Update in Chronic Obstructive Pulmonary Disease 2019.
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ABSTRACT:
SUBMITTER: Alter P
PROVIDER: S-EPMC8054880 | biostudies-literature | 2020 Aug
REPOSITORIES: biostudies-literature
Publications
Update in Chronic Obstructive Pulmonary Disease 2019.
Alter Peter P Baker Jonathan R JR Dauletbaev Nurlan N Donnelly Louise E LE Pistenmaa Carrie C Schmeck Bernd B Washko George G Vogelmeier Claus F CF
American journal of respiratory and critical care medicine 20200801 3
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Project description:BackgroundThere is considerable variation in reported chronic obstructive pulmonary disease (COPD) prevalence internationally, partly due to differing definitions in use. Accurate estimates of disease prevalence are important for allocation of health-care resources, yet UK estimates of COPD prevalence have not been updated for a decade. We calculated yearly COPD prevalence in England between 2000 and 2019 using different definitions of COPD.MethodsWe used routinely collected primary care electronic healthcare record (EHR) data from the Clinical Practice Research Datalink (CPRD) Aurum database linked with secondary care data from the Hospital Episode Statistics (HES) Admitted Patient Care (APC) database. Mid-year point prevalence was calculated yearly from 2000 to 2019 in English adults aged ≥40 years using 5 definitions: (i) validated COPD, (ii) Quality and Outcomes Framework (QOF) COPD, (iii) COPD symptoms, inhaler prescription, and no asthma diagnosis, (iv) hospitalisation with COPD as any diagnosis, (v) hospitalisation with COPD as primary or secondary diagnosis. Prevalence was further stratified by gender, age group, and region.ResultsA total of 12,745,793 people were included over the 20-year period. Annual cohort sizes ranged from 4,373,538 in 2000 to 6,159,496 in 2019. Estimates of COPD prevalence increased every year from 2000 and the difference in estimated prevalence between the validated and QOF definitions has grown over time. In 2019, a COPD prevalence of 4.9% was found using validated events in either primary or secondary care (definition 1 or definition 5). Additionally, including potentially undiagnosed cases (definition 3) in the COPD definition produced an increased prevalence of 6.7%.ConclusionCommon definitions of COPD (eg, QOF codes), may underestimate the true prevalence. The extent of this underestimate has increased over time and could lead to under-allocation of resources where need is estimated based on these definitions. Standardisation of COPD coding in routine EHRs and metrics such as spirometry is key to accurate disease monitoring.
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