title: Characteristics of prevalent and new COPD cases in Greece: the GOLDEN study.
abstract: BACKGROUND
  Greece has one of the highest rates of smoking and chronic obstructive pulmonary disease (COPD) in Europe.
  
  
  OBJECTIVE
  The study aimed to record both the disease characteristics among a sample of Greek COPD patients and the nationwide rates of newly diagnosed COPD cases.
  
  
  METHODS
  In this noninterventional, epidemiological cross-sectional study, a representative nationwide sample of 45 respiratory centers provided data on the following: 1) the demographic and clinical characteristics of COPD patients and 2) newly diagnosed COPD cases monitored over a period of 6 months by each physician.
  
  
  RESULTS
  Data from 6,125 COPD patients were collected. Advanced age (median age: 68 years), male predominance (71.3%), largely overweight status with median body mass index (BMI) =27.5 kg/m(2), high percentage of current and ex-smokers (89.8%), and presence of comorbidities (81.9%) were evident in the sample. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011 criteria, majority of the COPD patients had moderate or severe airflow limitation (61%). Severity of airflow limitation was significantly associated with older age, male sex, obesity, ex-smoking status, and presence of comorbidity (all P-values <0.001). A total of 61.3% of the patients received medication, mostly bronchodilators (64.4%) and fixed-dose combinations of long-acting β2-agonists and inhaled corticosteroids (39.9%), while 35.9% reported taking medication on demand. The majority (81.1%) of patients reported a preference for fewer inhalations of their bronchodilator therapy. Based on the mixed-effect Poisson model, the rate of newly diagnosed COPD cases was estimated to be 18.2% (95% confidence interval: 14.9-22.3) per pulmonologist/3 months. Of those newly diagnosed, the majority of patients had mild or moderate airflow limitation (78.2%).
  
  
  CONCLUSIONS
  The Greek Obstructive Lung Disease Epidemiology and health ecoNomics study reflected the real-life profile of COPD patients and provided evidence on the profile of new COPD cases in Greece. Various demographic factors were delineated, which can assist in designing more effective diagnostic and management strategies for COPD in Greece.
authors.affiliation: Medical Department, Novartis Hellas, Athens, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Mitsiki
authors.affiliation: Department of Respiratory Medicine, Medical School, University of Thessaly, University Hospital of Larissa, Larissa, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Bania
authors.affiliation: Medical Department, Novartis Hellas, Athens, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Varounis
authors.affiliation: Department of Respiratory Medicine, Medical School, University of Thessaly, University Hospital of Larissa, Larissa, Greece.
authors.forename: Konstantinos I
authors.initials: KI
authors.lastname: Gourgoulianis
authors.affiliation: School of Social Sciences, Hellenic Open University, Athens, Greece.
authors.forename: Evangelos C
authors.initials: EC
authors.lastname: Alexopoulos
mesh_terms: D000368:Aged; D001993:Bronchodilator Agents / Q000627:therapeutic use; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004338:Drug Combinations; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008168:Lung / Q000187:drug effects / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D012129:Respiratory Function Tests; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016540:Smoking Cessation; D000074606:Smoking Prevention; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D004338:Drug Combinations
keywords: COPD; characteristics; epidemiology; health care management; health care system; nationwide sampling; new cases; newly diagnosed; prevalent cases