Navigating COPD and Bronchiectasis: A COPD Foundation Survey of Differences in Patient-Perceived Health Care Experiences by Sex.

Abstract

Rationale: Chronic lung diseases, including chronic obstructive pulmonary disease (COPD) and bronchiectasis (BE), may differ by sex in symptom onset, diagnostic delays, and disease burden. This study examined health care experiences and symptom burden among individuals with self-reported COPD, BE, or nontuberculous mycobacteria (NTM).

Methods: This cross-sectional study analyzed data from an online survey of U.S. and international participants with self-reported COPD, BE, or NTM, recruited via COPD Foundation social media. The questionnaire, developed with input from COPD Foundation leadership, physician-researchers, and patient stakeholders, assessed health care experiences, disease burden, and symptoms. A subset of women answered menopause-related questions. Descriptive statistics were compared by sex and disease group: COPD (with/without BE or NTM) and BE (with/without NTM). T-tests assessed continuous variables; Chi-square or Fisher's exact tests analyzed categorical variables.

Results: Among 632 respondents (mean age 70±9 years, 74% women), 68% reported COPD and 32% BE. Women with COPD were younger (p=0.048) and sought care sooner after symptom onset (p<0.010) than men. More women with COPD did not have their diagnosis explained by a health care provider (p=0.038) and reported diagnosis-related anxiety, depression, or fear (p=0.007). Among participants with BE, men were more likely to receive a confirmed diagnosis sooner (p=0.038) and during hospitalization (p=0.024). Disease management burden, pulmonologist visit frequency, Chronic Airways Assessment Test scores, numbers of comorbidities, and financial burden were similar across groups. Over 75% of women were postmenopausal, and one-third reported worsened pulmonary symptoms postmenopause.

Conclusions: Differences in diagnostic delays and symptom burden highlight the need for further research into health care disparities to improve pulmonary care and outcomes.