دورية أكاديمية
Patient and physician factors associated with symptomatic undiagnosed asthma or COPD.
| العنوان: | Patient and physician factors associated with symptomatic undiagnosed asthma or COPD. |
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| المؤلفون: | Cherian M; The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada., Magner KMA; The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada., Whitmore GA; Desautels Faculty of Management, McGill University, Montreal, QC, Canada., Vandemheen KL; The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada., FitzGerald JM; Department of Medicine, The University of British Columbia, Vancouver, BC, Canada.; Deceased., Bergeron C; Department of Medicine, The University of British Columbia, Vancouver, BC, Canada., Boulet LP; Centre de Recherche, Hôpital Laval, Université Laval, Quebec City, QC, Canada., Cote A; Centre de Recherche, Hôpital Laval, Université Laval, Quebec City, QC, Canada., Field SK; Cumming School of Medicine, University of Calgary, Calgary, AB, Canada., Penz E; Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada., McIvor RA; Firestone Institute for Respiratory Health, McMaster University, Hamilton, ON, Canada., Lemière C; Department of Medicine, Université de Montréal, Montreal, QC, Canada., Gupta S; Department of Medicine and Li Ka Shing Knowledge Institute of St Michael's Hospital, University of Toronto, Toronto, ON, Canada., Mayers I; Department of Medicine, University of Alberta, Edmonton, AB, Canada., Bhutani M; Department of Medicine, University of Alberta, Edmonton, AB, Canada., Hernandez P; Department of Medicine, Dalhousie University, Halifax, NS, Canada., Lougheed MD; Department of Medicine, Queen's University, Kingston, ON, Canada., Licskai CJ; Department of Medicine, University of Western Ontario, London, ON, Canada., Azher T; Department of Medicine, Memorial University, St John's, NL, Canada., Ainslie M; Department of Medicine, University of Manitoba, Winnipeg, MB, Canada., Ezer N; Department of Medicine, McGill University, Montreal, QC, Canada., Mulpuru S; The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada., Aaron SD; The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada saaron@ohri.ca. |
| المصدر: | The European respiratory journal [Eur Respir J] 2023 Feb 23; Vol. 61 (2). Date of Electronic Publication: 2023 Feb 23 (Print Publication: 2023). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: European Respiratory Society Country of Publication: England NLM ID: 8803460 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 1399-3003 (Electronic) Linking ISSN: 09031936 NLM ISO Abbreviation: Eur Respir J Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Sheffield, United Kingdom : European Respiratory Society Original Publication: Copenhagen : Published jointly by the Society and Munksgaard, 1988- |
| مواضيع طبية MeSH: | Pulmonary Disease, Chronic Obstructive* , Asthma*/drug therapy , Physicians*, Humans ; Quality of Life ; Bronchodilator Agents/therapeutic use ; Forced Expiratory Volume ; Spirometry |
| مستخلص: | Background: It remains unclear why some symptomatic individuals with asthma or COPD remain undiagnosed. Here, we compare patient and physician characteristics between symptomatic individuals with obstructive lung disease (OLD) who are undiagnosed and individuals with physician-diagnosed OLD. Methods: Using random-digit dialling and population-based case finding, we recruited 451 participants with symptomatic undiagnosed OLD and 205 symptomatic control participants with physician-diagnosed OLD. Data on symptoms, quality of life and healthcare utilisation were analysed. We surveyed family physicians of participants in both groups to elucidate differences in physician practices that could contribute to undiagnosed OLD. Results: Participants with undiagnosed OLD had lower mean pre-bronchodilator forced expiratory volume in 1 s percentage predicted compared with those who were diagnosed (75.2% versus 80.8%; OR 0.975, 95% CI 0.963-0.987). They reported greater psychosocial impacts due to symptoms and worse energy and fatigue than those with diagnosed OLD. Undiagnosed OLD was more common in participants whose family physicians were practising for >15 years and in those whose physicians reported that they were likely to prescribe respiratory medications without doing spirometry. Undiagnosed OLD was more common among participants who had never undergone spirometry (OR 10.83, 95% CI 6.18-18.98) or who were never referred to a specialist (OR 5.92, 95% CI 3.58-9.77). Undiagnosed OLD was less common among participants who had required emergency department care (OR 0.44, 95% CI 0.20-0.97). Conclusions: Individuals with symptomatic undiagnosed OLD have worse pre-bronchodilator lung function and present with greater psychosocial impacts on quality of life compared with their diagnosed counterparts. They were less likely to have received appropriate investigations and specialist referral for their respiratory symptoms. Competing Interests: Conflict of interest: M. Cherian reports no conflict of interest. K.M.A. Magner reports no conflict of interest. G.A. Whitmore reports no conflict of interest. K.L. Vandemheen reports no conflict of interest. C. Bergeron reports grants, contracts or honoraria from Novartis, Biohaven, AstraZeneca, Sanofi, Valeo and Grifols; and advisory board participation Sanofi, AstraZeneca, GlaxoSmithKline, Takeda and Valeo. L-P. Boulet reports grants, contracts, consulting fees or honoraria from Amgen, AstraZeneca, GlaxoSmithKline, Merck, Sanofi-Regeneron, Covis and Novartis; royalties or licences from UptoDate and Taylor & Francis; leadership roles with the Global Initiative for Asthma (GINA), Global Asthma Association (INTERASMA) and Canadian Thoracic Society; and holds the Laval University Chair on Knowledge Transfer, Prevention and Education in Respiratory and Cardiovascular Health. A. Cote reports grants, contracts, consulting fees or honoraria from GlaxoSmithKline, AstraZeneca, Valeo, Sanofi-Regeneron and Covis; and advisory board participation with AstraZeneca, Sanofi and Valeo. S.K. Field reports grants, contracts, consulting fees or honoraria from Bayer, Insmed, Merck, Valeo and GlaxoSmithKline. E. Penz reports grants, contracts, consulting fees or honoraria from the Saskatchewan Health Research Foundation, CIHR, Respiratory Research Centre, SCPOR, AstraZeneca, Saskatchewan Cancer Agency, GlaxoSmithKline, Sanofi, Genzyme, ICBEM and Boehringer Ingelheim; and leadership roles with the Canadian Thoracic Society COPD Assembly, CIHR Institute Advisory Board and Youth4Change. R.A. McIvor reports no conflict of interest. C. Lemière repots grants, contracts, consulting fees or honoraria from GlaxoSmithKline, AstraZeneca, Sanofi and Novartis; and royalties or licences from UptoDate. S. Gupta reports no conflict of interest. I. Mayers reports no conflict of interest. M. Bhutani reports grants, contracts, consulting fees, support for travel or honoraria from the CIHR, AstraZeneca, GlaxoSmithKline, Novartis, Grifols, Sanofi, Covis, Valeo, Lung Association of Saskatchewan, Canadian Thoracic Society and Lung Association of Alberta and Northwest Territories; and leadership roles with the Canadian Thoracic Society and Alberta Health Services. P. Hernandez reports grants, contracts, support for travel or honoraria from the CIHR, Cyclomedia, Boehringer Ingelheim, Vertex, Grifols, AstraZeneca, Boehringer Ingelheim, Janssen and Canadian Thoracic Society; advisory board participation with Acceleron, AstraZeneca, Boehringer Ingelheim, Covis, GlaxoSmithKline, Grifols, Janssen, Novartis, Sanofi, Takeda and Valeo; and leadership roles with the Canadian Thoracic Society. M.D. Lougheed reports grants, contracts or honoraria from the CIHR, AstraZeneca, GlaxoSmithKline, Canadian Thoracic Society and MDBriefcase; advisory board participation with AstraZeneca; leadership roles with the Canadian Thoracic Society, Health Quality Ontario and the Lung Association. C.J. Licskai reports no conflict of interest. T. Azher reports no conflict of interest. M. Ainslie reports no conflict of interest. N. Ezer reports grants, contracts or honoraria from the CIHR, Rossy Cancer Network, Covis Pharma, GlaxoSmithKline, AstraZeneca, Fédération des Omnipracticiens du Québec and Médecin du Québec Magazine; advisory board participation with GlaxoSmithKline; leadership role with the Quebec Ministry of Health Lung Cancer Screening Implementation Committee; and receipt of study drug from Covis. S. Mulpuru reports no conflict of interest. S.D. Aaron reports honoraria from AstraZeneca, Sanofi and GlaxoSmithKline; and advisory board participation with AstraZeneca, GlaxoSmithKline and Sanofi. (Copyright ©The authors 2023. For reproduction rights and permissions contact permissions@ersnet.org.) |
| المشرفين على المادة: | 0 (Bronchodilator Agents) |
| تواريخ الأحداث: | Date Created: 20221103 Date Completed: 20230227 Latest Revision: 20230227 |
| رمز التحديث: | 20230227 |
| DOI: | 10.1183/13993003.01721-2022 |
| PMID: | 36328359 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1399-3003 |
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| DOI: | 10.1183/13993003.01721-2022 |