Prevalence and Characteristics of Asthma-Chronic Obstructive Pulmonary Disease Overlap in Routine Primary Care Practices

被引：45

作者：

Krishnan, Jerry A. ^{[1
]}

Nibber, Anjan ^{[2
]}

Chisholm, Alison ^{[3
]}

Price, David ^{[4
,5
]}

Bateman, Eric D. ^{[6
]}

Bjermer, Leif ^{[7
]}

van Boven, Job F. M. ^{[9
]}

Brusselle, Guy ^{[10
]}

Costello, Richard W. ^{[11
]}

Dandurand, Ronald J. ^{[12
,13
,14
]}

Diamant, Zuzana ^{[8
,15
]}

van Ganse, Eric ^{[16
]}

Gouder, Caroline ^{[17
]}

van Kampen, Sanne C. ^{[3
]}

Kaplan, Alan ^{[18
]}

Kocks, Janwillem ^{[5
,19
]}

Miravitlles, Marc ^{[20
]}

Niimi, Akio ^{[21
]}

Pizzichini, Emilio ^{[22
]}

Rhee, Chin Kook ^{[23
]}

Soriano, Joan B. ^{[24
]}

Vogelmeier, Claus ^{[25
]}

Roman-Rodriguez, Miguel ^{[26
]}

Carter, Victoria ^{[5
,27
]}

D'Urzo, Anthony D. ^{[28
]}

Roche, Nicolas ^{[29
]}

机构：

[1] Univ Illinois, Dept Med, Chicago, IL 60612 USA

[2] Univ Oxford, Med Sch, Oxford, England

[3] Resp Effectiveness Grp, Cambridge, England

[4] Univ Aberdeen, Ctr Acad Primary Care, Aberdeen, Scotland

[5] Observat & Pragmat Res Inst, Singapore, Singapore

[6] Univ Cape Town, Dept Med, Div Pulmonol, Cape Town, South Africa

[7] Lund Univ, Sect Resp Med & Allergol, Dept Clin Sci, Lund, Sweden

[8] Lund Univ, Resp Med & Allergol, Lund, Sweden

[9] Univ Groningen, Dept Gen Practice & Elderly Care Med, Groningen Res Inst Asthma & COPD, Univ Med Ctr Groningen, Groningen, Netherlands

[10] Ghent Univ Hosp, Dept Resp Med, Lab Translat Res Obstruct Pulm Dis, Ghent, Belgium

[11] Royal Coll Surg, Dept Resp Med, Dublin, Ireland

[12] McGill Univ, CIUSSS Ouest Ille Montreal, Montreal Chest Inst, Meakins Christie Labs,Oscillometry Unit,Hlth Ctr, Montreal, PQ, Canada

[13] McGill Univ, Ctr Innovat Med, Hlth Ctr, Montreal, PQ, Canada

[14] Ctr Res Inst, Montreal, PQ, Canada

[15] Univ Med Ctr Groningen, Dept Clin Pharm & Pharmacol, Groningen, Netherlands

[16] Croix Rousse Univ Hosp, Resp Med, Lyon, France

[17] Mater Dei Hosp, Dept Resp Med, Msida, Malta

[18] Univ Toronto, Family Phys Airways Grp Canada, Toronto, ON, Canada

[19] Gen Practitioners Res Inst, Groningen, Netherlands

[20] Univ Hosp Vall dHebron, Vall dHebron Res Inst VHIR, Pneumol Dept, CIBER Enfermedades Resp CIBERES, Barcelona, Spain

[21] Nagoya City Univ, Dept Resp Med Allergy & Clin Immunol, Nagoya, Aichi, Japan

[22] Univ Fed Santa Catarina, Florianopolis, SC, Brazil

[23] Catholic Univ Korea, Pulm Allergy & Crit Care Med, Dept Internal Med, Seoul St Marys Hosp,Coll Med, Seoul, South Korea

[24] Univ Autonoma Madrid, Hosp Univ Princesa IISP, Madrid, Spain

[25] Univ Marburg, German Ctr Lung Res, Dept Med Pulm & Crit Med, Marburg, Germany

[26] IdISBa, Primary Care Chron Resp Dis Res Unit, Inst Invest Sanitaria Isl Baleres, Palma De Mallorca, Spain

[27] Optimum Patient Care, Cambridge, England

[28] Univ Toronto, Family & Community Med, Toronto, ON, Canada

[29] Univ Paris 05, Grp Hosp Cochin, AP HP, Pneumol & Soins Intensifs Resp, Paris, France

来源：

ANNALS OF THE AMERICAN THORACIC SOCIETY | 2019年 / 16卷 / 09期

关键词：

asthma-COPD overlap; asthma; comorbidities; COPD; primary care; BRONCHODILATOR REVERSIBILITY; COPD; GUIDELINES; DIAGNOSIS; PATIENT; HEALTH;

D O I：

10.1513/AnnalsATS.201809-607OC

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

100201 [内科学];

摘要：

Rationale: Adults may exhibit characteristics of both asthma and chronic obstructive pulmonary disease (COPD), a situation recently described as asthma-COPD overlap (ACO). There is a paucity of information about ACO in primary care. Objectives: To estimate the prevalence and describe characteristics of individuals with ACO in primary care practices among patients currently diagnosed with asthma, COPD, or both; and to compare the prevalence and characteristics of ACO among the three source populations. Methods: The Respiratory Effectiveness Group conducted a crosssectional study of individuals >= 40 years old and with >= 2 outpatient primary care visits over a 2-year period in the UK Optimum Patient Care Research Database. Patients were classified into one of three source populations based on diagnostic codes: 1) COPD only, 2) both asthma and COPD, or 3) asthma only. ACO was defined as the presence of all of the following 1) age >= 40 years, 2) current or former smoking, 3) post-bronchodilator airflow limitation (forced expiratory volume in 1 second/forced vital capacity <0.7), and 4) >= 12% and >= 200 ml reversibility in post-bronchodilator forced expiratory volume in 1 second. Results: Among 2,165 individuals (1,015 COPD only, 395 with both asthma and COPD, and 755 asthma only), the overall prevalence of ACO was 20% (95% confidence interval, 18-23%). Patients with ACO had a mean age of 70 years (standard deviation, 11 yr), 60% were men, 73% were former smokers (the rest were current smokers), and 66% were overweight or obese. Comorbid conditions were common in patients with ACO, including diabetes (53%), cardiovascular disease (36%), hypertension (30%), eczema (23%), and rhinitis (21%). The prevalence of ACO was higher in patients with a diagnosis of both asthma and COPD (32%) compared with a diagnosis of COPD only (20%; P < 0.001) or asthma only (14%; P < 0.001). Demographic and clinical characteristics of ACO varied across these three source populations. Conclusions: One in five individuals with a diagnosis of COPD, asthma, or both asthma and COPD in primary care settings have ACO based on the Respiratory Effectiveness Group ACO Working group criteria. The prevalence and characteristics of patients with ACO varies across the three source populations.

引用

页码：1143 / 1150

页数：8

共 29 条

[1]

[Anonymous], 2014, GINA GOLD DIAGNOSIS

[2]

[Anonymous], 2000, WHO TECHN REP SER

[3]

Bronchodilator response in the lung health study over 11 yrs [J].