Enfermedad pulmonar obstructiva crónica: los pacientes en la vida real. Estudio LEONPOC

García, Silvia García; Fernández, L.M. Rodríguez; García, Javier Juan; Naveiro-Rilo, J.C.

doi:10.1016/j.aprim.2017.01.002

Cited by 5 publications

(3 citation statements)

References 37 publications

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“…Nonetheless, an over-diagnosis of COPD is also possible. A cross-sectional study 36 conducted in 2017 in the primary care setting in Spain reported an over-diagnose of COPD of 21%. We had to acknowledge this potential over-diagnosis of COPD in our population as a limitation of the study, which would contribute to an over-diagnosis of chronic obstructive airway diseases of approximately 4%.…”

Section: Discussionmentioning

confidence: 99%

Multimorbidity clusters in patients with chronic obstructive airway diseases in the EpiChron Cohort

Carmona-Pírez

Poblador‐Plou

Ioakeim-Skoufa

et al. 2021

Sci Rep

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Chronic obstructive airway diseases such as chronic obstructive pulmonary disease (COPD), asthma, rhinitis, and obstructive sleep apnea (OSA) are amongst the most common treatable and preventable chronic conditions with high morbidity burden and mortality risk. We aimed to explore the existence of multimorbidity clusters in patients with such diseases and to estimate their prevalence and impact on mortality. We conducted an observational retrospective study in the EpiChron Cohort (Aragon, Spain), selecting all patients with a diagnosis of allergic rhinitis, asthma, COPD, and/or OSA. The study population was stratified by age (i.e., 15–44, 45–64, and ≥ 65 years) and gender. We performed cluster analysis, including all chronic conditions recorded in primary care electronic health records and hospital discharge reports. More than 75% of the patients had multimorbidity (co-existence of two or more chronic conditions). We identified associations of dermatologic diseases with musculoskeletal disorders and anxiety, cardiometabolic diseases with mental health problems, and substance use disorders with neurologic diseases and neoplasms, amongst others. The number and complexity of the multimorbidity clusters increased with age in both genders. The cluster with the highest likelihood of mortality was identified in men aged 45 to 64 years and included associations between substance use disorder, neurologic conditions, and cancer. Large-scale epidemiological studies like ours could be useful when planning healthcare interventions targeting patients with chronic obstructive airway diseases and multimorbidity.

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Section: Discussionmentioning

confidence: 99%

Multimorbidity clusters in patients with chronic obstructive airway diseases in the EpiChron Cohort

Carmona-Pírez

Poblador‐Plou

Ioakeim-Skoufa

et al. 2021

Sci Rep

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“…En contraste con Betancourt Peña et al 29 quienes en su estudio reportan el uso más frecuente de β2 -agonistas de acción corta, lo cual difiere con el presente estudio dado que nuestros pacientes se administran este tipo de medicamentos, pero de acción larga. Nuestros resultados son concordantes con lo reportado por García García et al 30 quienes igualmente reportan sobre prescripción farmacológica especialmente en los pacientes con menor gravedad de su enfermedad. Respecto al tratamiento no farmacológico E. Pleguezuelos et al 10 documentan que de acuerdo con lo definido por la OMS es necesario evaluar al paciente con EPOC desde diversos aspectos entre ellos el tratamiento no farmacológico, al cual en ocasiones no se le da la importancia necesaria para garantizar una atención integral.…”

Section: Discussionunclassified

Caracterización de los pacientes con EPOC clínico en algunos municipios del departamento de Boyacá, Colombia

Robayo

Laverde

Cubaque

et al. 2022

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Introducción: las enfermedades no transmisibles ocupan el primer lugar de morbimortalidad en el departamento de Boyacá según las recientes estadísticas, en este grupo de enfermedades se encuentra la Enfermedad Pulmonar Obstructiva Crónica (EPOC) situación probablemente derivada de la actividad económica y ocupacional de la región. Objetivo: caracterizar los pacientes con EPOC clínicamente estable de algunos municipios del departamento de Boyacá. Identificar los factores de riesgo. Determinar el tratamiento farmacológico y no farmacológico. Establecer características espirométricas de la población estudiada. Métodos: estudio transversal descriptivo con muestreo aleatorio probabilístico entre febrero de 2016 a diciembre de 2018. Resultados: se seleccionaron 248 pacientes con diagnóstico espirométrico confirmado, predominó el sexo masculino 52,8%, la edad promedio fue de 75 años, talla promedio de 1,55cm y peso promedio de 60Kg. Respecto a características demográficas el 88,3% tiene apoyo familiar y el 56,5% alcanzó escolaridad básica primaria. Respecto a la gravedad de la EPOC el 42,3% se clasificó como GOLD 1, 42,7% GOLD 2, 13,3% GOLD 3 y 1,6% GOLD 4; no se establecieron diferencias significativas en los parámetros CVF y VEF1/CVF entre grupos, mientras que VEF1 disminuyó en todos los grupos. Se observó que la medicación que reciben es en forma de monoterapia, terapia doble o terapia triple. Conclusiones: se evidenció que casi la mitad de los pacientes en los cuatro grupos reportó contaminación del aire en espacios cerrados, aspecto similar a la exposición laboral a material particulado; no se evidenciaron diferencias significativas en los parámetros CVF y relación VEF1 /CVF entre los grupos; se observó las medidas no farmacológicas se enfocan en vacunación y oxigenoterapia y las medidas farmacológicas en la administración de monoterapia y terapia triple en mayor proporción; finalmente, alrededor del 20% de los pacientes de cada uno de los grupos no reciben tratamiento farmacológico.

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“…Although ICS use is limited to specific indications, ICSs have been widely prescribed in clinical practice to individuals who are unlikely to benefit from their use. 9 , 10 , 28 , 34 Another concern related to ICS use in COPD is safety issues, especially because the use of these medications is associated with an increased risk of pneumonia. 35 Recently, some researchers reviewing data from large clinical trials have recommended withdrawal of ICSs from the treatment regimen of patients for whom these medications are not indicated, with maintenance of appropriate bronchodilator therapy.…”

Section: Discussionmentioning

confidence: 99%

Management of COPD within the Brazilian Unified Health Care System in the state of Bahia: an analysis of real-life medication use patterns

et al. 2019

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Objective: To describe COPD pharmacological treatment patterns in the state of Bahia, Brazil, and to evaluate the extent to which these patterns conform to clinical guidelines for the management of COPD. Methods: This was a cross-sectional study of 441 patients referred from the Public Health Care Network of the state of Bahia to a public referral outpatient clinic of a COPD management program of the Brazilian Unified Health Care System. Individuals with a spirometry-confirmed diagnosis of moderate to very severe COPD were included in the study. Patients were evaluated as to whether they had used any COPD medications in the last seven days. The appropriateness or inappropriateness (undertreatment or overtreatment) of the patient’s pharmacological treatment was evaluated by comparing the patient’s current treatment with that recommended by national and international guidelines. Results: A total of 383 individuals were included in the analysis. Approximately half of the patients (49.1%) used long-acting bronchodilators. These patients were older and had had the disease longer. Of the sample as a whole, 63.7% and 83.0% did not receive pharmacological treatment in accordance with international and national recommendations, respectively. Inappropriateness due to undertreatment was indentified in more than half of the patients. Conclusions: Long-acting bronchodilators are frequently underused in individuals with moderate to very severe COPD within the Brazilian Unified Health Care System in the state of Bahia. Most patients in our sample were treated inappropriately, and undertreatment predominated. Strategies to improve access to long-acting bronchodilators and the quality of COPD pharmacological management are required.

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Enfermedad pulmonar obstructiva crónica: los pacientes en la vida real. Estudio LEONPOC

Abstract: Although there have been several published guidelines, management of COPD patients in real life should be improved.

Cited by 5 publications

References 37 publications

Multimorbidity clusters in patients with chronic obstructive airway diseases in the EpiChron Cohort

Multimorbidity clusters in patients with chronic obstructive airway diseases in the EpiChron Cohort

Caracterización de los pacientes con EPOC clínico en algunos municipios del departamento de Boyacá, Colombia

Management of COPD within the Brazilian Unified Health Care System in the state of Bahia: an analysis of real-life medication use patterns

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