Characteristics of outpatients with COPD in daily practice: The E4 Spanish project

The objective of this 1-week cross-sectional survey was to assess the clinical features of outpatients with chronic obstructive pulmonary disease (COPD). A one-page questionnaire was used to collect demographic data, smoking status, and COPD-related variables. Ten or 20 consecutive patients were selected from Primary care or specialised setting during a week. Pulmonary function (FEV1) was measured using an electronic device (Piko-1). The study sample comprised 11,973 COPD patients (83% men) with a mean (sd) age of 67 (10.7) years. Thirty-five percent of patients were current smokers and smoked a mean of 17.4 (9.9) cigarettes daily. COPD severity according to GOLD stages was mild in 20% of patients, moderate in 38%, severe in 30%, and very severe in 12%. A higher percentage of men showed severe (33%) or very severe (14%) disease compared to women (16% and 6%, respectively) (P<0.005). Forty-two percent of patients had severe functional impairment and 35% continued smoking. Moreover, 11% of patients with very severe COPD smoked more than 20 cigarettes a day. The mean frequency of visits in the previous year was every 4.6 (4.1) months, with cough as the main reason for consultation. The most commonly used drugs were long-acting beta2-agonists (78%) and inhaled steroids (77%). Inhaled steroids were used by 84% of patients with very severe, 82% with severe disease, 73% with moderate disease, and 69% with mild disease (chi2 for trend, P<0.0001). This survey carried out in a real life setting shows that 42% of the patients who completed the questionnaire had severe COPD, 35% of them continued smoking, and 69% of patients with mild COPD used inhaled steroids.