TY - JOUR
T1 - Prevalence and characteristics of asthma-chronic obstructive pulmonary disease overlap in routine primary care practices
AU - Krishnan, Jerry A.
AU - Nibber, Anjan
AU - Chisholm, Alison
AU - Price, David
AU - Bateman, Eric D.
AU - Bjermer, Leif
AU - van Boven, Job FM
AU - Brusselle, Guy
AU - Costello, Richard W.
AU - Dandurand, Ronald J.
AU - Diamant, Zuzana
AU - Van Ganse, Eric
AU - Gouder, Caroline
AU - van Kampen, Sanne C.
AU - Kaplan, Alan
AU - Kocks, Janwillem
AU - Miravitlles, Marc
AU - Niimi, Akio
AU - Pizzichini, Emilio
AU - Rhee, Chin Kook
AU - Soriano, Joan B.
AU - Vogelmeier, Claus
AU - Román-Rodriguez, Miguel
AU - Carter, Victoria
AU - Roche, Nicolas
PY - 2019/9
Y1 - 2019/9
N2 - 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: 1) Estimate the prevalence and describe characteristics of individuals with ACO in primary care practices among patients currently diagnosed with asthma, COPD, or both; and 2) Compare the prevalence and characteristics of ACO between the three source populations.METHODS: The Respiratory Effectiveness Group (REG) conducted a cross-sectional study of individuals ≥40 years old and with ≥2 outpatient primary care visits over a 2-year period in the United Kingdom's Optimum Patient Care Research Database (OPCRD). Patients were classified into one of three source populations based on diagnostic codes: (A) COPD only; (B) both asthma and COPD; or (C) 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 (BD) airflow limitation (forced expired volume in the first second [FEV1] / forced vital capacity [FVC] < 0.7), and (4) ≥12% and ≥200 mL reversibility in post-BD FEV1.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% CI 18 to 23%). Patients with ACO had a mean age of 70 years (standard deviation 11 years), 60% were men, 73% were former smokers (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 REG ACO Working group criteria. The prevalence and characteristics of patients with ACO varies across the three source populations.
AB - 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: 1) Estimate the prevalence and describe characteristics of individuals with ACO in primary care practices among patients currently diagnosed with asthma, COPD, or both; and 2) Compare the prevalence and characteristics of ACO between the three source populations.METHODS: The Respiratory Effectiveness Group (REG) conducted a cross-sectional study of individuals ≥40 years old and with ≥2 outpatient primary care visits over a 2-year period in the United Kingdom's Optimum Patient Care Research Database (OPCRD). Patients were classified into one of three source populations based on diagnostic codes: (A) COPD only; (B) both asthma and COPD; or (C) 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 (BD) airflow limitation (forced expired volume in the first second [FEV1] / forced vital capacity [FVC] < 0.7), and (4) ≥12% and ≥200 mL reversibility in post-BD FEV1.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% CI 18 to 23%). Patients with ACO had a mean age of 70 years (standard deviation 11 years), 60% were men, 73% were former smokers (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 REG ACO Working group criteria. The prevalence and characteristics of patients with ACO varies across the three source populations.
KW - Asthma
KW - COPD
KW - Comorbidities
KW - Asthma-COPD overlap
KW - Primary care
KW - DIAGNOSIS
KW - asthma-COPD overlap
KW - GUIDELINES
KW - asthma
KW - BRONCHODILATOR REVERSIBILITY
KW - comorbidities
KW - primary care
KW - PATIENT
KW - HEALTH
UR - https://www.atsjournals.org/general/author
UR - https://www.atsjournals.org/doi/10.1513/AnnalsATS.201809-607OC
UR - http://www.mendeley.com/research/prevalence-characteristics-asthmacopd-overlap-routine-primary-care-practices
UR - http://www.scopus.com/inward/record.url?scp=85071785500&partnerID=8YFLogxK
U2 - 10.1513/AnnalsATS.201809-607OC
DO - 10.1513/AnnalsATS.201809-607OC
M3 - Article
C2 - 31162945
VL - 16
SP - 1143
EP - 1150
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
IS - 9
ER -
