To assess the comparative respiratory disease burden among subjects with COPD versus an at-risk population in worksite and community settings.
A prospective, longitudinal, study was initiated as part of employer and community wellness activities offered by a local health plan. Subjects aged 25+ years are eligible if they provide valid spirometry readings and complete a Respiratory Health Questionnaire. This questionnaire includes items related to respiratory symptoms, activity limitations, healthcare resource use, and perceived health status (as measured by a Visual Analog Scale [VAS]). Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria are used to group enrollees as COPD subjects (FEV1/FVC <0.70; stages 1-4) or at-risk subjects (chronic respiratory symptoms and FEV1/FVC >0.70; stage 0).
589 subjects were enrolled through December 2004: 70% at worksites, 17% at senior centers, and 13% at community sites. 102 subjects (17%) met the criteria for GOLD stages 0 to 4: 30 in the at-risk group, 26 with mild COPD (stage 1), 32 with moderate COPD (stage 2) and 14 with severe or very severe COPD (stages 3 and 4). Subjects in the at-risk group were, on average, younger than those with COPD (52 versus 63 years old). At-risk subjects were as likely as those with COPD to report wheezing (37% versus 33%) or shortness of breath (47% and 44%) as somewhat, moderately, or very bothersome. Respiratory-related activity limitations were reported by 37% of at-risk subjects versus 31% of COPD subjects. At-risk subjects were less likely as those with COPD to report use of respiratory medications (17% versus 32%), and equally likely to report use of respiratory-related emergency room or hospital services (10%). Mean VAS scores were similar (75), although the median score was lower for the at-risk group (75 versus 80).
Subjects with chronic respiratory symptoms and normal lung function reported similar symptom burden and quality of life to those with COPD.
At-risk subjects, classified based on GOLD criteria, experience a substantial respiratory disease burden.
Jeno Marton, None.