[Treatment of chronic obstructive pulmonary disease in 5 Latin American cities: the PLATINO study].
OBJECTIVE
PLATINO project is a population-based study designed to determine the prevalence of chronic obstructive pulmonary disease (COPD) in São Paulo, Brazil; Mexico City, Mexico; Montevideo, Uruguay; Santiago de Chile, Chile; and Caracas, Venezuela. The objective of this portion of PLATINO was to describe preventive and pharmacological treatment of COPD patients and factors associated with such treatment.


METHODS
Eligible subjects completed a questionnaire and underwent postbronchodilator spirometry.


RESULTS
Of the total of 5529 individuals who answered items referring to treatment, 758 had COPD (ratio of postbronchodilator forced expiratory volume in 1 second to forced vital capacity of <0.7), and 86 of them had been previously diagnosed by a physician. Among all COPD patients, only half of smokers or former smokers had been advised to quit and 24.7% had received some type of respiratory medication. Only 13.5% had used inhaled corticosteroids, and those were the patients with the most severe disease. In the group of patients who had a previous medical diagnosis of COPD, 69% of the smokers or former smokers had been advised to quit by a physician and 75.6% had received respiratory medication in the preceding year: 43% reported having used inhaled medication and 36% had used bronchodilators. Rates of vaccination against influenza and the use of mucolytic drugs and inhalers varied from one health care facility to another. All drug prescriptions were based on previous spirometry.


CONCLUSIONS
Spirometry emerged not only as a diagnostic tool, but also as a factor associated with treatment, against a background of uneven use of available health care resources in these 5 Latin American cities.
López Varela
María Victorina
MV
Facultad de Medicina, Universidad de la República, Montevideo, Uruguay. mlopez@chasque.net
Muiño
Adriana
A
Pérez Padilla
Rogelio
R
Jardim
José Roberto
JR
Tálamo
Carlos
C
Montes de Oca
María
M
Valdivia
Gonzalo
G
Pertuzé
Julio
J
Halbert
Ron
R
Menezes
Ana María
AM
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D005100:Expectorants / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007251:Influenza, Human / Q000276:immunology / Q000517:prevention & control; D007843:Latin America; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D013147:Spirometry / Q000379:methods*; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000379:methods*
D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D005100:Expectorants