Defining COPD exacerbations: impact on estimation of incidence and burden in primary care

Abstract

Aims:

To investigate the impact of definition on the incidence of chronic obstructive pulmonary disease (COPD) exacerbations in primary care.

Methods:

In a one-year prospective, observational study, data from diary cards were used to determine the incidence of symptom- and healthcare-defined exacerbations. One hundred and twenty seven patients completed =80% of days in the diary card and were included in the analysis.

Results:

Incidence of COPD exacerbation varied according to definition. Mean yearly rates were 2.3 for symptom- and 2.8 for healthcare-defined exacerbations. Although patients with FEV₁ < 50% had a higher mean yearly rate of healthcare-defined exacerbations than those with FEV₁ = 50% (3.2 vs 2.3; p = 0.003), patients with less severe disease reported recurrent exacerbations. There was limited agreement between symptom- and healthcare-defined exacerbations.

Conclusion:

Lung function does not appear to be a valid criterion for assigning COPD management directed at patients with recurrent exacerbation.

Full Text

The Full Text of this article is available as a PDF (859.1 KB).