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Geographic differences in clinical characteristics and management of COPD: the EPOCA study
Open accessAbstract
AIMS: Data on differences in clinical characteristics and management of COPD in different countries and settings are limited. We aimed to characterize the profile of patients with COPD in a number of countries and their treatment in order to evaluate adherence to recommendations of international guidelines. METHOD: This was an observational, international, cross-sectional study on patients with physician-diagnosed COPD. Demographic and clinical characteristics, risk factors, and treatment were collected by their physician via an internet web-based questionnaire developed for the study. RESULTS: A total of 77 investigators from 17 countries provided data on 833 patients. The countries with the highest number of patients included were: Argentina (128), Ecuador (134), Spain (162), and Hong Kong (153). Overall, 79.3% were men and 81% former smokers, with a mean FEV1 = 42.7%, ranging from 34.3% in Hong Kong to 58.8% in Ecuador. Patients reported a mean of 1.6 exacerbations the previous year, with this frequency being significantly and negatively correlated with FEV1 (%) (r = -0.256; p < 0.0001). Treatment with short-acting bronchodilators and theophyllines was more frequent in Ecuador and Hong Kong compared with Spain and Argentina, and in patients belonging to lower socioeconomic levels (p < 0.0001 for all comparisons). Inadequacy of treatment with inhaled corticosteroids and theophyllines was high, with significant differences among countries. CONCLUSIONS: Differences in the clinical characteristics and management of COPD were significant across countries. Adherence to international guidelines appears to be low. Efforts should be made to disseminate and adapt guidelines to the socioeconomic reality of different settings.
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Metadata
- Authors
- Miravitlles, M.
- Affiliations
- Hospital Clínic de Barcelona (ES)
- Corresponding author
- Miravitlles, Marc
- ORCID
- Miravitlles, Marc
- Venue
- International Journal of Chronic Obstructive Pulmonary Disease
- Publisher
- Informa UK Limited
- Published
- 2008-12
- Volume
- Volume 3
- Issue
- 4
- Pages
- 803-814
- ISSN
- 1176-9106 (ISSN-L)
- 1178-2005
- PMC
- PMC2650616
- OpenAlex
- W2112674445
- Cited by
- 58
- References
- 42
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 3 · 2021: 4 · 2020: 6 · 2019: 3 · 2018: 4 · 2017: 7 · 2016: 1 · 2015: 4 · 2014: 2 · 2013: 5 · 2012: 1
- FWCI
- 4.59
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of COPD (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Funders
- GlaxoSmithKline
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Inhalation and Respiratory Drug Delivery
- Keywords
- chronic obstructive pulmonary disease, regional variation, clinical features, COPD management, guideline adherence, exacerbations, FEV1, short-acting bronchodilators, theophylline, inhaled corticosteroids, socioeconomic status, cross-national comparison
- MeSH terms
- Administration, Inhalation, Adrenal Cortex Hormones, Aged, Aged, 80 and over, Bronchodilator Agents, Cross-Sectional Studies, Drug Utilization, Female, Forced Expiratory Volume, Humans, International Cooperation, Male, Middle Aged, Practice Patterns, Physicians', Prospective Studies, Surveys and Questionnaires, Residence Characteristics, Social Class, Theophylline, Treatment Outcome, Practice Guidelines as Topic, Respiratory System Agents, Health Care Surveys, Guideline Adherence, Internet, Pulmonary Disease, Chronic Obstructive, Health Status Disparities, Healthcare Disparities, Prescription Drugs
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