THE PROFILE OF CHRONIC OBSTRUCTIVE DISEASE IN THE PRIMARY CARE SETTING

Abstract

PURPOSE: Chronic Obstructive Pulmonary Disease (COPD) is one of the most prevalent chronic diseases. COPD management is being investigated in large clinical trials but we do not know if they are studying the typical patient with COPD cared for in primary care. In order to fill the gap of knowledge in COPD we undertook to describe the current profile of patients with COPD in primary care practice. METHODS: Family practitioners were provided with an update on COPD management and a workshop on office spirometry. Patients identified underwent spirometry, six minute walk test and completed questionnaires on their symptoms of COPD, quality of life, depression and anxiety. RESULTS: A total of 50 patients were tested. 23 (46%) were women, the mean age of patients was 66 years (1.6). Mean FEV1/FVC was 65% (15) with FEV1 68% (25.8). Exposure to smoking was an average of 52 pack years (23.2) with 26 (52%) current smokers. 6MWT mean 369m (18). Score on the scale for their risk of COPD was 25 and for diagnosis of COPD was 27; with a score above 17 and 19 respectively being indicative of COPD. Normal anxiety and depression with scores on those scales 6 and 4 respectively. 25 (50%) patients were in GOLD stage 0, 0 in stage 1, 12 (24%) stage 2, 11 (22%) stage 3 and 2 (4%) stage 4. MRC score 0 in 10 (20%) subjects, score 1 in 17 (34%), score 2 in 7 (14%), score 3 in 6 (12%) and score 4 in 10 (20%). There were 31 (62%) patients with BODE score 0-2, 7 (14%) score 3-4, 6 (12%) score 5-6, and 6 (12%) score 7-10. CONCLUSION: This population had relatively milder disease than those included in most studies assessing treatment of COPD. CLINICAL IMPLICATIONS: This pilot study describes the profile of COPD patients cared for in the primary care setting. Education efforts need to focus on awareness of diagnosis and treatment of COPD as well as on smoking cessation.