European Respiratory Journal · 2002 · 563 citations · 19 references
MedicineHealth SciencesOccupational HealthPulmonary Function TestingPulmonologyChronic DiseaseChronic Disease BurdenChronic Obstructive Pulmonary DiseaseObstructive Lung DiseaseRespiratory DiseaseChronic Obstructive Pulmonary Disease DisparitiesChronic Obstructive Pulmonary Disease EpidemiologyComparative Disease SeverityDisease Severity EstimationDisease Severity PerceptionLung DiseasesRandom Digit DialingRespiratory Disease Burden
No international survey has yet quantified COPD burden in the general population. The Confronting COPD International Survey aimed to quantify COPD morbidity and burden in 2000. The study screened 201,921 households via random‑digit dialing in eight countries, identifying 3,265 subjects with COPD, chronic bronchitis, emphysema, or chronic bronchitis symptoms. The survey revealed that COPD patients in North America and Europe, with a mean age of 63.3 years and 44.2% female, largely underestimate their disease severity, face substantial activity limitations, frequent work loss and emergency care use, and that many with severe breathlessness describe their condition as mild or moderate, highlighting a significant societal and individual burden.
To date, no international surveys estimating the burden of chronic obstructive pulmonary disease (COPD) in the general population have been published. The Confronting COPD International Survey aimed to quantify morbidity and burden in COPD subjects in 2000. From a total of 201,921 households screened by random-digit dialling in the USA, Canada, France, Italy, Germany, the Netherlands, Spain and the UK, 3,265 subjects with a diagnosis of COPD, chronic bronchitis or emphysema, or with symptoms of chronic bronchitis, were identified. The mean age of the subjects was 63.3 yrs and 44.2% were female. Subjects with COPD in North America and Europe appear to underestimate their morbidity, as shown by the high proportion of subjects with limitations to their basic daily life activities, frequent work loss (45.3% of COPD subjects of <65 yrs reported work loss in the past year) and frequent use of health services (13.8% of subjects required emergency care in the last year), and may be undertreated. There was a significant disparity between subjects' perception of disease severity and the degree of severity indicated by an objective breathlessness scale. Of those with the most severe breathlessness (too breathless to leave the house), 35.8% described their condition as mild or moderate, as did 60.3% of those with the next most severe degree of breathlessness (breathless after walking a few minutes on level ground). This international survey confirmed the great burden to society and high individual morbidity associated with chronic obstructive pulmonary disease in subjects in North America and Europe.
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