Underdiagnosis, false diagnosis and treatment of COPD in a selected population in Northern Greece.

IF 2.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Dionisios Spyratos, Diamantis Chloros, Dionisia Michalopoulou, Ioanna Tsiouprou, Konstantinos Christoglou, Lazaros Sichletidis
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引用次数: 5

Abstract

Background: In the primary care setting, diagnosis and treatment of COPD is not always consistent with GOLD guidelines.

Objectives: To calculate the prevalence of COPD underdiagnosis, false diagnosis and treatment in the general population of northern Greece.

Methods: Observational study in the context of an early COPD detection and smoking cessation project. Inclusion criteria: >40-year-old, current and former smokers (>10 pack-years) in five primary care centres of northern Greece from 2012 to 2019. Participation was achieved via a campaign (posters and advertisements in the mass media).

Results: We examined 5,226 subjects (mean age: 58.2 ± 12.7 years, 61.5% males, current smokers: 56.2%) of whom 564 (10.8%) had symptoms and spirometrically confirmed COPD. There were 5 groups of 'interest:' a) 117/264 (44.3%) with a previous correct diagnosis COPD and correct treatment; b) 139/264 (52.7%) previous correct diagnosis COPD but overtreatment; c) 8/264 (3%) previous correct diagnosis COPD but undertreatment; d) 461 subjects (63.6% of those with previous COPD diagnosis) had previous false diagnosis of COPD (= also overtreatment); e) 300/564 (53.2%) previously not diagnosed COPD (=underdiagnosis and also undertreatment). We found that 322/461 (69.8%) of those with a previous false diagnosis have been prescribed long-acting bronchodilators plus ICS.

Conclusion: Among the general population subjects in northern Greece, more than 50% of patients with COPD were underdiagnosed, more than 50% of correctly diagnosed COPD patients were overtreated and most patients taking inhaled drugs were those with a false diagnosis of COPD (possibly GOLD stage 0).

Abstract Image

Abstract Image

希腊北部选定人群慢性阻塞性肺病的诊断不足、诊断错误和治疗
背景:在初级保健机构中,COPD的诊断和治疗并不总是与GOLD指南一致。目的:计算希腊北部普通人群中COPD漏诊、误诊和治疗的患病率。方法:在COPD早期发现和戒烟项目的背景下进行观察性研究。纳入标准:2012年至2019年在希腊北部5个初级保健中心的>40岁、当前和曾经吸烟者(>10包年)。参与是通过运动(大众传播媒介的海报和广告)实现的。结果:我们检查了5226名受试者(平均年龄:58.2±12.7岁,61.5%为男性,目前吸烟者:56.2%),其中564名(10.8%)有COPD症状并经肺活量测定证实。有5组“感兴趣”:a) 117/264(44.3%)既往正确诊断COPD并正确治疗;b) 139/264(52.7%)既往正确诊断COPD但过度治疗;c) 8/264(3%)既往正确诊断COPD但治疗不足;d) 461名受试者(占既往COPD诊断者的63.6%)既往有COPD误诊(也为过度治疗);e) 300/564(53.2%)以前未诊断为COPD(=诊断不足和治疗不足)。我们发现,322/461(69.8%)的先前错误诊断的患者开过长效支气管扩张剂加ICS。结论:在希腊北部的普通人群受试者中,超过50%的COPD患者被误诊,超过50%的正确诊断的COPD患者被过度治疗,大多数服用吸入药物的患者是被误诊为COPD的患者(可能是GOLD期0)。
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来源期刊
European Journal of General Practice
European Journal of General Practice PRIMARY HEALTH CARE-MEDICINE, GENERAL & INTERNAL
CiteScore
5.10
自引率
5.90%
发文量
31
审稿时长
>12 weeks
期刊介绍: The EJGP aims to: foster scientific research in primary care medicine (family medicine, general practice) in Europe stimulate education and debate, relevant for the development of primary care medicine in Europe. Scope The EJGP publishes original research papers, review articles and clinical case reports on all aspects of primary care medicine (family medicine, general practice), providing new knowledge on medical decision-making, healthcare delivery, medical education, and research methodology. Areas covered include primary care epidemiology, prevention, diagnosis, pharmacotherapy, non-drug interventions, multi- and comorbidity, palliative care, shared decision making, inter-professional collaboration, quality and safety, training and teaching, and quantitative and qualitative research methods.
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