Abstract
This article deals with the prevalence and the possible reasons of COPD underestimation in the population and gives suggestions on how to overcome the obstacles and make the correct diagnosis in order to provide the patients with the appropriate therapy. COPD is diagnosed in later or very advanced stages. In Italy the rate of COPD under-diagnosis ranges between 25 and 50% and, as a consequence, the patient does not consult his doctor until the symptoms have worsened, mainly due to exacerbations. A missed diagnosis influences the timing of therapeutic intervention, thus contributing to the evolution into more severe stages of the illness. An incisive intervention to limit under-diagnosis cannot act only in remittance (passive diagnosis), but must be the promoter for a series of preventive actions: primary, secondary and rehabilitative. To reduce under-diagnosis, some actions need to be taken, such as screening programs for smokers subjects, use of questionnaires aimed to qualify and monitor the disease severity, spirometry, early diagnosis. There is a consensus regarding diagnoses based on screening of at-risk subjects and symptoms, rather than screening of the general population. In practice, all individuals over 40 years of age with risk factors should make a spirometry test. Screening actions on a national scale can be the following: compilation of questionnaires in waiting rooms of doctor's offices or performing simple maneuvers to evaluate the expiratory force at pharmacies. It is now widely recognized that COPD is a complex syndrome with several pulmonary and extrapulmonary components; as a result, the airway obstruction as assessed by FEV1 by itself does not adequately describe the complexity of the disease and FEV1 cannot be used alone for the optimal diagnosis, assessment, and management of the disease. The identification and subsequent grouping of key elements of the COPD syndrome into clinically meaningful and useful subgroups (phenotypes) can guide therapy more effectively. In conclusion, we firmly believe that an early and correct diagnosis can influence positively the progress of the disease (lowering the lung function impairment), decrease the risk of exacerbations, relieve symptoms and increase the patients' quality of life leading also to a decrease in costs associated to the exacerbations and hospitalization of the patient.
| Original language | English |
|---|---|
| Article number | 63 |
| Journal | Multidisciplinary Respiratory Medicine |
| Volume | 9 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2014 |
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Keywords
- COPD
- Early diagnosis
- Indicators
- Phenotype
- Spirometry
- Underestimation
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
Health and social impacts of COPD and the problem of under-diagnosis. / Carlone, Stefano; Balbi, Bruno; Bezzi, Michela; Brunori, Marco; Calabro, Stefano; Barbaro, Maria Pia Foschino; Micheletto, Claudio; Privitera, Salvatore; Torchio, Roberto; Schino, Pietro; Vianello, Andrea.
In: Multidisciplinary Respiratory Medicine, Vol. 9, No. 1, 63, 2014.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Health and social impacts of COPD and the problem of under-diagnosis
AU - Carlone, Stefano
AU - Balbi, Bruno
AU - Bezzi, Michela
AU - Brunori, Marco
AU - Calabro, Stefano
AU - Barbaro, Maria Pia Foschino
AU - Micheletto, Claudio
AU - Privitera, Salvatore
AU - Torchio, Roberto
AU - Schino, Pietro
AU - Vianello, Andrea
PY - 2014
Y1 - 2014
N2 - This article deals with the prevalence and the possible reasons of COPD underestimation in the population and gives suggestions on how to overcome the obstacles and make the correct diagnosis in order to provide the patients with the appropriate therapy. COPD is diagnosed in later or very advanced stages. In Italy the rate of COPD under-diagnosis ranges between 25 and 50% and, as a consequence, the patient does not consult his doctor until the symptoms have worsened, mainly due to exacerbations. A missed diagnosis influences the timing of therapeutic intervention, thus contributing to the evolution into more severe stages of the illness. An incisive intervention to limit under-diagnosis cannot act only in remittance (passive diagnosis), but must be the promoter for a series of preventive actions: primary, secondary and rehabilitative. To reduce under-diagnosis, some actions need to be taken, such as screening programs for smokers subjects, use of questionnaires aimed to qualify and monitor the disease severity, spirometry, early diagnosis. There is a consensus regarding diagnoses based on screening of at-risk subjects and symptoms, rather than screening of the general population. In practice, all individuals over 40 years of age with risk factors should make a spirometry test. Screening actions on a national scale can be the following: compilation of questionnaires in waiting rooms of doctor's offices or performing simple maneuvers to evaluate the expiratory force at pharmacies. It is now widely recognized that COPD is a complex syndrome with several pulmonary and extrapulmonary components; as a result, the airway obstruction as assessed by FEV1 by itself does not adequately describe the complexity of the disease and FEV1 cannot be used alone for the optimal diagnosis, assessment, and management of the disease. The identification and subsequent grouping of key elements of the COPD syndrome into clinically meaningful and useful subgroups (phenotypes) can guide therapy more effectively. In conclusion, we firmly believe that an early and correct diagnosis can influence positively the progress of the disease (lowering the lung function impairment), decrease the risk of exacerbations, relieve symptoms and increase the patients' quality of life leading also to a decrease in costs associated to the exacerbations and hospitalization of the patient.
AB - This article deals with the prevalence and the possible reasons of COPD underestimation in the population and gives suggestions on how to overcome the obstacles and make the correct diagnosis in order to provide the patients with the appropriate therapy. COPD is diagnosed in later or very advanced stages. In Italy the rate of COPD under-diagnosis ranges between 25 and 50% and, as a consequence, the patient does not consult his doctor until the symptoms have worsened, mainly due to exacerbations. A missed diagnosis influences the timing of therapeutic intervention, thus contributing to the evolution into more severe stages of the illness. An incisive intervention to limit under-diagnosis cannot act only in remittance (passive diagnosis), but must be the promoter for a series of preventive actions: primary, secondary and rehabilitative. To reduce under-diagnosis, some actions need to be taken, such as screening programs for smokers subjects, use of questionnaires aimed to qualify and monitor the disease severity, spirometry, early diagnosis. There is a consensus regarding diagnoses based on screening of at-risk subjects and symptoms, rather than screening of the general population. In practice, all individuals over 40 years of age with risk factors should make a spirometry test. Screening actions on a national scale can be the following: compilation of questionnaires in waiting rooms of doctor's offices or performing simple maneuvers to evaluate the expiratory force at pharmacies. It is now widely recognized that COPD is a complex syndrome with several pulmonary and extrapulmonary components; as a result, the airway obstruction as assessed by FEV1 by itself does not adequately describe the complexity of the disease and FEV1 cannot be used alone for the optimal diagnosis, assessment, and management of the disease. The identification and subsequent grouping of key elements of the COPD syndrome into clinically meaningful and useful subgroups (phenotypes) can guide therapy more effectively. In conclusion, we firmly believe that an early and correct diagnosis can influence positively the progress of the disease (lowering the lung function impairment), decrease the risk of exacerbations, relieve symptoms and increase the patients' quality of life leading also to a decrease in costs associated to the exacerbations and hospitalization of the patient.
KW - COPD
KW - Early diagnosis
KW - Indicators
KW - Phenotype
KW - Spirometry
KW - Underestimation
UR - http://www.scopus.com/inward/record.url?scp=84951064512&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84951064512&partnerID=8YFLogxK
U2 - 10.1186/2049-6958-9-63
DO - 10.1186/2049-6958-9-63
M3 - Article
AN - SCOPUS:84951064512
VL - 9
JO - Multidisciplinary Respiratory Medicine
JF - Multidisciplinary Respiratory Medicine
SN - 1828-695X
IS - 1
M1 - 63
ER -