As many as 20 percent of adults with known risk factors are currently undiagnosed but suffer from chronic obstructive pulmonary disease (COPD), states a research article in CMAJ (Canadian Medical Association Journal).
COPD is a common and costly respiratory condition that is estimated to affect 10% of people 40 years of age and older.
This study was conducted to measure the prevalence of COPD in an at-risk population of adults aged 40 years or more with a smoking history of at least 20 pack-years, the number of packs smoked per day, multiplied by the number of years smoked, who visited a primary practitioner for any reason. The study evaluated the accuracy of prior diagnosis or nondiagnosis of COPD and identified associated clinical characteristics.
In a study of 1003 participants, the researchers identified COPD in approximately one of every five adults. Although more than three-quarters of the patients with COPD reported at least one respiratory symptom, two-thirds were unaware of their diagnosis. "These findings suggest that adults who attend a primary care practice with known risk factors for COPD are important targets for screening and early intervention," write Dr. Roger Goldstein, West Park Healthcare Centre, Toronto, Ontario and coauthors.
Underdiagnosis of COPD has been previously reported but according to the authors the extent of it in their study was especially striking given that all of the patients had two important risk factors for COPD.
The authors conclude that early detection of COPD in high-risk patients in a primary care setting is feasible and successful early intervention could result in important reductions in mortality, morbidity and health care costs associated with COPD, although this remains to be demonstrated in future evaluations. Further research is indicated to define more clearly the reasons for underdiagnosis and overdiagnosis of COPD in primary care settings.
- Kylie Hill, Roger S Goldstein, Gordon H Guyatt, Maria Blouin, Wan C Tan, Lori L Davis, Diane M Heels-Ansdell, Marko Erak, Pauline J Bragaglia, Itamar E Tamari, Richard Hodder, and Matthew B Stanbrook. Prevalence and underdiagnosis of chronic obstructive pulmonary disease among patients at risk in primary care. CMAJ, 2010; DOI: 10.1503/cmaj.091784
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