PURPOSE: COPD has been identified as the leading cause of preventable hospitalizations in Canada. As part of a multi-national survey, we sought to understand patient and physician perceptions of COPD in Canada as compared to other nations.
METHODS: Using random sampling from population research panels, investigators recruited from 14 nations (Brazil, Canada, China, Denmark, France, Germany, Italy, Netherlands, Poland, South Korea, Spain, Australia, Turkey and the UK) COPD patients and physicians (both primary practitioners and respiratory specialists) to complete an online survey. Patients were eligible if they suffered from physician-diagnosed chronic bronchitis, emphysema and/or COPD and suffered from compatible symptoms.
RESULTS: Of 2,000 patients surveyed, 150 were Canadian; of 1400 physicians, 100 were Canadian. Of Canadian patients (mean age 62 years), 59% reported having at least one exacerbation of COPD in the preceding year, significantly lower than the 69% reported in the overall survey (p < 0.001). During such events, morbidity was substantial with 89% reporting at least some impact on their ability to work with 37% unable to work at all. 58% reported interference with speech and 61% had problems with self care such as dressing. Canadian Physicians viewed exacerbations as significant, with 86% reporting moderate or greater long term impact arising from COPD exacerbations. Nonetheless, Canadian patients exhibited less and delayed health care seeking behaviour as compared to their counterparts globally. While 73% of international respondents would typically attempt to see a health care professional when experiencing an exacerbation, only 55% of Canadians would (p < 0.0005 ). Amongst all those who went to see a healthcare professional 28% would seek such help after 2 days and a further 26 % after 3 or more days while the corresponding figures for Canadian patients were 20% and 36%, respectively. The percentage of Canadian patients typically taking no action for an exacerbation was greater than the global average (8% vs. 5%).
CONCLUSIONS: Despite shared patient and physician perception that COPD exacerbations cause substantial morbidity and have long term sequelae, Canadian patients report diminished and delayed health care seeking behaviour as compared to comparable patients in other countries.
CLINICAL IMPLICATIONS: Attention to patient self-management plans may reduce COPD exacerbation consequences in Canada.
DISCLOSURE: Kenneth Chapman: University grant monies: CIHR, Grant monies (from sources other than industry): UHN Foundation, CIHR, Grant monies (from industry related sources): Amgen, AstraZeneca, Boehringer-Ingelheim, CSL Behring, Forest Labs, GlaxoSmithKline, Novartis, Parangenix, Roche and Talecris, Consultant fee, speaker bureau, advisory committee, etc.: AstraZeneca, Boehringer-Ingelheim, GlaxoSmithKline, Grifols, Merck Frosst, Novartis, Nycomed, Pfizer and Talecris
Alan Kaplan: Grant monies (from industry related sources): AZ, GSK, Nycomed, Merck Frosst, Consultant fee, speaker bureau, advisory committee, etc.: Boehringer Ingelheim, AstraZeneca, Pfizer, GlaxoSmithKline, Nycomed, Merck Frosst, Novartis, Graceway, Talecris, Janssen Ortho, Trudell, Purdue, Sanofi
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