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Education, Teaching, and Quality Improvement |

Are We Actively Looking for the Comorbidities Associated With Chronic Obstructive Pulmonary Disease (COPD)?

Navitha Ramesh, MD; Waleed Quwatli, MD; Neelima Divakaran, MD; Ruth Kouides, MD
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Unity Health System, Rochester, NY


Chest. 2013;144(4_MeetingAbstracts):530A. doi:10.1378/chest.1703523
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Abstract

SESSION TITLE: Clinical Improvement Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: To determine the rates of screening for comorbidities commonly associated with COPD as recommended by the GOLD Guidelines.

METHODS: Design: Retrospective analysis. Setting: Community hospital resident continuity clinic. Subjects: Patients with a billed COPD visit (ICD code 496) during 2010 or 2011 with COPD confirmed by Pulmonary function Tests (PFTs). Records were reviewed for demographics and documentation of screening for, or diagnosis of, the following: hypertension, diabetes mellitus, metabolic syndrome, osteoporosis, and depression.

RESULTS: 335 patients with a COPD visit were reviewed. Of those, 193 patients did not have any PFTs, 19 had PFTs done beyond our study period, and 62 had PFT’s that did not show COPD (normal, asthma, restrictive lung disease). Therefore, 61 patients were included in the study. We screened 100% (61/61) of our patients for hypertension. 75% (43/61) were hypertensive. We screened 80.3% (49/61) for diabetes and 30.6% (15/49) were diabetic. For metabolic syndrome, 42.6% (26/61) were screened and 76.9% (20/26) screened positive. For osteoporosis, 19.7%(12/61) were screened; of whom, 41.6% (5/12) had osteoporosis, 50% (6/12) had osteopenia and 8.3% (1/12) had normal density. For depression, 49.2% (30/61) were screened and 36.7% (14/30) were depressed.

CONCLUSIONS: Other than for hypertension, our screening rates were sub-optimal, especially for metabolic syndrome, depression and osteoporosis.

CLINICAL IMPLICATIONS: COPD often coexists with other comorbidities that have a significant impact on prognosis. In COPD, diabetes is independently associated with reduced lung function. Osteoporosis and depression are often under-diagnosed, and are associated with poor health status and prognosis. Our findings indicate that further efforts to improve screening rates are needed.

DISCLOSURE: The following authors have nothing to disclose: Navitha Ramesh, Waleed Quwatli, Neelima Divakaran, Ruth Kouides

No Product/Research Disclosure Information


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