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brief-report
Author(s):
Luis Verde-Remeseiro ,
Estrella López-Pardo ,
Alberto Ruano-Ravina ,
Francisco Gude-Sampedro ,
Ramón Castro-Calvo
Publication date (Print and electronic): October 2015
Journal: Gaceta Sanitaria
Publisher: Ediciones Doyma, S.L.
Keywords: Enfermedad pulmonar obstructiva crónica, Espirometría, Historia clínica electrónica, España, Pulmonary disease, Chronic obstructive, Spirometry, Medical records systems, Computerized, Spain
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Chronic obstructive pulmonary disease (COPD) is a significant health problem in developed countries. We aimed to estimate the prevalence of COPD in a single Spanish healthcare area. We also aimed to assess if there are any differences in prevalence and spirometry use among primary care services by utilizing already registered information. We designed a cross-sectional study to determine the prevalence of COPD and the performance of spirometries in each primary care service. A total of 8,444 patients were diagnosed with COPD, with a prevalence of 2.6% for individuals older than 39 years. The prevalence increased with age and was much higher in men. Significant heterogeneity was found in the prevalence of COPD and spirometry use among primary care services. COPD was underdiagnosed and there was wide variability in spirometry use in our area. Greater efforts are needed to diagnose COPD in order to improve its clinical outcomes and to refine registries so that they can be used as reliable sources of information. La enfermedad pulmonar obstructiva crónica (EPOC) es un importante problema de salud en los países desarrollados. Se pretende estimar la prevalencia de la EPOC en un área sanitaria española para evaluar si existen diferencias en la prevalencia y en el uso de espirometrías entre los servicios de atención primaria utilizando información proveniente de registros. Se diseñó un estudio transversal para obtener la prevalencia de la EPOC y la realización de espirometrías en cada servicio de atención primaria. Hay 8444 pacientes diagnosticados de EPOC, con una prevalencia del 2,6% en mayores de 39 años. La prevalencia aumenta con la edad y es mucho más alta en los hombres que en las mujeres. Se observa una importante heterogeneidad en la prevalencia de la EPOC y en el uso de espirometrías entre servicios de primaria. La EPOC está infradiagnosticada y hay una fuerte variabilidad en el uso de espirometrías dentro de un área sanitaria. Deben hacerse más esfuerzos para diagnosticar la EPOC con el fin de mejorar los resultados clínicos, y refinar los registros para que puedan utilizarse como fuentes fiables de información sanitaria. Abstract
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Most cited references40
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The applications of capture-recapture models to epidemiological data.
W Shau, A-Ching Chao, Shaoping Lin … (2001)
Capture-recapture methodology, originally developed for estimating demographic parameters of animal populations, has been applied to human populations. This tutorial reviews various closed capture-recapture models which are applicable to ascertainment data for estimating the size of a target population based on several incomplete lists of individuals. Most epidemiological approaches merging different lists and eliminating duplicate cases are likely to be biased downwards. That is, the final merged list misses those who are in the population but were not ascertained in any of the lists. If there are no matching errors, then the duplicate information collected from a capture-recapture experiment can be used to estimate the number of missed under proper assumptions. Three approaches and their associated estimation procedures are introduced: ecological models; log-linear models, and the sample coverage approach. Each approach has its unique way of incorporating two types of source dependencies: local (list) dependence and dependence due to heterogeneity. An interactive program, CARE (for capture-recapture) developed by the authors is demonstrated using four real data sets. One set of data deals with infection by the acute hepatitis A virus in an outbreak in Taiwan; the other three sets are ascertainment data on diabetes, spina bifida and infants' congenital anomaly discussed in the literature. These data sets provide examples to show the usefulness of the capture-recapture method in correcting for under-ascertainment. The limitations of the methodology and some cautionary remarks are also discussed. Copyright 2001 John Wiley & Sons, Ltd.
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Clinical Audit of COPD Patients Requiring Hospital Admissions in Spain: AUDIPOC Study
Francisco Pozo-Rodríguez, José Luis López-Campos, Carlos J. Álvarez-Martínez … (2012)
Backgrounds AUDIPOC is a nationwide clinical audit that describes the characteristics, interventions and outcomes of patients admitted to Spanish hospitals because of an exacerbation of chronic obstructive pulmonary disease (ECOPD), assessing the compliance of these parameters with current international guidelines. The present study describes hospital resources, hospital factors related to case recruitment variability, patients’ characteristics, and adherence to guidelines. Methodology/Principal Findings An organisational database was completed by all participant hospitals recording resources and organisation. Over an 8-week period 11,564 consecutive ECOPD admissions to 129 Spanish hospitals covering 70% of the Spanish population were prospectively identified. At hospital discharge, 5,178 patients (45% of eligible) were finally included, and thus constituted the audited population. Audited patients were reassessed 90 days after admission for survival and readmission rates. A wide variability was observed in relation to most variables, hospital adherence to guidelines, and readmissions and death. Median inpatient mortality was 5% (across-hospital range 0–35%). Among discharged patients, 37% required readmission (0–62%) and 6.5% died (0–35%). The overall mortality rate was 11.6% (0–50%). Hospital size and complexity and aspects related to hospital COPD awareness were significantly associated with case recruitment. Clinical management most often complied with diagnosis and treatment recommendations but rarely (<50%) addressed guidance on healthy life-styles. Conclusions/Significance The AUDIPOC study highlights the large across-hospital variability in resources and organization of hospitals, patient characteristics, process of care, and outcomes. The study also identifies resources and organizational characteristics associated with the admission of COPD cases, as well as aspects of daily clinical care amenable to improvement.
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Degree of control of physician-diagnosed asthma and COPD in Italy.
G Caramori, G Bettoncelli, M. Carone … (2007)
It is important for the Italian National Health Service to obtain data on the degree of control of asthma and chronic obstructive pulmonary disease (COPD) in the general population in Italy in order for balanced planning of future investments in these diseases to be made. Currently, precise estimates of these parameters are not available in literature. In collaboration with the Italian Academy of General Practitioners (SIMG; www.simg.it) we have investigated the degree of control of physician-diagnosed asthma and COPD in Italy. A standardised questionnaire on asthma and COPD has been self-administered to a sample of 1937 Italian family physicians (representing around 5% of all the Italian doctors involved in general practice) chosen to cover all the Italian counties. We have collected questionnaire data from 19,917 patients with asthma and COPD followed in their practice and 12,438 (62.4%) were correctly filled in enabling evaluation. We selected the number of emergency room visits, hospitalisations and intensive care unit admissions for asthma and COPD in the last 12 months as objective measures of the degree of asthma and COPD morbidity in these patients. The figures were respectively 12.4% (emergency room visits), 17.3% (hospitalisations) and 1.2% (intensive care unit admissions) of all patients with physician-diagnosed asthma and COPD. This data suggests that in Italy the morbidity of asthma and COPD remains high; representing a significant burden for the Italian National Health Service. There is a clear necessity for further studies to investigate the causes of this incomplete control.
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Author and article information
Contributors
Luis Verde-Remeseiro: Role: ND
Estrella López-Pardo: Role: ND
Alberto Ruano-Ravina: Role: ND
Francisco Gude-Sampedro: Role: ND
Ramón Castro-Calvo: Role: ND
Journal
Journal ID (publisher-id): gs
Title: Gaceta Sanitaria
Abbreviated Title: Gac Sanit
Publisher: Ediciones Doyma, S.L. (Barcelona, Barcelona, Spain )
ISSN (Print): 0213-9111
Publication date (Print and electronic): October 2015
Volume: 29
Issue: 5
Pages: 390-392
Affiliations
[02] Santiago de Compostela orgnameUniversity of Santiago de Compostela orgdiv1Department of Preventive Medicine and Public Health Spain
[04] Santiago de Compostela orgnameSantiago de Compostela University Clinic Hospital orgdiv1Epidemiology Unit Spain
Article
Publisher ID: S0213-91112015000500015
DOI: 10.1016/j.gaceta.2015.03.006
PubMed ID: 25959609
SO-VID: abb19516-8c05-428c-8f3e-8015ea296ac5
License:
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
History
Date accepted : 23 March 2015
Date received : 04 February 2015
Page count
Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 3
Product
SciELO Spain
Keywords: Enfermedad pulmonar obstructiva crónica,Espirometría,Historia clínica electrónica,España,Pulmonary disease,Chronic obstructive,Spirometry,Medical records systems,Computerized,Spain
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Keywords: Enfermedad pulmonar obstructiva crónica, Espirometría, Historia clínica electrónica, España, Pulmonary disease, Chronic obstructive, Spirometry, Medical records systems, Computerized, Spain
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