Comorbidities, patient knowledge, and disease management in a national sample of patients with COPD

Purpose Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States but is often under-treated. COPD often overlaps with other conditions such as hypertension and osteoporosis, which are less morbid but which may be treated more aggressively. We evaluated the prevalence of these comorbid conditions and compared testing, patient knowledge, and management in a national sample of patients with COPD. Methods and Methods A survey was administered by telephone in 2006 to 1,003 COPD patients to evaluate the prevalence of comorbid conditions, diagnostic testing, knowledge, and management using standardized instruments. The completion rate was 87%. Results Among 1,003 patients with COPD, 61% reported moderate or severe dyspnea and 41% a prior hospitalization for COPD. The most prevalent comorbid diagnoses were hypertension (55%), hypercholesterolemia (52%), depression (37%), cataracts (31%) and osteoporosis (28%). Only 10% of respondents knew their FEV1 (95% CI: 8, 12%) compared to 79% who knew their blood pressure (95% CI: 76%, 83%). Seventy-two percent (95% CI: 69%, 75%) reported taking any medication for COPD – usually a short-acting bronchodilator – whereas 87% (95% CI: 84%, 90%) of patients with COPD and hypertension were taking an antihypertensive medication and 72% (95% CI: 68%, 75%) of patients with COPD and hypercholesterolemia were taking a statin. Conclusion Although most of these COPD patients in this national sample were symptomatic and many had been hospitalized for COPD, COPD self-knowledge was low and COPD was undertreated compared to generally asymptomatic, less morbid conditions such as hypertension