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1 University of Nebraska, Pulmonary and Critical Care Medicine Section, Omaha, NE, USA. 2 Respiratory Division, Catholic University of Leuven, Leuven, Belgium. 3 University of Liverpool, Dept of Medicine, Clinical Sciences Centre, University Hospital Aintree, Liverpool, UK. 4 Thoracic Medicine, National Heart and Lung Institute, Imperial College School of Medicine, London, UK. 5 Worldwide Epidemiology, GlaxoSmithKline Research and Development, Greenford, UK. 6 Dept of Respiratory Medicine, University of Antwerp, Antwerp, Belgium. 7 Dept of Respiratory Medicine, Hvidovre University Hospital, Copenhagen, Denmark
CORRESPONDENCE: S. Rennard, Pulmonary and Critical Care Medicine Section, University of Nebraska Medical Center, 985125 Nebraska Medical Center, Omaha, NE 68198-5125, USA. Fax: 1 402 5594878. E-mail: srennard@unmc.edu
Keywords: chronic obstructive pulmonary disease, epidemiology, guidelines, management, subject perspective
Received: December 10, 2001
Accepted May 1, 2002
This study was supported by GlaxoSmithKline Research and Development, Greenford, UK.
To date, no international surveys estimating the burden of chronic obstructive pulmonary disease (COPD) in the general population have been published. The Confronting COPD International Survey aimed to quantify morbidity and burden in COPD subjects in 2000.
From a total of 201,921 households screened by random-digit dialling in the USA, Canada, France, Italy, Germany, the Netherlands, Spain and the UK, 3,265 subjects with a diagnosis of COPD, chronic bronchitis or emphysema, or with symptoms of chronic bronchitis, were identified.
The mean age of the subjects was 63.3 yrs and 44.2% were female. Subjects with COPD in North America and Europe appear to underestimate their morbidity, as shown by the high proportion of subjects with limitations to their basic daily life activities, frequent work loss (45.3% of COPD subjects of <65 yrs reported work loss in the past year) and frequent use of health services (13.8% of subjects required emergency care in the last year), and may be undertreated. There was a significant disparity between subjects' perception of disease severity and the degree of severity indicated by an objective breathlessness scale. Of those with the most severe breathlessness (too breathless to leave the house), 35.8% described their condition as mild or moderate, as did 60.3% of those with the next most severe degree of breathlessness (breathless after walking a few minutes on level ground).
This international survey confirmed the great burden to society and high individual morbidity associated with chronic obstructive pulmonary disease in subjects in North America and Europe.
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