title: Characteristics of undertreatment in COPD in the general population.
abstract: BACKGROUND
  We wished to characterize undertreatment in COPD.
  
  
  METHODS
  Among 5,812 individuals with COPD defined by FEV1/FVC &lt; 0.7 participating in the Copenhagen General Population Study, we identified 920 individuals with FEV1 &lt; 60% predicted. Prescriptions were identified in an all-inclusive nationwide registry. For each individual, we examined treatment with medication in the year before the day of the baseline examination, as well as treatment in the first year after the examination. Multivariable logistic regression analyses were applied in individuals with FEV1 &lt; 60% predicted to identify predictors of treatment in the first year after baseline.
  
  
  RESULTS
  Only 30% of individuals with COPD and FEV1 &lt; 60% predicted were treated with medication in the year before the examination, whereas 42.2% were treated with medication in the first year after. Reporting six to 10 previous respiratory infections during the preceding 10 years that required consulting a doctor and/or staying home from work was the strongest predictor of treatment with medication (OR, 7.9; 95% CI, 3.5-19.8; P &lt; .001). Breathlessness, low FEV1, previous admissions with a discharge diagnosis of COPD, and former smoking were also predictors of treatment with medication, whereas comorbidity predicted lack of treatment. In subgroup analysis, among individuals with FEV1 &lt; 50% predicted, visits to the general practitioner and age were additional predictors of treatment, whereas male sex and being a widow/widower predicted lack of treatment.
  
  
  CONCLUSIONS
  In this study, we observed important characteristics of a major undertreatment in individuals with COPD in the general population. Previous reported respiratory infections were the strongest predictors of treatment with medications, which indicates that most COPD treatment is initiated because of acute exacerbations.
authors.affiliation: Department of Respiratory Medicine, Odense University Hospital and Clinical Institute, University of Southern Denmark, Odense, Denmark; The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark. Electronic address: trulsingebrigtsen@gmail.com.
authors.forename: Truls S
authors.initials: TS
authors.lastname: Ingebrigtsen
authors.affiliation: The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark.
authors.forename: Jacob L
authors.initials: JL
authors.lastname: Marott
authors.affiliation: Department of Respiratory Medicine, Odense University Hospital and Clinical Institute, University of Southern Denmark, Odense, Denmark; Respiratory Research Group, Manchester Academic Health Sciences Centre, University Hospital South Manchester NHS Foundation Trust, Manchester, England.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Vestbo
authors.affiliation: Department of Clinical Pharmacology, Odense University Hospital and Clinical Institute, University of Southern Denmark, Odense, Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Hallas
authors.affiliation: Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Copenhagen, Denmark; The Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Børge G
authors.initials: BG
authors.lastname: Nordestgaard
authors.affiliation: Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Dahl
authors.affiliation: The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark; Respiratory Section, Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark; Department of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Lange
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000368:Aged; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D012044:Regression Analysis; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014797:Vital Capacity / Q000502:physiology*
chemical_list: D000305:Adrenal Cortex Hormones; D001993:Bronchodilator Agents