Clinical research studyComorbidities, Patient Knowledge, and Disease Management in a National Sample of Patients with COPD
Section snippets
Materials and Methods
Participants were drawn from a national sample of 4003 households in which 1 or more persons reported a diagnosis of a form of COPD. COPD was ascertained by the questionnaire item, “Have you ever been diagnosed by a physician as having: emphysema; chronic obstructive pulmonary disease (COPD); [or] alpha-one antitrypsin deficiency?” Patients with COPD with a co-diagnosis of asthma were not excluded because of the overlap of these 2 conditions in clinical practice. The sampling frame was derived
Results
The characteristics of the 1003 patients who responded to the survey, stratified by gender, are shown in Table 1. The mean age (± standard deviation) was 61 ± 10 years, and 58% were women. Respondents lived mostly in the Midwest and the South of the United States and were predominantly white. Half had no education beyond high school. Ninety-five percent noted a history of daily cigarette use, and 47% of women and 39% of men smoked cigarettes regularly at the time of the survey. A co-diagnosis
Discussion
This national survey of patients with diagnosed COPD suggested that comorbid diagnoses of hypertension, hypercholesterolemia, depression, and osteoporosis occur frequently in patients with COPD. Although this was a COPD survey and despite similar amounts of clinical testing, patients' knowledge of their cholesterol levels and blood pressure far exceeded their knowledge of their FEV1. COPD was undertreated compared with other conditions, such as hypertension, which is generally asymptomatic and
Conclusions
Comorbidities are common in COPD and likely add to the complexity and cost of care. Although patients with COPD take a large number of medications, relatively few of these medications are for COPD. This discrepancy may relate to poor physician and patient knowledge about COPD26 or reflect the more limited evidence base for COPD compared with other leading causes of death. Although advances in COPD pathophysiology and clinical research are needed to have a full impact, better education and
Acknowledgments
We thank the COPD Foundation, which commissioned the survey, and the firm of Schulman, Ronca and Bucuvalas, Inc, which administered the survey, performed initial data analyses, and assisted with some aspects of the initial manuscript preparation.
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Funding: The COPD Foundation and National Institutes of Health HL077612 and HL075476.
Conflict of Interest: R. Graham Barr, MD, DrPH: none. Bartolome R. Celli, MD: research grants from Glaxo Smith Kline (GSK), Boehringer Ingelheim (BI), Forrest Medical, Astra Zeneca; advisory board payments from GSK, BI, Almirall, Astra Zeneca; speakers' fees from GSK, BI, Astra Zeneca, Almirall. David Mannino, MD: research funding from GSK, Pfizer, and Novartis; consultant or speakers' fees from GSK, Pfizer, BI, Astra-Zeneca, Dey, and Sepracor. Thomas Petty, MD: none. Stephen I. Rennard, MD: research grants from Almirall, Lorillard, Centocor, Novartis, GSK, Philip Morris, Institute for Science and Health, Roche; consultancy and advisory board payments from Abbott, Johnson & Johnson, Almirall, Novartis, Altana, Roche, Anthera, Quintiles, GSK, Targegen; speakers' fees from Adams, Novartis, AstraZeneca, Pfizer. Frank C. Sciurba, MD: consultancy for Astra Zeneca, BI, Dey, GSK, Novartis, Pfizer, PneumRX, Respironics, Schering and Sepracor. James K. Stoller, MD, MS: consultancy for Talecris Biotherapeutics, BI; speaker for Grifols, Baxter, CSL-Behring, Pfizer, Talecris. Byron M. Thomashow, MD: speakers' fees and consultancy for BI, Pfizer and GSK. Gerard M. Turino, MD: research grant from BI; consultancy for Talecris Corporation.
Authorship: All authors had access to the data and played a role in writing this manuscript.