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Obstructive Lung Diseases |

The Impact of Comorbidities on the Management of Chronic Obstructive Pulmonary Disease (COPD) in Respiratory Specialist Practice FREE TO VIEW

Kenneth Chapman, MD; Deborah Casey, MD; Kim Lavoie, PhD; Renata Rea, RRT; Katherine Arias, PhD; Paul Jones, MD
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University Health Network, Toronto, ON, Canada


Chest. 2015;148(4_MeetingAbstracts):738A. doi:10.1378/chest.2265360
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Abstract

SESSION TITLE: COPD Posters VI

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Patients with COPD commonly suffer from significant medical comorbidities. We undertook the following survey of Canadian respiratory specialist practices to determine whether comorbid illnesses or symptoms influence management.

METHODS: In this pilot program, we recruited respiratory specialists from practices across Canada, asking questions about their COPD management practices and asking them to recruit their patients with COPD, request such patients to complete a short questionnaire about medical history, medication use, symptoms of COPD and symptoms of other illnesses. Physicians completed a short patient specific questionnaire for patients recruited.

RESULTS: In a four-month period, 23 respiratory specialists completed practice-related questionnaires, recruited 210 patients who completed questionnaires and completed 187 patient-related questionnaires. Mean patient age was 70.8 years; 117 were men and 93 were women. Comorbidities were reported by 90% of patients with 64% reporting 2 or more. On a 10 point Likert scale, physicians reported that arrhythmias, heart failure and ischemic heart disease had moderately high impact on their management, obesity and benign prostatic hypertrophy (BPH) had intermediate impact and diabetes and depression minimal impact. Although 69% of men had prostate related symptoms that were moderate or severe, only 20% of men used medications for BPH, 71% of whom used inhaled anticholinergic medications previously associated with acute urinary retention. Amongst men with severe prostate symptoms, 60% inhaled anticholinergic therapy.

CONCLUSIONS: Co-morbidities of COPD are common but do not always influence COPD therapy. Depresssion is overlooked and patients with prostate disease or symptoms commonly receive inhaled anticholinergic agents.

CLINICAL IMPLICATIONS: Side-effects of therapy and sub-optimal outcomes of COPD management may result from failure to modify therapy to address common co-morbidities.

DISCLOSURE: Kenneth Chapman: University grant monies: CIHR, Grant monies (from industry related sources): Almirall, Grant monies (from industry related sources): AstraZeneca, Grant monies (from industry related sources): Novartis, Grant monies (from industry related sources): GSK, Grant monies (from industry related sources): Boehringer Ingelheim, Grant monies (from industry related sources): Roche, Grant monies (from industry related sources): Grifols, Grant monies (from industry related sources): CSL Behring, Grant monies (from industry related sources): Takeda, Consultant fee, speaker bureau, advisory committee, etc.: GSK, Consultant fee, speaker bureau, advisory committee, etc.: AstraZeneca, Grant monies (from industry related sources): Novartis, Consultant fee, speaker bureau, advisory committee, etc.: Grifols, Consultant fee, speaker bureau, advisory committee, etc.: CSL Behring Deborah Casey: University grant monies: UHN, Consultant fee, speaker bureau, advisory committee, etc.: GSK, Consultant fee, speaker bureau, advisory committee, etc.: Almirall, Grant monies (from industry related sources): Vitallaire, Grant monies (from industry related sources): Pfizer, Grant monies (from industry related sources): Grifols, Grant monies (from industry related sources): Novartis, Grant monies (from industry related sources): GSK Kim Lavoie: Grant monies (from industry related sources): Abbvie, Consultant fee, speaker bureau, advisory committee, etc.: Almirall, Consultant fee, speaker bureau, advisory committee, etc.: Abbvie, Consultant fee, speaker bureau, advisory committee, etc.: AZ, Consultant fee, speaker bureau, advisory committee, etc.: Boehringer Ingelheim, Consultant fee, speaker bureau, advisory committee, etc.: Almirall, Consultant fee, speaker bureau, advisory committee, etc.: Janssen, Consultant fee, speaker bureau, advisory committee, etc.: Novartis, Consultant fee, speaker bureau, advisory committee, etc.: Takeda, University grant monies: CIHR Renata Rea: Employee: Almirall, Consultant fee, speaker bureau, advisory committee, etc.: AstraZeneca Katherine Arias: Employee: AstraZeneca Paul Jones: Consultant fee, speaker bureau, advisory committee, etc.: Almirall, Consultant fee, speaker bureau, advisory committee, etc.: GSK, Consultant fee, speaker bureau, advisory committee, etc.: AZ, Consultant fee, speaker bureau, advisory committee, etc.: Menarini, Consultant fee, speaker bureau, advisory committee, etc.: Roche, Consultant fee, speaker bureau, advisory committee, etc.: Mundipharma, Consultant fee, speaker bureau, advisory committee, etc.: Janssen, Grant monies (from industry related sources): GSK, Grant monies (from industry related sources): AZ, Grant monies (from industry related sources): Novartis, Consultant fee, speaker bureau, advisory committee, etc.: Novartis, Grant monies (from industry related sources): BI, Consultant fee, speaker bureau, advisory committee, etc.: BI

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