title: Effect of ethnicity on the prevalence, severity, and management of COPD in general practice.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) remains a major cause of mortality and hospital use. Little is known in the UK about the variation in COPD prevalence, severity, and management depending on ethnicity.
  
  
  OBJECTIVE
  To examine differences by ethnicity in COPD prevalence, severity, and management.
  
  
  METHODS
  Cross-sectional study using routinely collected computerised data from general practice in three east-London primary care trusts (Newham, Tower Hamlets, and City and Hackney) with multiethnic populations of people who are socially deprived.
  
  
  METHODS
  Routine demographic, clinical, and hospital admission data from 140 practices were collected.
  
  
  RESULTS
  Crude COPD prevalence was 0.9%; the highest recorded rates were in the white population. Severity of COPD, measured by percentage-predicted forced expiratory volume in 1 second, did not vary by ethnicity. South Asians and black patients were less likely than white patients to have breathlessness, indicated by a Medical Research Council dyspnoea grade of ≥4 (odds ratio [OR] 0.7 [95% confidence interval (CI) = 0.6 to 0.9] and 0.6 [95% CI = 0.4 to 0.8]). Black patients were less likely than white patients to receive inhaled medications. Influenza and pneumococcal vaccine rates were highest among groups of South Asians (OR 3.0 [95% CI = 2.1 to 4.3] and 1.8 [95% CI = 1.4 to 2.3] respectively). Both minority ethnic groups had low referral rates to pulmonary rehabilitation. In Tower Hamlets, black patients were more likely to be admitted to hospital for respiratory causes.
  
  
  CONCLUSIONS
  Differences in COPD prevalence and severity by ethnicity were identified, and significant differences in drug and non-drug management and hospital admissions observed. Systematic ethnicity recording in general practice is needed to be able to explore such differences and monitor inequalities in healthcare by ethnicity.
authors.affiliation: Barts and the London School of Medicine and Dentistry, London.
authors.forename: Alice
authors.initials: A
authors.lastname: Martin
authors.forename: Ellena
authors.initials: E
authors.lastname: Badrick
authors.forename: Rohini
authors.initials: R
authors.lastname: Mathur
authors.forename: Sally
authors.initials: S
authors.lastname: Hull
mesh_terms: D000328:Adult; D000368:Aged; D001211:Asia, Western / Q000208:ethnology; D044383:Black People / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice; D006760:Hospitalization; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000208:ethnology*; D019141:Respiratory System Agents / Q000627:therapeutic use; D044465:White People / Q000208:ethnology
chemical_list: D019141:Respiratory System Agents