Factors Associated with Patient Education in Patients with Chronic Obstructive Pulmonary Disease (COPD) – A Primary Health Care Register-Based Study

Abstract

Purpose: Patient education in chronic obstructive pulmonary disease (COPD) is recommended in treatment strategy documents, since it can improve the ability to cope with the disease. Our aim was to identify the extent of and factors associated with patient education in patients with COPD in a primary health care setting. Patients and Methods: In this nationwide study, we identified 29,692 COPD patients with a registration in the Swedish National Airway Register (SNAR) in 2019. Data on patient education and other clinical variables of interest were collected from SNAR. The database was linked to additional national registers to obtain data about pharmacological treatment, exacerbations and educational level. Results: Patient education had been received by 44% of COPD patients, 72% of whom had received education on pharmacological treatment including inhalation technique. A higher proportion of patients who had received education were offered smoking cessation support, had performed spirometry and answered the COPD Assessment Test (CAT), compared with patients without patient education. In the adjusted analysis, GOLD grade 2 (OR 1.29, 95% CI 1.18–1.42), grade 3 (OR 1.41, 95% CI 1.27–1.57) and grade 4 (OR 1.79, 95% CI 1.48–2.15), as well as GOLD group E (OR 1.17, 95% CI 1.06–1.29), ex-smoking (OR 1.70, 95% CI 1.56–1.84) and current smoking (OR 1.45, 95% CI 1.33–1.58) were positively associated with having received patient education, while cardiovascular disease (OR 0.92, 95% CI 0.87–0.98) and diabetes (OR 0.93, 95% CI 0.87–1.00) were negatively associated with receipt of patient education. Conclusion: Fewer than half of the patients had received patient education, and the education had mostly been given to those with more severe COPD, ex-and current smokers and patients with fewer comorbidities. Our study highlights the need to enhance patient education at an earlier stage of the disease.