Prevalence of Asthma Characteristics in COPD Patients in a Dutch Well-Established Asthma/COPD Service for Primary Care

Abstract

Purpose

Primary care COPD guidelines indicate that COPD patients with asthma characteristics should be treated as having asthma. This study aims to describe the prevalence of asthma characteristics in patients with a pulmonologist-confirmed working diagnosis of COPD or ACO.

Patients and Methods

This retrospective cross-sectional study used real-life data (collected between 2007 and 2017) from a Dutch asthma/COPD-service, a structured web-based system in which pulmonologists support general practitioners in their diagnosis of patients with suspicion of obstructive lung disease. The prevalence of asthma characteristics (history of asthma, atopy, symptoms, and reversibility) and blood eosinophil (Eos) counts were assessed in patients with a working diagnosis of COPD or ACO.

Results

Of the 14,141 patients, ≥40 years in the dataset, 4475 (31.6%) were diagnosed with asthma, 3532 (25.0%) with COPD, and 1276 (9.0%) with ACO. Asthma characteristics were present in 65.6% (n=1956) of the COPD and 90.9% (n=1059) of the ACO patients. Eos counts of ≥ 300 cells per μL were found in 35.7% (n=924) of the COPD patients and 35.3% (n=341) of the ACO patients.

Conclusion

In this group of COPD and ACO patients remotely diagnosed by pulmonologists, a substantial proportion would be considered to have asthma characteristics according to the guidelines. This may explain the high number of inhaled corticosteroid (ICS) prescriptions found in primary care COPD patients. Prospective studies are necessary to identify patients who may or may not benefit from ICS containing treatment. Hence, personalized care in primary care can be optimized.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): COPD

Journal ID (pmc): copd

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date (Electronic): 06 July 2020

Publication date Collection: 2020

Volume: 15

Pages: 1601-1611

Affiliations

[1 ]General Practitioners Research Institute , Groningen, the Netherlands

[2 ]University of Groningen, University Medical Center Groningen, GRIAC Research Institute , Groningen, the Netherlands

[3 ]Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen , Groningen, the Netherlands

[4 ]Department of Pediatric Pulmonology and Pediatric Allergology, University of Groningen, University Medical Center Groningen, Beatrix Children’s Hospital , Groningen, the Netherlands

[5 ]Astma/COPD Dienst, CERTE Laboratories , Groningen, the Netherlands

[6 ]Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen , Groningen, the Netherlands

[7 ]GlaxoSmithKline , Zeist, the Netherlands

[8 ]Observational and Pragmatic Research Institute , Singapore

Author notes

Correspondence: Anna Jetske Baron Email [e-mail]

Article

Publisher ID: 247819

DOI: 10.2147/COPD.S247819

PMC ID: 7351624

Copyright statement: © 2020 Baron et al.

License:

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Page count

Figures: 6, Tables: 1, References: 43, Pages: 11

Funding

Funded by: General Practitioners Research Institute and GlaxoSmithKline BV

This study is funded by General Practitioners Research Institute and GlaxoSmithKline BV.

Categories

Subject: Original Research