Determinants in the Underdiagnosis of COPD in Spain—CONOCEPOC Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Collection
2.2. Statistical Analysis
3. Results
3.1. Chronic Respiratory Symptoms and Respiratory Disease Reported
3.2. Seeking Medical Attention for Respiratory Symptoms. Associated Factors and Situation According to the Autonomous Community
3.3. Use of Spirometry. Associated Factors, Evolution over Time, and Situation According to the Autonomous Community
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total | With Respiratory Symptoms | Without Respiratory Symptoms | p-Value | |
---|---|---|---|---|
N | 6529 | 1618 (24.8) | 4911 (75.2) | |
Age (years), (average ± SD) | 61.5 (13.1) | 63.8 (13.4) | 60.8 (12.9) | <0.001 |
Sex (male), n (%) | 3238 (49.5) | 796 (49.2) | 2440 (49.7) | 0.734 |
Setting < 10,000 inhabitants | 2758 (42.2) | 695 (45.6) | 2063 (44.1) | 0.302 |
Smoking history | ||||
Accumulated consumption (pack-years), (average ± SD) | 19.3 (18.7) | 23.4 (19.4) | 16.5 (17.7) | <0.001 |
Attempted to quit smoking, (average ± SD) | 609 (63.6) | 268 (70) | 34.1 (59.3) | 0.001 |
Attempts to quit, median (P25–P75) | 2 (1–3) | 2 (1–4) | 2 (1–3) | 0.94 |
Never smoked, n (%) | 3554 (54.4) | 736 (45.5) | 2817 (57.4) | <0.001 |
Former smoker, n (%) | 2018 (30.9) | 499 (30.8) | 1519 (30.9) | 0.83 |
Current smoker, n (%) | 958 (14.7) | 383 (23.7) | 575 (11.7) | <0.001 |
Have tried alternatives to tobacco, (%) | 4.5 | 9.6 | 3.4 | <0.001 |
Respiratory symptoms, (%) | ||||
Chronic cough | 17.5 | 450 (27.9) | - | |
Chronic expectoration | 9.5 | 325 (20.1) | - | |
Chest wheezing or noises | 12.9 | 269 (16.6) | - | |
Shortness of breath or trouble breathing | 55.6 | 1283 (79.3) | - | |
COPD risk, n (%) | 627 (38.8) | |||
Suffer from a respiratory disease, n (%) | 1174 (17.9) | 410 (25.3) | 764 (15.5) | <0.001 |
Asthma | 95 (1.5) | 57 (3.5) | 38 (0.7) | <0.001 |
Bronchitis or emphysema or COPD | 199 (3.1) | 125 (7.7) | 74 (1.5) | <0.001 |
Perceived level of health *, (average ± SD) | 7.4 (1.7) | 6.7 (1.9) | 7.6 (1.6) | <0.001 |
Self-reported health status, n (%) | <0.001 | |||
Poor (<5) | 334 (5.1) | 162 (10) | 172 (3.5) | |
Average (5–7) | 2536 (38.9) | 847 (52.3) | 1690 (34.4) | |
Good (>7) | 3659 (56) | 609 (37.5) | 3049 (62.1) |
Patient with Chronic Respiratory Symptoms | Sought Medical Attention | Didn’t Seek Medical Attention | p-Value | |
---|---|---|---|---|
N | 1618 | 836 (51.7) | 782 (48.3) | |
Sex (male), n (%) | 796 (49.2) | 416 (49.8) | 380 (48.6) | 0.639 |
Age (years), (average ± SD) | 63.8 (13.4) | 65.2 (13.3) | 62.2 (13.3) | <0.001 |
Setting < 10,000 inhabitants | 695 (42.9) | 334 (39.9) | 361 (46.2) | 0.027 |
Smoking history | <0.001 | |||
Current smoker, n (%) | 736 (45.5) | 162 (19.4) | 221 (28.3) | |
Former smoker, n (%) | 499 (30.8) | 269 (32.2) | 230 (29.4) | |
Never smoked, n (%) | 383 (23.7) | 405 (48.4) | 331 (42.3) | |
Chronic cough, (%) | 27.9 | 27.1 | 29.7 | 0.501 |
Chronic expectoration, (%) | 20.1 | 21.3 | 20.1 | 0.207 |
Chest wheezing or noises, (%) | 16.6 | 16.4 | 16.4 | 0.976 |
Shortness of breath or trouble breathing, (%) | 79.3 | 82.2 | 76.9 | 0.130 |
COPD risk, n (%) | 627 (38.8) | 333 (39.8) | 294 (37.6) | 0.356 |
Presence of respiratory disease reported, n (%) | 410 (25.3) | 227 (27.2) | 183 (23.4) | 0.009 |
Have gone to the emergency room for worsening of respiratory symptoms, n (%) | 209 (12.9) | 174 (20.8) | 35 (4.5) | <0.001 |
Perceived level of health, (average ± SD) | 6.7 (1.9) | 6.3 (2.0) | 7.0 (1.7) | <0.001 |
Doctor seen, n (%) | ||||
Family medicine specialist | 468 (56) | |||
Pulmonologist | 368 (44) |
OR (95% CI) | p-Value | |
---|---|---|
Area of residence | ||
Area ≥ 10,000 inhabitants (ref.) | ||
Area < 10,000 inhabitants | 0.797 (0.651–0.975) | 0.027 |
Smoking status | ||
Never (ref.) | ||
Former smoker | 0.956 (0.761–1.201) | 0.698 |
Active smoker | 0.599 (0.467–0.769) | <0.001 |
Presence of respiratory disease | ||
No (ref.) | ||
Yes | 1.409 (1.090–1.822) | 0.009 |
Have gone to emergency room for respiratory problem | ||
No (ref.) | ||
Yes | 5.610 (3.845–8.186) | <0.001 |
OR (95% CI) | p-Value | Adjusted Autonomous Community OR (95% CI) | p-Value | |
---|---|---|---|---|
Sex, female (ref.) | ||||
Male | 1.508 (2.024–1.123) | 0.006 | 1.535 (2.074–1.136) | 0.005 |
Area ≥ 10,000 inhab. (ref.) | ||||
Area < 10,000 inhab. | 0.655 (0.890–0.483) | 0.007 | 0.691 (0.957–0.498) | 0.026 |
Age 40–50 years old (ref.) | ||||
51–60 years old | 1.868 (3.112–1.121) | 0.017 | 1.865 (3.136–1.109) | 0.019 |
61–70 years old | 1.068 (1.661–0.687) | 0.769 | 1.135 (1.780–0.723) | 0.582 |
>71 years old | 0.910 (1.381–0.600) | 0.659 | 0.902 (1.380–0.589) | 0.633 |
Smoking status | ||||
Never (ref.) | ||||
Former smoker | 1.684 (2.370–1.197) | 0.003 | 1.696 (2.407–1.195) | 0.003 |
Current smoker | 1.394 (2.070–0.939) | 0.099 | 1.393 (2.084–0.931) | 0.107 |
COPD, No (ref.) | ||||
Yes COPD | 3.134 (13.746–0.715) | 0.13 | 2.524 (11.564–0.551) | 0.233 |
COPD risk | 1.472 (1.998–1.085) | 0.013 | 1.488 (2.035–1.088) | 0.013 |
Doctor seen, | ||||
Family (ref.) | ||||
Pulmonologist | 5.438 (7.728–3.826) | <0.001 | 6.151 (8.869–4.265) | <0.001 |
Emergency room for respiratory problem | ||||
Yes (ref.) | ||||
No | 0.334 (0.518–0.215) | <0.001 | 0.335 (0.523–0.214) | <0.001 |
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Calle Rubio, M.; Rodríguez Hermosa, J.L.; Miravitlles, M.; López-Campos, J.L. Determinants in the Underdiagnosis of COPD in Spain—CONOCEPOC Study. J. Clin. Med. 2022, 11, 2670. https://doi.org/10.3390/jcm11092670
Calle Rubio M, Rodríguez Hermosa JL, Miravitlles M, López-Campos JL. Determinants in the Underdiagnosis of COPD in Spain—CONOCEPOC Study. Journal of Clinical Medicine. 2022; 11(9):2670. https://doi.org/10.3390/jcm11092670
Chicago/Turabian StyleCalle Rubio, Myriam, Juan Luis Rodríguez Hermosa, Marc Miravitlles, and José Luis López-Campos. 2022. "Determinants in the Underdiagnosis of COPD in Spain—CONOCEPOC Study" Journal of Clinical Medicine 11, no. 9: 2670. https://doi.org/10.3390/jcm11092670
APA StyleCalle Rubio, M., Rodríguez Hermosa, J. L., Miravitlles, M., & López-Campos, J. L. (2022). Determinants in the Underdiagnosis of COPD in Spain—CONOCEPOC Study. Journal of Clinical Medicine, 11(9), 2670. https://doi.org/10.3390/jcm11092670