RT Journal Article
SR Electronic
T1 Missed opportunities to diagnose COPD
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 182
VO 38
IS Suppl 55
A1 David Price
A1 David Halpin
A1 Robert Winter
A1 Susan L. Hill
A1 Eric Bateman
A1 Daryl Freeman
A1 Dermot Ryan
A1 Matthew Kearney
A1 Kevin Holton
A1 Annie Burden
A1 Julie von Ziegenweidt
A1 Laurence Mascarenhas
A1 Alison Chisholm
A1 Rupert Jones
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/182.abstract
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.