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Comorbidities, Patient Knowledge, and Disease Management in a National Sample of Patients with COPD |
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| Authors: | R. Graham Barr Bartolome R. Celli David M. Mannino Thomas Petty Stephen I. Rennard Frank C. Sciurba James K. Stoller Byron M. Thomashow Gerard M. Turino |
| Affiliation: | a Division of General Medicine, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY b Division of Pulmonary, Allergy and Critical Care, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY c Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY d Pulmonary and Critical Care Division, Caritas-St Elizabeth's Medical Center, Tufts University, Boston, Mass e Department of Preventive Medicine and Environmental Health, University of Kentucky College of Public Health, Lexington f Departments of Medicine, University of Colorado and Rush-Presbyterian St Luke's, Chicago, Ill g Pulmonary and Critical Care Medicine Section, Department of Internal Medicine, University of Nebraska Medical Center, Omaha h Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa i Department of Pulmonary, Allergy, and Critical Care Medicine, Cleveland Clinic, Cleveland, Ohio j James P. Mara Center, St-Luke's-Roosevelt Hospital, New York, NY |
| Abstract: | ObjectiveChronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States but is often undertreated. COPD often overlaps with other conditions such as hypertension and osteoporosis, which are less morbid but may be treated more aggressively. We evaluated the prevalence of these comorbid conditions and compared testing, patient knowledge, and management in a national sample of patients with COPD.MethodsA survey was administered by telephone in 2006 to 1003 patients with COPD to evaluate the prevalence of comorbid conditions, diagnostic testing, knowledge, and management using standardized instruments. The completion rate was 87%.ResultsAmong 1003 patients with COPD, 61% reported moderate or severe dyspnea and 41% reported a prior hospitalization for COPD. The most prevalent comorbid diagnoses were hypertension (55%), hypercholesterolemia (52%), depression (37%), cataracts (31%), and osteoporosis (28%). Only 10% of respondents knew their forced expiratory volume in 1 second (95% confidence interval [CI], 8-12) compared with 79% who knew their blood pressure (95% CI, 76-83). Seventy-two percent (95% CI, 69-75) reported taking any medication for COPD, usually a short-acting bronchodilator, whereas 87% (95% CI, 84-90) of patients with COPD and hypertension were taking an antihypertensive medication and 72% (95% CI, 68-75) of patients with COPD and hypercholesterolemia were taking a statin.ConclusionAlthough most patients with COPD in this national sample were symptomatic and many had been hospitalized for COPD, COPD self-knowledge was low and COPD was undertreated compared with generally asymptomatic, less morbid conditions such as hypertension. |
| Keywords: | Asthma Chronic bronchitis Chronic obstructive pulmonary disease Comorbidities Emphysema |
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