COPD awareness and treatment in China

Xu, Guodong; Fan, Guohui; Niu, Wenquan

doi:10.1016/s2213-2600(18)30200-5

Cited by 6 publications

(7 citation statements)

References 4 publications

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“…Despite the burden of symptoms, they did not seek medical help, as they felt COPD symptoms as part of their daily smoking routine or due to aging. These data indicate that COPD awareness is poor among smokers, and strategies to increase COPD awareness should be developed [32][33][34] . The smoking population underestimates their respiratory symptoms; however, exercise activity is many times reduced.…”

Section: Discussionmentioning

confidence: 97%

Underestimation of respiratory symptoms by smokers: a thorn in chronic obstructive pulmonary disease diagnosis

Gogou

Kotsiou

Siachpazidou

et al. 2021

npj Prim. Care Respir. Med.

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Primary care centers are ideal positions to identify chronic obstructive pulmonary disease (COPD). We determined the COPD prevalence among ever-smokers aged 40–65 years attending a 2-year program conducted in 22 Greek primary healthcare centers and made comparisons between genders, patients less than or greater than 55 years, and newly or previously diagnosed COPD patients. A total of 117 persons, after studying 1100 people, were diagnosed with previously unknown or known COPD, providing a COPD prevalence of 10.6% among the study population. In all, 7.5% of the participants were newly diagnosed with COPD. Women with COPD reported smoking less but experienced worse respiratory and depressive symptoms than men. A total of 19% of the COPD population below 55 years experienced wheezing and exacerbations more frequently than older patients. Newly diagnosed COPD patients were significantly younger, reported a significant burden of symptoms without seeking medical help. Primary health care has a crucial role in the early detection of COPD among unsuspecting smokers.

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Section: Discussionmentioning

confidence: 97%

Underestimation of respiratory symptoms by smokers: a thorn in chronic obstructive pulmonary disease diagnosis

Gogou

Kotsiou

Siachpazidou

et al. 2021

npj Prim. Care Respir. Med.

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“…This could be explained by the enrolment of patients from secondary and tertiary hospitals, where patients with mild disease are not routinely managed. This could also be due to patients at early stages of the disease with mild symptoms not seeking medical attention for COPD symptoms or not being diagnosed by physicians [30].…”

Section: Discussionmentioning

confidence: 99%

REALizing and improving management of stable COPD in China: Results of a multicentre, prospective, observational study (REAL)

Wang

Cai

Cao

et al. 2022

Preprint

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Background Chronic obstructive pulmonary disease (COPD) management in China is far from adequate, with underdiagnosis and undertreatment being the major barriers to optimal care and improved patient outcomes. To better understand the burden of COPD and its management in China, real-world characterization of the severity and treatment of COPD across the country is needed. Methods We conducted a 52-week multicentre, prospective, observational study on outpatients (≥ 40 years old) diagnosed with COPD, enrolled from 50 secondary and tertiary hospitals across six geographical regions. Data were collected in routine clinical practice. Results Between December 2017 and August 2020, 5013 patients were enrolled and 4978 included in the analysis. Mean (standard deviation [SD]) age was 66.2 (8.9) years and 79.5% were male. Most COPD outpatients (90%) had moderate-to-very-severe airflow limitation (Global Initiative for Chronic Obstructive Lung Disease [GOLD] II–IV). Overall, the annual rate (per patient) of COPD exacerbations of any severity was 0.56 (95% confidence interval [CI]: 0.54–0.58). During 1-year, 1536 (30.8%) patients experienced ≥ 1 exacerbation of any severity and 960 (19.3%) patients had ≥ 1 exacerbation requiring hospitalization/emergency visit. The annual severe exacerbation rate was 0.31 (95% CI: 0.29–0.33). Mean (SD) COPD assessment test score was 14.6 (7.6) at baseline and 10.6 (6.8) at follow-up; however, 42–55% of patients had persistent dyspnoea, chest tightness and wheezing at 1-year. The most prescribed treatments were inhaled corticosteroid (ICS)/long-acting β2-agonist (LABA) combination (36.0%), ICS/LABA + long-acting muscarinic antagonist (LAMA) (17.7%) and LAMA monotherapy (15.3%). Among patients with high exacerbation risk (GOLD Groups C and D), 10.1% and 13.1, respectively, did not receive any long-acting inhalers; only 53.8% and 63.6% of Group C and D patients with ≥ 1 exacerbation during follow-up were prescribed ICS-containing therapy, respectively. Mean (SD) adherence (actual drug taken days/follow-up days) for long-acting inhalers was 59.0% (34.3). Mean (SD) score for the COPD questionnaire was 6.7 (2.4). Conclusions These results indicate a high burden of severe exacerbations and symptoms in Chinese outpatients with COPD, and low adherence with treatment guidelines, highlighting the need for more effective management nationwide. Trial Registration: The trial was registered on 20 March 2017 (ClinicalTrials.gov identifier: NCT03131362).

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“…In the absence of widespread systematic spirometry screening for COPD and its risk factors in China, there is interest in approaches to raise disease awareness and diagnosis [10]. From a humanistic standpoint, while COPD prevalence is half that of asthma, it is considerably more deadly, accounting for eight times more deaths globally [2].…”

Section: Discussionmentioning

confidence: 99%

“…Although testing via spirometry is recommended for diagnosis of COPD, implementing a spirometry-based public screening programme in China faces considerable challenges including low awareness of the condition among the general population and non-specific symptoms [10]. Furthermore, spirometry is not widely available and would require a major investment and behavioural change in China’s large healthcare system [11].…”

Section: Introductionmentioning

confidence: 99%

Characteristics and health burden of the undiagnosed population at risk of chronic obstructive pulmonary disease in China

et al. 2019

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BackgroundChronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality in China. However, identifying patients has proved challenging, resulting in widespread under-diagnosis of the condition. We examined the prevalence of COPD diagnosis and COPD risk among adults in urban mainland China, the factors associated with having a COPD diagnosis or COPD risk, and the healthcare resource use and health outcomes of these groups compared with controls.MethodsRespondents to the 2017 National Health and Wellness Survey in China (n = 19,994) were classified into three groups: ‘COPD Diagnosed’, ‘COPD Risk (undiagnosed)’, and Control (unaffected), based on their self-reported diagnosis and Lung Function Questionnaire (LFQ) score. The groups were characterised by sociodemographic, health-related quality of life (HRQoL), productivity impairment, and healthcare resource use. Pairwise comparisons (t tests and chi-squared tests) and multivariable regression analyses were used to investigate factors associated with being at risk of, or diagnosed with, COPD.Results3320 (16.6%) respondents had a suspected risk of COPD but did not report receiving a diagnosis. This was projected to 105.3 million people, or 16.9% of adult urban Chinese. Of these respondents with an identified risk, only 554 (16.7%) were aware of COPD by name. Relative to those without COPD, those with a risk of COPD (undiagnosed) had significantly greater healthcare resource use, lower productivity and lower HRQoL not only compared to those without COPD, but also compared to people with a COPD diagnosis. Factors associated with increased odds of being at risk of COPD were older age, smoking, alcohol consumption, overweight BMI, occasional exercise, higher comorbidities, asthma diagnosis, being female, lower education, not being employed, and living in a high pollution province (p < 0.05).ConclusionsThere is a substantial group of individuals, undiagnosed, but living with a risk of COPD, who have impaired HRQoL, lower productivity and elevated healthcare resource use patterns. Case-detection tools such as the LFQ may prove a quick and cost-effective approach for identifying these at-risk individuals for further definitive testing and appropriate treatment in China.

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COPD awareness and treatment in China

Cited by 6 publications

References 4 publications

Underestimation of respiratory symptoms by smokers: a thorn in chronic obstructive pulmonary disease diagnosis

Underestimation of respiratory symptoms by smokers: a thorn in chronic obstructive pulmonary disease diagnosis

REALizing and improving management of stable COPD in China: Results of a multicentre, prospective, observational study (REAL)

Characteristics and health burden of the undiagnosed population at risk of chronic obstructive pulmonary disease in China

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