Comorbidity in patients with chronic obstructive pulmonary disease in family practice: a cross sectional study

Abstract

BackgroundChronic obstructive pulmonary disease (COPD) is frequent and often coexists with other diseases. The aim of this study was to quantify the prevalence of COPD and related chronic comorbidity among patients aged over 40 years visiting family practices in an area of Madrid.MethodsAn observational, descriptive, cross-sectional study was conducted in a health area of the Madrid Autonomous Region (Comunidad Autónoma de Madrid). The practice population totalled 198,670 persons attended by 129 Family Physicians (FPs), and the study population was made up of persons over the age of 40 years drawn from this practice population. Patients were deemed to have COPD if this diagnosis appeared on their clinical histories. Prevalence of COPD; prevalence of a further 25 chronic diseases in patients with COPD; and standardised prevalence ratios, were calculated.ResultsPrevalence of COPD in family medicine was 3.2% (95% CI 3.0–3.3) overall, 5.3% among men and 1.4% among women; 90% of patients presented with comorbidity, with a mean of 4 ± 2.04 chronic diseases per patient, with the most prevalent related diseases being arterial hypertension (52%), disorders of lipid metabolism (34%), obesity (25%), diabetes (20%) and arrhythmia (15%). After controlling for age and sex, the observed prevalence of the following ten chronic diseases was higher than expected: heart failure; chronic liver disease; asthma; generalised artherosclerosis; osteoporosis; ischaemic heart disease; thyroid disease; anxiety/depression; arrhythmia; and obesity.ConclusionsPatients with COPD, who are frequent in family practice, have a complex profile and pose a clinical and organisational challenge to FPs.

Comorbidities of Chronic Obstructive Pulmonary Disease Patients at Respirology and Critical Care Outpatient Clinic Dr. Hasan Sadikin General Hospital, Bandung, Indonesia

“…This is similar to the national survey which found COPD prevalence in male (5.3%) to be greater than female (1.4%). 8 Same results are shown in the studies by Almagro et al 16 (353 of 398 subjects) and Yamasaki et al 4 (462 of 608 subjects). One explanation may be that cigarette smoking as a risk factor of COPD is more common in male than female.…”

“…8,9 Apart from the differences in study location and potential risk factors, our small simple size may explain this difference.…”

“…7 The type of comorbidities that frequently occurred in this study was hypertension, as corroborated by other studies except a study by Ekstrom et al 17 in Sweden where heart failure is the most common comorbidity. 8,9,15,16 contractively, the Swedish National Oxygen Register, as explained in their paper, found a high sensitivity and specificity for cardiovascular disease but low sensitivity for less serious and less acute condition such as hypertension. 17 The exact mechanism linking hypertension and COPD has not yet known.…”

“…6 The COPD is mostly accompanied by comorbidities that can impact patients' prognosis, change the effectiveness of COPD therapy, cause potentially dangerous therapeutic interactions and increase patients' expenses in treating the disease. 2,[7][8][9] The definition of comorbidity is the presence of one or more diseases or health conditions in an individual at a given time. 10 Comorbidity is different from complication.…”

“…Comorbidity can occur regardless of COPD, having the same cause(s), or sharing the same risk factors. 7,8 It has been shown that 96.4% COPD patients had one or more comorbidities. 9 Cardiovascular disease, skeletal muscle dysfunction, metabolic syndrome, osteoporosis, depression and lung cancer are the most common comorbidities in 31 COPD patients.…”