Exacerbations as a starting point of pro-active chronic obstructive pulmonary disease management

Maria C. Zoia, Angelo G. Corsico, Massimiliano Beccaria, Roberta Guarnone, Gabriella Cervio, Renato Testi, Maria A. Bressan, Ernesto Pozzi, Isa Cerveri

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Chronic obstructive pulmonary disease (COPD) exacerbations could represent an opportunity for pro-active COPD management rather than mere treatment if previously unknown disease is discovered; the extent of underdiagnosis and undertreatment of COPD in patients attending an emergency department (ED) with an exacerbation is not known. During 2002, we recalled 131 COPD patients in stable conditions, 4-8 weeks after they had attended the ED or been discharged from our University Hospital (North-West of Italy). Information on diagnosis and management prior to the ED attendance were collected; spirometry and arterial blood gas analyses were performed. One-third of patients had never been diagnosed and treated even though 83% of them had moderate-to-very-severe COPD and about 30% already had respiratory failure. Only 20% had received information on the nature of the disease and none had received a written action plan. Only 60% were receiving long-acting bronchodilators and 41% of patients with respiratory failure were receiving long-term oxygen. A substantial number of undiagnosed and untreated patients with moderate-to-very-severe COPD came to our attention through an exacerbation. This enforces the importance of exacerbations as the starting point of pro-active COPD management and of the ED as a valuable sentinel to identify this subset of patients.

Original languageEnglish
Pages (from-to)1568-1575
Number of pages8
JournalRespiratory Medicine
Volume99
Issue number12
DOIs
Publication statusPublished - Dec 2005

Fingerprint

Disease Management
Chronic Obstructive Pulmonary Disease
Hospital Emergency Service
Respiratory Insufficiency
Blood Gas Analysis
Bronchodilator Agents
Spirometry
Italy
Disease Progression
Oxygen

Keywords

  • Primary care
  • Underdiagnosis
  • Undertreatment

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Exacerbations as a starting point of pro-active chronic obstructive pulmonary disease management. / Zoia, Maria C.; Corsico, Angelo G.; Beccaria, Massimiliano; Guarnone, Roberta; Cervio, Gabriella; Testi, Renato; Bressan, Maria A.; Pozzi, Ernesto; Cerveri, Isa.

In: Respiratory Medicine, Vol. 99, No. 12, 12.2005, p. 1568-1575.

Research output: Contribution to journalArticle

Zoia, Maria C. ; Corsico, Angelo G. ; Beccaria, Massimiliano ; Guarnone, Roberta ; Cervio, Gabriella ; Testi, Renato ; Bressan, Maria A. ; Pozzi, Ernesto ; Cerveri, Isa. / Exacerbations as a starting point of pro-active chronic obstructive pulmonary disease management. In: Respiratory Medicine. 2005 ; Vol. 99, No. 12. pp. 1568-1575.
@article{534214e98ae345c89e4be8f18c211e83,
title = "Exacerbations as a starting point of pro-active chronic obstructive pulmonary disease management",
abstract = "Chronic obstructive pulmonary disease (COPD) exacerbations could represent an opportunity for pro-active COPD management rather than mere treatment if previously unknown disease is discovered; the extent of underdiagnosis and undertreatment of COPD in patients attending an emergency department (ED) with an exacerbation is not known. During 2002, we recalled 131 COPD patients in stable conditions, 4-8 weeks after they had attended the ED or been discharged from our University Hospital (North-West of Italy). Information on diagnosis and management prior to the ED attendance were collected; spirometry and arterial blood gas analyses were performed. One-third of patients had never been diagnosed and treated even though 83{\%} of them had moderate-to-very-severe COPD and about 30{\%} already had respiratory failure. Only 20{\%} had received information on the nature of the disease and none had received a written action plan. Only 60{\%} were receiving long-acting bronchodilators and 41{\%} of patients with respiratory failure were receiving long-term oxygen. A substantial number of undiagnosed and untreated patients with moderate-to-very-severe COPD came to our attention through an exacerbation. This enforces the importance of exacerbations as the starting point of pro-active COPD management and of the ED as a valuable sentinel to identify this subset of patients.",
keywords = "Primary care, Underdiagnosis, Undertreatment",
author = "Zoia, {Maria C.} and Corsico, {Angelo G.} and Massimiliano Beccaria and Roberta Guarnone and Gabriella Cervio and Renato Testi and Bressan, {Maria A.} and Ernesto Pozzi and Isa Cerveri",
year = "2005",
month = "12",
doi = "10.1016/j.rmed.2005.03.032",
language = "English",
volume = "99",
pages = "1568--1575",
journal = "Respiratory Medicine",
issn = "0954-6111",
publisher = "W.B. Saunders Ltd",
number = "12",

}

TY - JOUR

T1 - Exacerbations as a starting point of pro-active chronic obstructive pulmonary disease management

AU - Zoia, Maria C.

AU - Corsico, Angelo G.

AU - Beccaria, Massimiliano

AU - Guarnone, Roberta

AU - Cervio, Gabriella

AU - Testi, Renato

AU - Bressan, Maria A.

AU - Pozzi, Ernesto

AU - Cerveri, Isa

PY - 2005/12

Y1 - 2005/12

N2 - Chronic obstructive pulmonary disease (COPD) exacerbations could represent an opportunity for pro-active COPD management rather than mere treatment if previously unknown disease is discovered; the extent of underdiagnosis and undertreatment of COPD in patients attending an emergency department (ED) with an exacerbation is not known. During 2002, we recalled 131 COPD patients in stable conditions, 4-8 weeks after they had attended the ED or been discharged from our University Hospital (North-West of Italy). Information on diagnosis and management prior to the ED attendance were collected; spirometry and arterial blood gas analyses were performed. One-third of patients had never been diagnosed and treated even though 83% of them had moderate-to-very-severe COPD and about 30% already had respiratory failure. Only 20% had received information on the nature of the disease and none had received a written action plan. Only 60% were receiving long-acting bronchodilators and 41% of patients with respiratory failure were receiving long-term oxygen. A substantial number of undiagnosed and untreated patients with moderate-to-very-severe COPD came to our attention through an exacerbation. This enforces the importance of exacerbations as the starting point of pro-active COPD management and of the ED as a valuable sentinel to identify this subset of patients.

AB - Chronic obstructive pulmonary disease (COPD) exacerbations could represent an opportunity for pro-active COPD management rather than mere treatment if previously unknown disease is discovered; the extent of underdiagnosis and undertreatment of COPD in patients attending an emergency department (ED) with an exacerbation is not known. During 2002, we recalled 131 COPD patients in stable conditions, 4-8 weeks after they had attended the ED or been discharged from our University Hospital (North-West of Italy). Information on diagnosis and management prior to the ED attendance were collected; spirometry and arterial blood gas analyses were performed. One-third of patients had never been diagnosed and treated even though 83% of them had moderate-to-very-severe COPD and about 30% already had respiratory failure. Only 20% had received information on the nature of the disease and none had received a written action plan. Only 60% were receiving long-acting bronchodilators and 41% of patients with respiratory failure were receiving long-term oxygen. A substantial number of undiagnosed and untreated patients with moderate-to-very-severe COPD came to our attention through an exacerbation. This enforces the importance of exacerbations as the starting point of pro-active COPD management and of the ED as a valuable sentinel to identify this subset of patients.

KW - Primary care

KW - Underdiagnosis

KW - Undertreatment

UR - http://www.scopus.com/inward/record.url?scp=28044447233&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=28044447233&partnerID=8YFLogxK

U2 - 10.1016/j.rmed.2005.03.032

DO - 10.1016/j.rmed.2005.03.032

M3 - Article

C2 - 15890509

AN - SCOPUS:28044447233

VL - 99

SP - 1568

EP - 1575

JO - Respiratory Medicine

JF - Respiratory Medicine

SN - 0954-6111

IS - 12

ER -