Undetected chronic obstructive pulmonary disease and asthma in people over 50 years with persistent cough.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) and asthma are underdiagnosed in primary care.


OBJECTIVE
To determine how often COPD or asthma are present in middle-aged and older patients who consult their GP for persistent cough.


METHODS
A cross-sectional study in 353 patients older than 50 years, visiting their GP for persistent cough and not known to have COPD or asthma.


METHODS
General practice in the Netherlands.


METHODS
All participants underwent extensive diagnostic work-up, including symptoms, signs, spirometry, and body plethysmography. All results were studied by an expert panel to diagnose or exclude COPD and/or asthma. The reproducibility of the panel diagnosis was assessed by calculation of Cohen's kappa statistic in a sample of 41 participants.


RESULTS
Of the 353 participants, 102 (29%, 95% confidence interval [CI] = 24 to 34%) were diagnosed with COPD. In 14 of these 102 participants, both COPD and asthma were diagnosed (4%, 95% CI = 2 to 7%). Asthma (without COPD) was diagnosed in 23 (7%, 95% CI = 4 to 10%) participants. Mean duration of cough was 93 days (median 40 days). The reproducibility of the expert panel was good (Cohen's kappa = 0.90).


CONCLUSIONS
In patients aged over 50 years who consult their GP for persistent cough, undetected COPD or asthma is frequently present.
Broekhuizen
Berna D L
BD
Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands. b.d.l.broekhuizen@umcutrecht.nl
Sachs
Alfred P E
AP
Hoes
Arno W
AW
Moons
Karel G M
KG
van den Berg
Jan W K
JW
Dalinghaus
Willem H
WH
Lammers
Ernst
E
Verheij
Theo J M
TJ
D000368:Aged; D001249:Asthma / Q000150:complications / Q000175:diagnosis*; D002908:Chronic Disease; D003371:Cough / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis*