PURPOSE: COPD is a disease with common and increasing morbidity and mortality that is often under diagnosed and under treated. Detecting patients at high risk for having COPD may help improve disease recognition and management. We evaluated the prevalence of airway obstruction consistent with COPD in primary care patients with a history of cigarette smoking and symptoms of chronic cough, but no COPD diagnosis.
METHODS: Cross-sectional evaluation of symptoms, general health (SF-12), exposure history and spirometry in adults ≥40 years of age with >10 pack-year smoking history. All patients self-reported symptoms of chronic bronchitis without use of pulmonary medications and no previous spirometry assessments. COPD was defined as a post-bronchodilator FEV1/FVC ≤; 0.7.
RESULTS: A total of 1283 subjects (mean age 52.9 years, 80% Caucasian, 55% female), were enrolled at 50 primary care sites within the US. Subjects reported a mean duration of trouble with productive cough of 9.0 years and a mean duration of 7.8 years with episodes of productive cough and phlegm per year. Approximately, one-fourth, one-third and 47% of primary care patients 40 and older, over 50 and over 60 years of age, respectively, with a history of cigarette smoking and chronic productive cough, had airway obstruction consistent with COPD. Airflow obstruction increased with age and with increasing smoking history. Less than good general health was reported by 21% of subjects and 75% of subjects reported some (i.e. a little or a lot) activity limitation when climbing stairs.
CONCLUSION: A significant proportion of subjects with symptoms of cough and sputum have evidence of airflow obstruction. This increases with age and pack years. Spirometry should be considered in anyone with a smoking history and respiratory symptoms. (ADC109043).
CLINICAL IMPLICATIONS: Clinicians should be vigilant to the potential for airflow obstruction in patients with symptoms of chronic bronchitis.
DISCLOSURE: Glenn Crater, Employee Employee of GlaxoSmith-Kline; No Product/Research Disclosure Information