PT  - JOURNAL ARTICLE
AU  - David Price
AU  - David Halpin
AU  - Robert Winter
AU  - Susan L. Hill
AU  - Eric Bateman
AU  - Daryl Freeman
AU  - Dermot Ryan
AU  - Matthew Kearney
AU  - Kevin Holton
AU  - Annie Burden
AU  - Julie von Ziegenweidt
AU  - Laurence Mascarenhas
AU  - Alison Chisholm
AU  - Rupert Jones
TI  - Missed opportunities to diagnose COPD
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - 182
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/182.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/182.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Rationale: Early diagnosis and intervention in the management of symptomatic chronic obstructive pulmonary disease (COPD) may reduce the associated impact on patients and economic burden on health systems.Objective: Characterise healthcare utilisation in the yrs preceding a definitive COPD diagnosis to identify “red flags” that may aid in earlier diagnosis.Method: Retrospective observational study using pooled routine practice data from the General Practice and Optimum Patient Care Research Databases. Patients were: ≥40 years, received a COPD diagnosis between 1990–2009; were prescribed ≥2 COPD therapies in the yr following diagnosis, and had ≥2yrs of continuous practice data prior to their diagnosis. Non-routine healthcare resource utilisation was monitored in the yrs preceding COPD diagnosis.Results: 38,859 eligible patients: 52.6% male, diagnosis with COPD at median (IQR) age of 68 (60–75) years. In the 2yrs prior to diagnosis, 56.4% consulted on multiple (≥2) occasions for lower respiratory (LR) complaints, 26.5% for lower respiratory tract infections. Of these, 34.5% received multiple prescriptions for oral steroids (71.4%) and/or antibiotics (82.5%). These patients also recorded more respiratory outpatient visits over the 10yrs, and inpatient hospitalisations over the 4yrs, prior to diagnosis. Significantly more patients diagnosed in secondary care (or within 2-weeks of a hospital admission) had received multiple LR prescriptions in the prior 2yrs than patients diagnosed in primary care (40.7%vs34.5% p=0.007).Conclusion: The data suggest increased use of non-routine respiratory resource by patients in the 2- to 10-yrs prior to their COPD diagnosis suggesting opportunities for earlier COPD diagnosis and/or assessment may be missed in the UK.