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Observational Study
. 2018 Apr 10:13:1115-1124.
doi: 10.2147/COPD.S158031. eCollection 2018.

Geographic variations of the prevalence and distribution of COPD phenotypes in Spain: "the ESPIRAL-ES study"

Bernardino Alcázar-Navarrete  1 , Juan Antonio Trigueros  2 , Juan Antonio Riesco  3   4 , Anna Campuzano  5 , Joselín Pérez  5
Affiliations
Observational Study

Geographic variations of the prevalence and distribution of COPD phenotypes in Spain: "the ESPIRAL-ES study"

Bernardino Alcázar-Navarrete et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: The purpose of this study was to assess the prevalence of COPD phenotypes at a national level and to determine their geographic distribution among different autonomous communities in Spain.

Patients and methods: A total of 1,610 patients (82% men, median age 67 years) recruited in primary care centers and pneumology services participated in an observational, cross-sectional, and multicenter study. Phenotypes evaluated were the non-exacerbator phenotype, the asthma-COPD overlap syndrome (ACOS), the exacerbator phenotype with emphysema, and the exacerbator phenotype with chronic bronchitis.

Results: The non-exacerbator phenotype was the most common (46.7%) followed by exacerbator with chronic bronchitis (22.4%) and exacerbator with emphysema (16.4%). The ACOS phenotype accounted for the lowest rate (14.5%). For each phenotype, the highest prevalence rates were concentrated in two or three autonomous communities, with relatively similar rates for the remaining regions. Overall prevalence rates were higher for the non-exacerbator and the exacerbator with chronic bronchitis phenotypes than for ACOS and the exacerbator with chronic bronchitis phenotypes. Differences in the distribution of COPD phenotypes according to gender, age, physician specialty, smoking habit, number of comorbidities, quality of life assessed with the COPD Assessment Test, and BODEx index (body mass index, airflow obstruction, dyspnea, and exacerbations) were all statistically significant.

Conclusion: Differences in the prevalence rates of COPD phenotypes among the Spanish autonomous communities have been documented. Mapping the distribution of COPD phenotypes is useful to highlight regional differences as starting point for comparisons across time. This geographic analysis provides health-care planners a valuable platform to assess changes in COPD burden at nationwide and regional levels.

Keywords: chronic obstructive; phenotype; pulmonary disease; quality of life.

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Conflict of interest statement

Disclosure Dr Alcázar-Navarrete reports personal fees from GSK; grants, personal fees, and non-financial support from Novartis AG; personal fees and non-financial support from Boehringer Ingelheim; personal fees and non-financial support from Chiesi; grants, personal fees, and non-financial support from Laboratorios Menarini; personal fees from Gebro; personal fees from Astra-Zeneca, outside the submitted work. Ms Anna Campuzano and Joselín Pérez are full-time employees at Grupo Ferrer Internacional. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Overall prevalence of COPD phenotypes in 1,610 patients with COPD (percentages and 95% CI in parenthesis).
Figure 2
Figure 2
Geographic distribution of the prevalence of the non-exacerbator COPD phenotype showing the highest prevalence rates in the Canary Islands, Castilla-La Mancha, and the Basque Country. Note: Courtesy of http://d-maps.com/carte.php?num_car=2210&lang=es.
Figure 3
Figure 3
Geographic distribution of the prevalence of the asthma–COPD overlap syndrome (ACOS) phenotype, with Murcia, Valencia, and Navarra showing the highest prevalence rates. Note: Courtesy of http://d-maps.com/carte.php?num_car=2210&lang=es.
Figure 4
Figure 4
Geographic distribution of the prevalence of the exacerbator phenotype with emphysema. The highest prevalence rate in Asturias followed by Cataluña, Extremadura, and Andalucía. Note: Courtesy of http://d-maps.com/carte.php?num_car=2210&lang=es.
Figure 5
Figure 5
Geographic distribution of the prevalence of the exacerbator phenotype with chronic bronchitis showing the highest prevalence rate in Castilla-León, Balearic Islands, and Madrid. Note: Courtesy of http://d-maps.com/carte.php?num_car=2210&lang=es.
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