The 10-year COPD Programme in Finland: effects on quality of diagnosis, smoking, prevalence, hospital admissions and mortality

Abstract

Background

The Finnish National Programme for Chronic Bronchitis and Chronic Obstructive Pulmonary Disease (COPD) 1998–2007 was set up to reduce the prevalence of COPD, improve COPD diagnosis and care, reduce the number of moderate to severe cases of the disease, and reduce hospitalisations and treatment costs due to COPD. Over 900 events for 25,000 participating healthcare workers were arranged. The major strengths of this programme included multidisciplinary strategies and web-based guidelines in nearly all primary health care centres around the country.

Methods

Data from national registries, epidemiological studies and questionnaires were used to measure whether the goals had been reached.

Results

The prevalence of COPD remained unchanged. Smoking decreased in males from 30% to 26% (p<0.001) and in females from 20% to 17% (p<0.001). Significant improvements in the quality of spirometry were obtained. Hospitalisation decreased by 39.7% (p<0.001). COPD costs were 88% lower than had been anticipated from earlier investigations. No increase in COPD mortality was observed.

Conclusions

In combination with other efforts, the Finnish 10-year COPD Programme had significant positive consequences: no further increases in COPD prevalence, reduced smoking prevalence, improved quality of diagnosis, and reduction in COPD-related hospitalisations.