A cross-sectional study on prevalence of chronic obstructive pulmonary disease (COPD) in India: rationale and methods

Abstract

BackgroundChronic obstructive pulmonary disease (COPD) is a common preventable and treatable chronic respiratory disease, which affects 210 million people globally. Global and national guidelines exist for the management of COPD. Although evidence-based, they are inadequate to address the phenotypic and genotypic heterogeneity in India. Co-existence of other chronic respiratory diseases can adversely influence the prognosis of COPD.India has a huge burden of COPD with various risk factors and comorbid conditions. However, valid prevalence estimates employing spirometry as the diagnostic tool and data on important comorbid conditions are not available. This study protocol is designed to address this knowledge gap and eventually to build a database to undertake long-term cohort studies to describe the phenotypic and genotypic heterogeneity among COPD patients in India.ObjectivesThe primary objective is to estimate the prevalence of COPD among adults aged ≥25 years for each gender in India. The secondary objective is to identify the risk factors for COPD and important comorbid conditions such as asthma and post-tuberculosis sequelae. It is also proposed to validate the currently available definitions for COPD diagnosis in India.Methods and analysisA cross-sectional study will be undertaken among the populations of sub-urban areas of Chennai and Shillong cities, which represent the Southern and Northeastern regions of India. We will collect data on sociodemographic variables, economic characteristics, risk factors of COPD and comorbidities. The Global Initiative for Obstructive Lung Disease (GOLD) and Global Initiative for Asthma (GINA) definitions will be used for the diagnosis of COPD and asthma. Data will be analysed for estimation of the prevalence of COPD, asthma and associated factors.Ethics and disseminationThis study proposal was approved by the respective institutional ethics committees of participating institutions. The results will be disseminated through publications in the peer-reviewed journals and a report will be submitted to the concerned public health authorities in India for developing appropriate research and management policies.

Structured pharmacist-led intervention programme to improve medication adherence in COPD patients: A randomized controlled study

“…3 The Global Burden of Disease Study revealed that COPD is the fourth leading cause of death worldwide, claimed 3.2 million lives in 2015, 4 and projected to be the third leading cause by 2030. 5 In addition to its impact on mortality, COPD is also associated with an appreciable impact on morbidity and costs. 2,6,[7][8][9] Consequently, it is a high priority area to focus on.…”

“…11 The lack of perceived benefit from therapy has also been associated with 30% of patients with COPD intentionally discontinuing their therapy. 26 Whilst the exact burden of COPD in India is currently unknown 5 although some studies have suggested prevalence rates of between 6.5% and 7.5% 27 prevalence rates for COPD are known to be appreciably higher in low and middle income countries such as India 2 Overall, China and India appear to account for 66% of global COPD mortality. 5,28 Alongside this appreciable burden, we are aware that there is currently very little published data on the impact of clinical pharmacist-led patient self-management in COPD in India.…”

“…26 Whilst the exact burden of COPD in India is currently unknown 5 although some studies have suggested prevalence rates of between 6.5% and 7.5% 27 prevalence rates for COPD are known to be appreciably higher in low and middle income countries such as India 2 Overall, China and India appear to account for 66% of global COPD mortality. 5,28 Alongside this appreciable burden, we are aware that there is currently very little published data on the impact of clinical pharmacist-led patient self-management in COPD in India. However, in other countries, published studies have shown that clinical pharmacist-led, continuous, individualized patient education that identifies and recognizes psychosocial components of patient behavior can enhance overall satisfaction with health care experience in patients with COPD.…”

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“…Patients with chronic cardiac, hepatic, renal, haematological malignancy, endocrine, neurological psychiatric diseases, (as determined by history, physical examination and screening investigations) pregnant and lactating mother, bronchiectasis, fibrosis, TB or significant co-morbidity that might affect lung function, (e.g. poorly controlled heart failure, atrial fibrillation or ischaemic heart disease) regular oxygen or nebulised bronchodilator therapy, respiratory infection, hospitalized within 6 weeks prior to visit and steroidal therapy were excluded from the study 17,18,19,20 . The socio-demographic parameters were assessed.…”

Ti doped BaMnO3 perovskite structure as photocatalytic agent for the degradation of noxious air and water pollutants

“…These pollutants not only alter the ecological balance but also degrades the indoor air quality (IAQ) associated with building structures in urban areas [21]. As a result, several health issues like pulmonary and respiratory disorders were observed, and approximately 500,000 cases were reported every year in India [31].…”