COPD in the population under surveillance by the Portuguese Sentinel Practice Network from 2007 to 2009

Abstract

COPD IN THE POPULATION UNDER SURVEILLANCE BY THE PORTUGUESE SENTINEL PRACTICE NETWORK FROM 2007 TO 2009 Objectives: To determine the number of chronic obstructive pulmonary disease (COPD)-related consultations among patients registered in the Portuguese Sentinel Practice Network (PSPN) between 2007 and 2009, to calculate the reasons for visits re- lated to COPD, to estimate the incidence of COPD, and to characterize COPD-related therapy. Study design: Dynamic cohort. Setting: Muticentric. Participants: Patients 45 years old from the lists of general practitioners in the PSPN between 2007 and 2009. Methods: A study of COPD-related consultations over a three-year period, reporting the frequency, the reasons for consulta- tion and treatments was conducted. The estimated incidence rate of COPD was calculated and extrapolated to the Portuguese population. The chi-square test to compare proportions and the t-student test for comparison of means were used. Results: During the study period, the population under observation was 106,953 individuals and 2,916 consultations related to COPD were reported. Of these, 62.5% were for males. New cases of COPD were reported in 173 persons 45 years old, of which 59.5% were males, with a median age of 66.9 years,. No significant age difference was found between genders. We cal- culated an annual incidence rate of 161.8/100,000 (95% CI: 139.4-187.7), higher in men. The reasons for consulting were re- newal of prescriptions (61.9%), follow-up appointments (22.9%) and exacerbation of symptoms (15.6%). Medication was pre- scribed in 87.3% of consultations, mainly for inhaled bronchodilators, including anti-cholinergic drugs (25.1%) and adrener- gic agonists (20.3%). Conclusions: There were more COPD-related visits and a higher incidence rate of COPD for men, though the value observed was lower than expected. This was probably due to under-diagnosis or to the fact that patients who do not attend Primary Health Care clinics were excluded. The prescription pattern found was consistent with the recommendations of the Global Ini- tiative for Chronic Obstructive Lung Disease.