Prevalence of asthma characteristics in copd patients in a dutch well-established asthma/copd service for primary care
Epidemiology, diagnosis and monitoringIntroduction: The role of Inhaled corticosteroids (ICS) in primary care COPD patients is under debate. It is unknown how many COPD patients may benefit from ICS treatment.
Aim: To describe the prevalence of asthma characteristics in patients with a pulmonologist confirmed working diagnosis of COPD or ACO.
Methods: Data was used from a Dutch asthma/COPD(AC)-service, a structured system in which pulmonologists support GPs in their diagnosis of patients with suspicion of obstructive lung disease. These data include, medical history, disease-related questionnaires and spirometry. The prevalence and the number of asthma characteristics were assessed.
Results: Of the 14,141 patients ≥40 years in the dataset, pulmonologists were able to diagnose 4475 (32%) with asthma, 3532 (25%) with COPD and 1276 (9%) with ACO. Of the total study population (n=4808), 9% used ICS. A history of asthma was reported in 7% of the COPD and 28% of the ACO patients. Signs of atopy were reported by 16% of the COPD and 41% of the ACO patients. Reversibility of ≥12% was present in 13% of the COPD and 42% of the ACO patients. Three or more asthma characteristics were present in 38% of the total study population, 30% of the COPD patients and 62% of the ACO patients. No asthma characteristics were present in 10% of the COPD and 2% of the ACO patients.
Conclusion: In this group of pulmonologists confirmed COPD or ACO patients, a substantial proportion would be considered to have signs of asthma. In the personalized approach of airway disease management, these patients might benefit from ICS containing treatment. Prospective studies are needed to guide personalized care in this patient group.