title: Phenotypic Variation in Patients with Chronic Obstructive Pulmonary Disease in Primary Care.
abstract: Introduction. Despite the high number of inactive patients with COPD, not all inactive patients are referred to physical therapy, unlike recommendations of general practitioner (GP) guidelines. It is likely that GPs take other factors into account, determining a subpopulation that is treated by a physical therapist (PT). The aim of this study is to explore the phenotypic differences between inactive patients treated in GP practice and inactive patients treated in GP practice combined with PT. Additionally this study provides an overview of the phenotype of patients with COPD in PT practice. Methods. In a cross-sectional study, COPD patient characteristics were extracted from questionnaires. Differences regarding perceived health status, degree of airway obstruction, exacerbation frequency, and comorbidity were studied in a subgroup of 290 inactive patients and in all 438 patients. Results. Patients treated in GP practice combined with PT reported higher degree of airway obstruction, more exacerbations, more vascular comorbidity, and lower health status compared to patients who were not referred to and treated by a PT. Conclusion. Unequal patient phenotypes in different primary care settings have important clinical implications. It can be carefully concluded that other factors, besides the level of inactivity, play a role in referral to PT.
authors.affiliation: Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, Netherlands; Research Centre for Autonomy and Participation of Persons with a Chronic Illness, Zuyd Hogeschool, P.O. Box 550, 6400 AN Heerlen, Netherlands; Physical Therapy Section in Multidisciplinary Centre, ParaMedisch Centrum Zuid, Veestraat 28, 6134 VJ Sittard, Netherlands.
authors.forename: Emmylou
authors.initials: E
authors.lastname: Beekman
authors.affiliation: Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, Netherlands.
authors.forename: Ilse
authors.initials: I
authors.lastname: Mesters
authors.affiliation: Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD Maastricht, Netherlands.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Spigt
authors.affiliation: Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD Maastricht, Netherlands.
authors.forename: Eva A M
authors.initials: EA
authors.lastname: van Eerd
authors.affiliation: Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, P.O. Box 1500, 3001 Heverlee, Belgium; Department of Respiratory Rehabilitation and Respiratory Division, University Hospital Leuven, P.O. Box 706, 3000 Leuven, Belgium.
authors.forename: Rik
authors.initials: R
authors.lastname: Gosselink
authors.affiliation: Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, Netherlands.
authors.forename: Rob A
authors.initials: RA
authors.lastname: de Bie
authors.affiliation: Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD Maastricht, Netherlands.
authors.forename: Onno C P
authors.initials: OC
authors.lastname: van Schayck
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D010641:Phenotype; D059825:Physical Therapists; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000473:pathology*