Prevalence of COPD among symptomatic patients in a primary care setting.
OBJECTIVE
Spirometry is recognized as the gold standard assessment for the diagnosis of COPD. However, spirometry continues to be underused, perpetuating the underdiagnosis of COPD. The aim of this study was to evaluate the prevalence of COPD in a primary care setting in patients with a smoking history and self-reported chronic bronchitis symptoms.


METHODS
This was a multi-center, cross-sectional study. The primary assessment was the percentage of patients with airway obstruction (post-bronchodilator FEV(1)/FVC ratio < or = 0.70) compared to those without obstruction (post-bronchodilator FEV(1)/FVC ratio > 0.70).


RESULTS
Airflow obstruction consistent with COPD was confirmed in 26% of patients (mean age 52.9 years, FEV(1) 81.4% predicted and smoking history 39.8 pack-years) that reported chronic bronchitis symptoms. Airflow obstruction increased with age and smoking history. Slight or moderate dyspnea was reported by 68% of patients and the majority had not talked to their doctor about cough and continued to smoke.


CONCLUSIONS
Patients were evaluated at a single visit. The definition of airway obstruction used may have lead to overdiagnosis in patients aged 70 and older.


CONCLUSIONS
This study confirms that many patients with COPD remain undiagnosed in the primary care setting. Evaluation of spirometry in patients with a smoking history and chronic bronchitis symptoms can aid in the diagnosis of COPD, allowing earlier treatment thereby reducing the burden of this debilitating disease.


BACKGROUND
Study code ADC109043; clinicaltrials.gov #NCT00442468.
Yawn
Barbara
B
Olmsted Medical Center, Rochester, MN, USA.
Mannino
David
D
Littlejohn
Thomas
T
Ruoff
Gary
G
Emmett
Amanda
A
Raphiou
Ibrahim
I
Crater
Glenn
G
D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000175:diagnosis* / Q000453:epidemiology; D029481:Bronchitis, Chronic / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology*; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013147:Spirometry / Q000592:standards; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology