Abstract
Background: The prevalence of nontuberculous mycobacterial pulmonary disease (NTMPD) has been increasing in Europe; yet, comprehensive analyses and reliable estimates on treatment practices are lacking. We developed methods to assess annual prevalence, and used chart audits to evaluate treatment practices in 5 European countries (EU5): United Kingdom (UK), France, Germany, Italy, and Spain.
Methods: NTMPD patients diagnosed annually was estimated by a 2-round Delphi method. A representative sample of physicians extracted treatment information from records of NTMPD patients with a confirmed diagnosis of Mycobacterium avium complex (MAC) or M. abscessus pulmonary disease.
Results: Approximately 88% of all physicians contacted and 62% (446) with qualified patients participated. Pulmonologists made up the largest group of study physicians (Italy 17%, UK 38%). In EU5 most NTMPD patients are male (73%) and have a history of smoking (75%); COPD is the most common comorbidity (33%). MAC was the predominant species reported (79%). NTMPD estimated annual prevalence in EU5 ranged from 5.9 (Spain) to 6.5/100,000 (UK). A wide regional heterogeneity within countries was noted, particularly in France (Parisian region [13.6/100,000] vs Southwest region [1.3/100,000]). Logistic regression analysis showed that the decision to treat was most dependent on country (odds ratio = 6.2, Spain vs France) and severity of presenting symptoms (odds ratio = 1.9, severe vs mild).
Conclusions: Annual prevalence of NTMPD is uniform on a per capita basis in EU5, but heterogeneous within different regions. The percentage of patients treated varies widely by country and severity.
- © 2014 ERS
