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. 2015 May 13:10:925-37.
doi: 10.2147/COPD.S82064. eCollection 2015.

Epidemiology, severity, and treatment of chronic obstructive pulmonary disease in the United Kingdom by GOLD 2013

Mireia Raluy-Callado  1 , Dimitra Lambrelli  1 , Sharon MacLachlan  1 , Javaria Mona Khalid  2
Affiliations

Epidemiology, severity, and treatment of chronic obstructive pulmonary disease in the United Kingdom by GOLD 2013

Mireia Raluy-Callado et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Objectives: In 2013, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) updated the management strategy on COPD based on severity using a combined assessment of symptoms, degree of airflow limitation, and number of exacerbations. This study quantified prevalence and incidence of COPD in the United Kingdom and estimated disease severity by GOLD 2013 categories A/B (low risk) and C/D (high risk).

Methods: The Clinical Practice Research Datalink was used to identify COPD patients ≥40 years. Patient characteristics were described, and prevalence was calculated on December 31, 2013. Five-year incidence (2009-2013) was estimated, with rates standardized using 2011 UK population age and sex. To classify patients by GOLD categories, spirometry results, the modified British Medical Research Council grade, and history of exacerbations were used.

Results: The prevalent cohort comprised 49,286 patients with COPD with mean age 70 years; 51.0% were male. Overall prevalence was 33.3 per 1,000 persons (95% confidence interval [CI]: 33.1-33.6); 66.4% were classified as GOLD A/B and 33.6% as C/D. The standardized prevalence of GOLD A/B was 21.9 per 1,000 persons (95% CI: 21.7-22.1) and of C/D was 11.1 (95% CI: 10.9-11.2). A total of 27,224 newly diagnosed COPD patients were identified with mean age 67 years at diagnosis; 53.0% were male. Incidence was 2.2 per 1,000 person-years (95% CI: 2.2-2.3); 68.7% were classified in categories A/B and 31.3% in C/D, of which 17.2% did not receive COPD maintenance medication.

Conclusion: A third of COPD patients in the UK are considered high risk (GOLD 2013 categories C/D), and a third of patients are diagnosed for the first time at these severe stages. Given the progressive nature of the disease, results suggest that closer attention to respiratory symptoms for early detection, diagnosis, and appropriate treatment of COPD in the UK is warranted.

Keywords: COPD; GOLD 2013; incidence; prevalence; primary care management.

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Figures

Figure 1
Figure 1
Age-stratified prevalence rates by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) category. Abbreviations: GOLD A, low symptoms, low risk; GOLD B, high symptoms, low risk; GOLD C, low symptoms, high risk; GOLD D, high symptoms, high risk.
Figure 2
Figure 2
Age-stratified incidence rates by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) category. Abbreviations: GOLD A, low symptoms, low risk; GOLD B, high symptoms, low risk; GOLD C, low symptoms, high risk; GOLD D, high symptoms, high risk.
Figure 3
Figure 3
Study patient identification.
See this image and copyright information in PMC

References

    1. Global Initiative for Chronic Obstructive Lung Disease (GOLD) Global Strategy for the Diagnosis, Management and Prevention of COPD. 2013. [Accessed January 29, 2014]. Available from: http://www.goldcopd.org/
    1. National Institute for Health and Care Excellence (NICE) National Clinical Guideline Centre for Acute and Chronic Conditions. Chronic Obstructive Pulmonary Disease. Management of Chronic Obstructive Pulmonary Disease in Adults in Primary and Secondary Care. 2010. [Accessed January 29, 2014]. Available from: http://guidance.nice.org.uk/cg101/guidance/pdf/english.
    1. Kiri VA, Soriano J, Visick G, Fabbri L. Recent trends in lung cancer and its association with COPD: an analysis using the UK GP Research Database. Prim Care Respir J. 2010;19(1):57–61. - PMC - PubMed
    1. Rodriguez LA, Wallander MA, Martin-Merino E, Johansson S. Heart failure, myocardial infarction, lung cancer and death in COPD patients: a UK primary care study. Respir Med. 2010;104(11):1691–1699. - PubMed
    1. Schneider C, Bothner U, Jick SS, Meier CR. Chronic obstructive pulmonary disease and the risk of cardiovascular diseases. Eur J Epidemiol. 2010;25(4):253–260. - PubMed

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