Poster Presentations: Wednesday, October 26, 2011 |

Acute Exacerbations of COPD - Pulmonologist's Perceptions Versus COPD Patient's Reality FREE TO VIEW

Jean Bourbeau, MD; Darcy Marciniuk, MD; Shannon Walker, MD; Paul Hernandez, MD; Charlie Chan, MD; Meyer Balter, MD
Chest. 2011;140(4_MeetingAbstracts):567A. doi:10.1378/chest.1119376
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PURPOSE: COPD has surpassed stroke to become the 3rd leading cause of death in North America. COPD exacerbations (AECOPD) are associated with worsening symptoms, impaired quality of life, and increased mortality. We studied patient and Pulmonologist perceptions of preventing and managing AECOPD.

METHODS: 58 Pulmonologists from across Canada participated in a COPD practice profile from June-October 2010, each reporting 10-20 outpatient office visits (n = 931). Patients also completed a questionnaire (n=640). Pulmonologists and patients were blinded to each other’s responses.

RESULTS: COPD disease severity was 4% Gold 1, 43% Gold 2, 40% Gold 3, and 13% Gold 4 patients. 57% (n=527) of patients experienced an AECOPD in the 12 prior months (40%, 46%, 67%, and 67% of Gold 1-4 patients respectively). 82% of patients had co-morbidities (2.7/patient), most commonly hypertension (45%) and ischemic heart disease (26%). 34% of patients were hospitalized for their AECOPD; 30% required urgent assessment in an Emergency Room. 39% of patients reported having never been informed about AECOPD symptoms, 43% of patients reported they had an action plan. Only 31% of those with an action plan had access to a case manager. A majority of moderate to severe patients were treated with triple therapy including a long-acting anticholinergic plus an ICS/LABA combination.

CONCLUSIONS: While not all COPD patients suffer exacerbations, almost half of Gold 2 patients reported an AECOPD in the 12 months prior to the survey. The frequency of AECOPD was higher in more severe COPD. A majority of COPD patients appear inadequately armed with the knowledge or tools to prevent or manage AECOPD.

CLINICAL IMPLICATIONS: The study suggests better communication with our patients is warranted, and that there is a need to more objectively acknowledge and assess these clinical gaps.

DISCLOSURE: Jean Bourbeau: Consultant fee, speaker bureau, advisory committee, etc.: AstraZeneca, Boehringer Ingelheim, Nycomed, Pfizer, Talecris, GlaxoSmithKline, Grant monies (from industry related sources): AstraZeneca, Boehringer Ingelheim, GSK, Merck, Novartis, Nycomed, Pfizer, Grant monies (from sources other than industry): CIHR, RHN FRSQ, RI MUHC

Darcy Marciniuk: Grant monies (from industry related sources): AstraZeneca, Boehringer Ingelheim, GSK, Novartis, Nycomed, Pfizer, Grant monies (from sources other than industry): Health Canada, Health Quality Council, Public Health Agency of Canada, Saskatchewan Medical Association, Saskatoon Health Region and the University of Saskatchewan

Shannon Walker: Grant monies (from industry related sources): Received money from several pharmaceutical company for presentations

Paul Hernandez: Grant monies (from industry related sources): speaker at CME - actelion, astrazeneca, boehringer ingelheim, glaxosmithkline, merck, nycomed, pfizer consultant - actelion, astrazeneca, boehringer ingelheim, eli lilly, glaxosmithkline, merck, novartis, nycomed, pfizer contract research - actelion, astrazeneca, boehringer ingelheim, csl behring, eli lilly, glaxosmithkline, novartis, nycomed, pfizer

Charlie Chan: Grant monies (from industry related sources): Abbott, AstraZeneca, Boehringer-Ingelheim, InterMune, Merck, Novartis, Nycomed, Pfizer, VitalAire.

Meyer Balter: Grant monies (from industry related sources): Advisory Board and Speaker fees for several industries

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