[Reliability of a chronic obstructive pulmonary disease diagnosis register in Primary Care].
OBJECTIVE
One of main limitations in studies of COPD in health databases could be the low quality of the information. Our first aim was evaluate reliability of the registry of COPD diagnosis register in Primary Care. A description and comparison is also presented of the characteristics of the patients according to the diagnostic confirmation.


METHODS
A cross-sectional study using healthcare databases of Cantabria. A pre-selected sample of 1,457 patients was obtained in which COPD diagnosis was specifically registered. COPD confirmation was classified into confirmed COPD, not confirmed-not rejected COPD, and diagnostic error (over-diagnosis). Descriptive and clinical characteristics, comorbidities, and treatments were collected in each group.


RESULTS
COPD was confirmed in 766 patients: 52.6% (95%CI: 49.9-55.2). Prevalence of over-diagnosis was 7.2% (95%CI: 5.9-8.6). There were statistically significant gender differences. In the COPD confirmed group age, tobacco consumption and severity according to FEV1 was higher. An average of 1.95 bronchial exacerbations during the last 4years was observed among diagnostic errors. Inhaled corticosteroids were prescribed in 74.9% of COPD confirmed patients, and in 41.9% of over-diagnosed patients.


CONCLUSIONS
The reliability of the COPD register was deficient, with only 52.6% with a confirmed diagnosis. Stable treatment for COPD was prescribed in all groups, highlighting the use of inhaled corticosteroids.
Centro de Salud de Gama, Servicio Cántabro de Salud, Bárcena de Cicero, España. Electronic address: garrastazul@gmail.com.
R
R
Garrastazu
Servicio de Neumología, Hospital Laredo, Laredo, España.
J L
JL
García-Rivero
Centro de Salud de Liérganes, Servicio Cántabro de Salud, Miera, España.
M
M
Ruiz-Nuñez
Centro de Salud Bajo Asón, Servicio Cántabro de Salud, Ampuero, España.
J M
JM
Helguera
Centro de Salud de Suances, Servicio Cántabro de Salud, Suances, España.
S
S
Arenal
Centro de Salud Campoo-Los Valles, Servicio Cántabro de Salud, Mataporquera, España.
C
C
Bonnardeux
Centro de Salud de Suances, Servicio Cántabro de Salud, Suances, España.
C
C
León
Servicio de Neumología, Hospital Universitari Vall d'Hebron, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, España.
M
M
Miravitlles
Área de Medicina Preventiva y Salud Pública, Universidad de Cantabria-IDIVAL, Santander, España.
M
M
Santibañez
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000368:Aged; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D000069342:Medical Overuse / Q000706:statistics & numerical data; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D012042:Registries; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013030:Spain; D064424:Tobacco Use / Q000453:epidemiology*
D000305:Adrenal Cortex Hormones
Atención Primaria; Chronic airflow obstruction; Diagnosis; Diagnóstico; Electronic health records; Enfermedad pulmonar obstructiva crónica; Epidemiology; Epidemiología; Primary Health Care; Registros electrónicos de salud