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Download 20170117-Undiagnosed Chronic Obstructive Pulmonary Disease.pdf
Judul Undiagnosed Chronic Obstructive Pulmonary Disease Contributes to the Burden of Health Care Use
Abstract Abstract
Rationale: Chronic obstructive pulmonary disease (COPD) remains
undiagnosed in many individuals with persistent airflow limitation.
These individuals may be susceptible to exacerbation-like respiratory
events that consume health care resources.
Objectives: To compare exacerbation-like respiratory events, event
prevalence, and differences in the odds of using medication and/or
health services between subjects with diagnosed and undiagnosed
COPD.
Methods: Subjects sampled from the general population
participating in the CanCOLD (Canadian Cohort Obstructive
Lung Disease) study, with at least 12 months of exacerbation-event
follow-up who were classified as having physician-diagnosed or
undiagnosed COPD were assessed. Exacerbation-like respiratory
events were captured using a questionnaire administered every
3 months.
Measurements and Main Results: A total of 355 subjects were
undiagnosed and 150 were diagnosed with COPD. Undiagnosed
subjects were less symptomatic and functionally impaired, had been
prescribed fewer respiratory medications, and had better health
status. The incidence of reported exacerbation-like events was higher
in diagnosed subjects and increased in both groups with the severity
of airflow obstruction. Although subjects with diagnosedCOPDwere
more often prescribed medication for exacerbation events, health
service use for exacerbation events was similar in both groups.
Conclusions: Most subjects with COPD in Canada remain
undiagnosed. These subjects are less symptomatic and impaired,
which may partly explain lack of diagnosis. Although patients with
undiagnosed COPD experience fewer exacerbations than those with
diagnosed COPD, they use a similar amount of health services for
exacerbation events; thus, the overall health system burden of
exacerbations in those with undiagnosed COPD is considerable.
Keywords: undiagnosed COPD; exacerbation; burden