Impact of chronic obstructive pulmonary disease (COPD) in the Asia-Pacific region: the EPIC Asia population-based survey.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is a clinical syndrome encompassing a group of chronic, progressive, and debilitating respiratory conditions, that are characterized by incompletely reversible airflow limitation. Within the Asia-Pacific region, prevalence estimates have been derived using various protocols and study methods, and there is little data on the impact of COPD exacerbations. This study aimed to provide a comprehensive picture of the current prevalence and burden of COPD in this region.


METHODS
A population-based survey was conducted in nine Asia-Pacific territories between 01 February 2012 and 16 May 2012. Overall, 112,330 households were screened to identify eligible subjects (aged ≥40 years, with a physician diagnosis of COPD, chronic bronchitis or emphysema, or with identifiable symptoms of chronic bronchitis). Out of a sample of 69,279 individuals aged ≥40 years, 4,289 subjects with COPD were identified. Data were collected via face-to-face interviews or by fixed-line telephone, using a structured questionnaire. A total of 1,841 completed questionnaires were analyzed.


RESULTS
The overall estimated COPD prevalence was 6.2%, with 19.1% of subjects having severe COPD. In the 12 months prior to the survey, nearly half of all subjects (46%) had experienced exacerbations, and 19% had been hospitalized as a result of their condition. When subjects were asked about the impact of their condition on employment, 23% said their condition kept them from working, and 42% felt that their condition limited their ability to work or their activities. Of those who reported taking prescription drugs, 20% did not know the name of the drugs they were taking. Prescription of oral corticosteroids was common, with 44% of subjects having used these during the previous year to manage their respiratory symptoms; in contrast, inhaler use was low (25%). Only 37% of subjects had taken a lung function test, and the majority (89%) of those tested did not know their test results.


CONCLUSIONS
Across the Asia-Pacific territories surveyed, the prevalence of COPD is high, indicating a substantial socioeconomic burden. Our findings suggest that there is considerable room for improvement in the management of COPD, and highlight a need to enhance patient and physician education in the region.
Duke-NUS Graduate School of Medicine, Singapore, Singapore.
Sam
S
Lim
Department of Medicine, University of Hong Kong, Pokfulam , Hong Kong.
David Chi-Leung
DC
Lam
Institute of Respiratory Medicine, Kuala Lumpur, Malaysia.
Abdul Razak
AR
Muttalif
Department of Pulmonology and Respiratory Medicine, Universitas Indonesia (FMUI), Jakarta, Indonesia.
Faisal
F
Yunus
Department of Internal Medicine, Chulalongkorn University, Bangkok, Thailand.
Somkiat
S
Wongtim
Respiratory Care Center, University Medical Center, Ho Chi Minh City, Vietnam.
Le Thi Tuyet
le TT
Lan
Takeda Pharmaceuticals (Asia-Pacific) Pte. Ltd, Singapore, Singapore.
Vikram
V
Shetty
Takeda Pharmaceuticals (Asia-Pacific) Pte. Ltd, Singapore, Singapore.
Romeo
R
Chu
State Key Lab of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People's Republic of China.
Jinping
J
Zheng
Chest Department, Taipei Veterans General Hospital and School of Medicine, National Yang Ming University, Taipei, Taiwan.
Diahn-Warng
DW
Perng
Division of Pulmonary and Critical Care Medicine, Philippine Heart Center, Quezon City, Philippines.
Teresita
T
de Guia
Asia-Pacific; Chronic obstructive pulmonary disease (COPD); Exacerbations; Impact; Population-based; Prevalence; Quality of life (QoL); Survey