Selected abstracts from the 3rd IPCRG International Scientific Meeting, Uppsala, May 2013

Abstract

Selected abstracts from the 3rd IPCRG International Scientific Meeting, Uppsala, May 2013 A1 PRIMARY CARE RESPIRATORY JOURNAL www.thepcrj.org http://dx.doi.org/10.4104/pcrj.2013.00056 IPCRG13-1052 GENDER DIFFERENCES IN COPD: FINDINGS OF AN EARLY DETECTION PROGRAMME IN SINGAPORE T. L. Tan,* K. C. Ong, A. Earnest Medicine, Yong Loo Lin School Of Medicine, National University of Singapore, The Edinburgh Clinic, KC Ong Chest and Medical Clinic, Duke-NUS Graduate Medical School, NUS, Singapore, Singapore Aim: This study aimed to examine gender differences in the prevalence of COPD as detected during a public awareness programme with spirometry measurement in screening for COPD in a self-selected population. Method: A series of public education events were held in selected locations in Singapore from 2010 to 2011 on the causes, symptoms and risk of developing COPD. After completing the risk assessment questionnaire, participants were invited to undergo spirometry. Results: 928 unique subjects participated in the public education events. The mean age was 52 years, 63% were men. 81 (8.7%) had clinically significant airflow obstruction (FEV1/FVC<0.7). Of these, 33 subjects (41%) had mild COPD, (FEV1 > 80% pred), 36 (44%) had moderate COPD (FEV1<80% but >50%pred) and the remaining had severe COPD. There were no significant differences between the proportion of male and female subjects with COPD (8.9% and 8.4% respectively). The proportion of smokers/ex-smokers among men was significantly higher than among women (81% vs 30% respectively [p<0.001]). The smoking and age-group adjusted prevalence of COPD among males and females was 6.9% and 8.2% respectively. Conclusion: In spite of significantly lower self-declared smoking rates among women, COPD was more prevalent in women as compared to men who were screened during the COPD public awareness programme in our study population. We postulate that this may be due to a general under-reporting of the smoking rates among women, or that women are more susceptible to smoking-related lung damage. Disclosure of Interest: T. L. Tan Grant / Research Support from: Boehringer Ingelheim, K. C. Ong Grant / Research. Support from: Boehringer Ingelheim, A. Earnest Grant / Research Support from: Boehringer Ingelheim IPCRG13-1059 HOW PAIN AFFECTS PHYSICAL PERFORMANCE IN PEOPLE WITH COPD W. D. Reid,* B. HajGhanbari, J. Garland, J. D. Road Physical Therapy, Respiratory Division, University of British Columbia, Vancouver, Canada Aim: The purpose of this study was to determine the relationship between pain and the six-minute walk distance test (6MWT), physical activity (assessed by 3D accelerometry), and concentric knee extensor torque in people with COPD. Methods: Twenty-six people with moderate to severe COPD completed the McGill Pain Questionnaire (MPQ), the Brief Pain Inventory (BPI), the Short Form-36 (SF-36), and a form to list medications and co-morbidities. After spirometry, participants performed the 6MWT. Physical activity was monitored for two days using a DynaPort MiniMod Monitor 3D accelerometer. At least 3 days after the 6MWT, maximal and fatiguing concentric contractions of the knee extensors were assessed on a Biodex dynamometer. Correlations were performed between pain severity and 6MWT, physical activity, and knee extensor torque. These physical performance measures were compared in COPD patients with the most severe pain versus those with moderate to no pain. Results: Pain severity was negatively correlated with 6MWT (p<0.05), and quality of life (p<0.05), and was positively correlated with body mass index (BMI) (p<0.001), and number of co-morbidities (p<0.001). Subjects with severe pain showed lower standing and activity times (p<0.01), lower 6MWT (p<0.05), higher BMI (p<0.001), had a higher number of co-morbidities (p<0.001) and lower quality of life (p<0.01) as compared to subjects with minimal or no pain. Conclusion: Pain in patients with COPD is associated with lower walking distances, reduced daily physical activity, and higher BMI. Pain is also associated with the number of comorbid conditions. Early evaluation and treatment of pain and comorbid conditions with pain-inducing symptoms should be considered in the assessment and treatment plan of people with COPD. Disclosure of Interest: None declared IPCRG13-1061 INHALED CORTICOSTEROIDS (ICS) USE FOR COPD IN A HEALTH AREA M. Román-Rodríguez,* G. Lamelas, F. Vargas, C. Contreras, M. A. Gongora, S. Gestoso, M. Corredor, M. Esteva IB-Salut. Balearic Health Service, Palma de Mallorca, Spain Aim: To describe the prescription of inhaled corticosteroids (ICS) in COPD patients in our health area and to identify factors possibly associated with it. Methods: Cross sectional study. Includes all patients in a health area diagnosed with chronic obstructive bronchitis or emphysema, who came to a primary care practice during the last two years. Measurements: demographics, smoking, prescription of inhaled corticosteroids, spirometric parameters, exacerbations and associated diseases. The information was obtained from registers of primary care medical records (AP). Results: A total of 15,440 patients. 70% men, mean age 68.6 years (SD = 12.25). Of the 13,719 patients with smoking records, 27.7% (3,802) were never smokers. 46.46% had no spirometric data available. 14% had associated diagnosis of asthma. A total of 6,887 (44.6%) took ICS, 38.1% of them using high doses. The mean age of patients taking ICS was significantly higher than those who do not take (71.03 vs 66.7 P <0.001). Active smokers were taking less ICS (34.6%) compared to former smokers (51%) and nonsmokers (51.7%) P <0.001. 48.9% of patients with spirometry recorded vs 40.8% were using ICS (P <0.001). Among those who have had exacerbations 58.3% were using ICS vs 36.2% P <0.001. The concomitant diagnosis of asthma was significantly associated with ICS treatment (71.5% vs 40.2%) P <0.001. Also rhinitis (51.4% vs 44.1) and allergic dermatitis (50.3% vs 44.4%) were significantly associated P <0.001. We did not find differences in consumption of ICS by sex. Conclusion: The percentage of prescription of ICS in COPD patients in our health area is lower than expected based on data from similar studies. There are different factors that significantly influence the prescribing of these drugs in our area. Disclosure of Interest: None declared IPCRG13-1069 PREVALENCE OF COPD AND ITS RISK FACTORS IN A RURAL AREA OF UGANDA Frederik van Gemert, Bruce Kirenga, Niels Chavannes, Moses Kamya, Simon Luzige, Patrick Musinguzi, Rupert * = corresponding author Abstracts 22/5/13 15:51 Page 1