The American Journal of Medicine
Volume 122, Issue 4 , Pages 348-355, April 2009

Comorbidities, Patient Knowledge, and Disease Management in a National Sample of Patients with COPD

  • R. Graham Barr, MD, DrPH

      Affiliations

    • Division of General Medicine, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY
    • Division of Pulmonary, Allergy and Critical Care, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY
    • Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
    • Corresponding Author InformationRequests for reprints should be addressed to R. Graham Barr, MD, DrPH, Columbia University Medical Center, 630 West 168th Street, New York, NY 10032
    • ,
  • Bartolome R. Celli, MD

      Affiliations

    • Pulmonary and Critical Care Division, Caritas-St Elizabeth's Medical Center, Tufts University, Boston, Mass
    • ,
  • David M. Mannino, MD

      Affiliations

    • Department of Preventive Medicine and Environmental Health, University of Kentucky College of Public Health, Lexington
    • ,
  • Thomas Petty, MD

      Affiliations

    • Departments of Medicine, University of Colorado and Rush-Presbyterian St Luke's, Chicago, Ill
    • ,
  • Stephen I. Rennard, MD

      Affiliations

    • Pulmonary and Critical Care Medicine Section, Department of Internal Medicine, University of Nebraska Medical Center, Omaha
    • ,
  • Frank C. Sciurba, MD

      Affiliations

    • Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa
    • ,
  • James K. Stoller, MD, MS

      Affiliations

    • Department of Pulmonary, Allergy, and Critical Care Medicine, Cleveland Clinic, Cleveland, Ohio
    • ,
  • Byron M. Thomashow, MD

      Affiliations

    • Division of Pulmonary, Allergy and Critical Care, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY
    • ,
  • Gerard M. Turino, MD

      Affiliations

    • James P. Mara Center, St-Luke's-Roosevelt Hospital, New York, NY

Abstract 

Objective

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States but is often undertreated. COPD often overlaps with other conditions such as hypertension and osteoporosis, which are less morbid but may be treated more aggressively. We evaluated the prevalence of these comorbid conditions and compared testing, patient knowledge, and management in a national sample of patients with COPD.

Methods

A survey was administered by telephone in 2006 to 1003 patients with COPD to evaluate the prevalence of comorbid conditions, diagnostic testing, knowledge, and management using standardized instruments. The completion rate was 87%.

Results

Among 1003 patients with COPD, 61% reported moderate or severe dyspnea and 41% reported a prior hospitalization for COPD. The most prevalent comorbid diagnoses were hypertension (55%), hypercholesterolemia (52%), depression (37%), cataracts (31%), and osteoporosis (28%). Only 10% of respondents knew their forced expiratory volume in 1 second (95% confidence interval [CI], 8-12) compared with 79% who knew their blood pressure (95% CI, 76-83). Seventy-two percent (95% CI, 69-75) reported taking any medication for COPD, usually a short-acting bronchodilator, whereas 87% (95% CI, 84-90) of patients with COPD and hypertension were taking an antihypertensive medication and 72% (95% CI, 68-75) of patients with COPD and hypercholesterolemia were taking a statin.

Conclusion

Although most patients with COPD in this national sample were symptomatic and many had been hospitalized for COPD, COPD self-knowledge was low and COPD was undertreated compared with generally asymptomatic, less morbid conditions such as hypertension.

Keywords: Asthma, Chronic bronchitis, Chronic obstructive pulmonary disease, Comorbidities, Emphysema

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 30.00 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

 Funding: The COPD Foundation and National Institutes of Health HL077612 and HL075476.

 Conflict of Interest: R. Graham Barr, MD, DrPH: none. Bartolome R. Celli, MD: research grants from Glaxo Smith Kline (GSK), Boehringer Ingelheim (BI), Forrest Medical, Astra Zeneca; advisory board payments from GSK, BI, Almirall, Astra Zeneca; speakers' fees from GSK, BI, Astra Zeneca, Almirall. David Mannino, MD: research funding from GSK, Pfizer, and Novartis; consultant or speakers' fees from GSK, Pfizer, BI, Astra-Zeneca, Dey, and Sepracor. Thomas Petty, MD: none. Stephen I. Rennard, MD: research grants from Almirall, Lorillard, Centocor, Novartis, GSK, Philip Morris, Institute for Science and Health, Roche; consultancy and advisory board payments from Abbott, Johnson & Johnson, Almirall, Novartis, Altana, Roche, Anthera, Quintiles, GSK, Targegen; speakers' fees from Adams, Novartis, AstraZeneca, Pfizer. Frank C. Sciurba, MD: consultancy for Astra Zeneca, BI, Dey, GSK, Novartis, Pfizer, PneumRX, Respironics, Schering and Sepracor. James K. Stoller, MD, MS: consultancy for Talecris Biotherapeutics, BI; speaker for Grifols, Baxter, CSL-Behring, Pfizer, Talecris. Byron M. Thomashow, MD: speakers' fees and consultancy for BI, Pfizer and GSK. Gerard M. Turino, MD: research grant from BI; consultancy for Talecris Corporation.

 Authorship: All authors had access to the data and played a role in writing this manuscript.

PII: S0002-9343(08)01072-3

doi:10.1016/j.amjmed.2008.09.042

The American Journal of Medicine
Volume 122, Issue 4 , Pages 348-355, April 2009

Article Tools

* Image Usage & Resolution