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. 2009 Apr;122(4):348-55.
doi: 10.1016/j.amjmed.2008.09.042.

Comorbidities, patient knowledge, and disease management in a national sample of patients with COPD

R Graham Barr  1 , Bartolome R Celli, David M Mannino, Thomas Petty, Stephen I Rennard, Frank C Sciurba, James K Stoller, Byron M Thomashow, Gerard M Turino
Affiliations

Comorbidities, patient knowledge, and disease management in a national sample of patients with COPD

R Graham Barr et al. Am J Med. 2009 Apr.

Abstract

Objective: Chronic 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.

Methods: A 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%.

Results: Among 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.

Conclusion: Although 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.

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Conflict of interest statement

Conflict of Interest Statement:

R. Graham Barr, MD, DrPH: none.

Bartolome R. Celli, MD: research grants from Glaxo Smith Kline (GSK), Boehringer Ingelheim (BI), Forrest Medical, Astra Zeneca; advisory board payments from GSK, BI, Almirall, Astra Zeneca; speakers fees from GSK, BI, Astra Zeneca, Almirall.

David Mannino, MD: research funding from GSK, Pfizer and Novartis; consultant or speakers fees from GSK, Pfizer, BI, Astra-Zeneca, Dey and Sepracor.

Thomas Petty, MD: none

Stephen I. Rennard, MD: research grants from Almirall, Lorillard, Centocor, Novartis, GSK, Philip Morris, Institute for Science and Health, Roche; consultancy and advisory board payments from Abbott, Johnson & Johnson, Almirall, Novartis, Altana, Roche, Anthera, Quintiles, GSK, Targegen; speakers fees from Adams, Novartis, AstraZeneca, Pfizer

Frank C. Sciurba, MD: consultancy for Astra Zeneca, BI, Dey, GSK, Novartis, Pfizer, PneumRX, Respironics, Schering and Sepracor.

James K. Stoller, MD, MS: consultancy for Talecris Biotherapeutics, BI; speaker for Grifols, Baxter, CSL-Behring, Pfizer, Talecris.

Byron M. Thomashow, MD: speakers fees and consultancy for BI, Pfizer and GSK.

Gerard M. Turino, MD: research grant from BI; consultancy for Talecris Corporation

Figures

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Figure 3
* Inhaled and nebulized treatments were not included in these totals.
Figure 4
Figure 4
Percent of participants who answered in the affirmative to the question: “During the past twelve months, as a result of costs or lack of coverage have you…?”
See this image and copyright information in PMC

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