UB6 0HE, UK. yogesh.puneker@spcorp.com
authors.forename: Yogesh Suresh
authors.initials: YS
authors.lastname: Punekar
authors.forename: Roberto
authors.initials: R
authors.lastname: Rodriguez-Roisin
authors.forename: Mark
authors.initials: M
authors.lastname: Sculpher
authors.forename: Paul
authors.initials: P
authors.lastname: Jones
authors.forename: Michael
authors.initials: M
authors.lastname: Spencer
mesh_terms: D017677:Age Distribution; D000368:Aged; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011159:Population Surveillance / Q000379:methods; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology