{"title":"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","authors":"Dionisios Spyratos, Diamantis Chloros, Dionisia Michalopoulou, Ioanna Tsiouprou, Konstantinos Christoglou, Lazaros Sichletidis","doi":"10.1080/13814788.2021.1912729","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In the primary care setting, diagnosis and treatment of COPD is not always consistent with GOLD guidelines.</p><p><strong>Objectives: </strong>To calculate the prevalence of COPD underdiagnosis, false diagnosis and treatment in the general population of northern Greece.</p><p><strong>Methods: </strong>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 <i>via</i> a campaign (posters and advertisements in the mass media).</p><p><strong>Results: </strong>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:' <b>a)</b> 117/264 (44.3%) with a previous correct diagnosis COPD and correct treatment; <b>b)</b> 139/264 (52.7%) previous correct diagnosis COPD but overtreatment; <b>c)</b> 8/264 (3%) previous correct diagnosis COPD but undertreatment; <b>d)</b> 461 subjects (63.6% of those with previous COPD diagnosis) had previous false diagnosis of COPD (= also overtreatment); <b>e)</b> 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.</p><p><strong>Conclusion: </strong>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).</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"27 1","pages":"97-102"},"PeriodicalIF":2.3000,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/13814788.2021.1912729","citationCount":"5","resultStr":"{\"title\":\"Underdiagnosis, false diagnosis and treatment of COPD in a selected population in Northern Greece.\",\"authors\":\"Dionisios Spyratos, Diamantis Chloros, Dionisia Michalopoulou, Ioanna Tsiouprou, Konstantinos Christoglou, Lazaros Sichletidis\",\"doi\":\"10.1080/13814788.2021.1912729\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>In the primary care setting, diagnosis and treatment of COPD is not always consistent with GOLD guidelines.</p><p><strong>Objectives: </strong>To calculate the prevalence of COPD underdiagnosis, false diagnosis and treatment in the general population of northern Greece.</p><p><strong>Methods: </strong>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 <i>via</i> a campaign (posters and advertisements in the mass media).</p><p><strong>Results: </strong>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:' <b>a)</b> 117/264 (44.3%) with a previous correct diagnosis COPD and correct treatment; <b>b)</b> 139/264 (52.7%) previous correct diagnosis COPD but overtreatment; <b>c)</b> 8/264 (3%) previous correct diagnosis COPD but undertreatment; <b>d)</b> 461 subjects (63.6% of those with previous COPD diagnosis) had previous false diagnosis of COPD (= also overtreatment); <b>e)</b> 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.</p><p><strong>Conclusion: </strong>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).</p>\",\"PeriodicalId\":54380,\"journal\":{\"name\":\"European Journal of General Practice\",\"volume\":\"27 1\",\"pages\":\"97-102\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2021-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1080/13814788.2021.1912729\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of General Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/13814788.2021.1912729\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of General Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13814788.2021.1912729","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Underdiagnosis, false diagnosis and treatment of COPD in a selected population in Northern Greece.
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).
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.