ABS62: Is well-known COPD, well-treated COPD?

Abstract

Introduction:

Chronic obstructive pulmonary disease (COPD) is an important problem of public health because of its high prevalence, recurrent visits to primary care, morbidity and mortality and its economic impact [1–3].

Aims and objectives:

To describe COPD patients, analyze their treatment and evaluate its agreement with current guidelines in an urban Primary Care centre (PCC).

Subjects and methods:

The computerized and paper health history from patients included as having COPD in our primary care computer database confirmed by spirometry was reviewed. We recorded age, sex, smoking habit, forced expired volume in one second (FEV1), classification according to the “Global Initiative for Chronic Obstructive Lung Disease” (GOLD), treatment (drugs and inhalation systems), anti-smoking counselling (ASC), exacerbations during the year before the review and level of patient care.

Results:

233 COPD patients, 97% men, middle aged 71,9 (SD10,2), ex-smokers 63%, smokers 36% (ASC30%). GOLD classification: 8,5% at risk, 4% mild, 44,2% moderate, 35,2% severe and 8,2% very severe. 68% patients used regular treatment with bronchodilators (at risk 33%, mild 59%, moderate 78%, severe 80% and very severe 83%, p<0,001), 45,5% with long-acting beta2 agonists (LAB2) (at risk 15%, mild 31%, moderate 43%, severe 72% and very severe 78%, p<0,001), 54% with inhaled corticosteroids (IC) (at risk 19%, mild 38%, moderate 59%, severe 71% and very severe 83%, p< 0,001), 36,9% with combination LAB2+IC (none at risk, mild 2,3%, moderate 37,2%, severe 45,3% and very severe 15,1%, p < 0,001), 5,4% with oxygen, 3% with mucolytics, 1% with oral corticosteroids and 1% with pulmonary rehabilitation. Metered dose inhalers (MDI) were used by 60,1%, MDI and spacer 32,2% and dry powder 43,8%. 1–3 exacerbations/year 48% and none 42%. Control in PCC 95,7% (68,2% PCC and 27,5% PCC/pneumologist).

Conclusions:

- Obstruction was mild-to-moderate in most of the patients.

- The beginning of treatment and patient control is done mainly by primary care physicians.

- The great majority of patients use some bronchodilator therapy.

- We must improve the use of regular treatment with bronchodilators and inhaled corticosteroids in mild cases and the greater the severity, the better agreement with the treatment.

Conflict of interest and funding

None.