Chronic obstructive pulmonary disease is underdiagnosed and undertreated in São Paulo (Brazil): results of the PLATINO study

Chronic obstructive pulmonary disease is underdiagnosed and undertreated in São Paulo (Brazil): results of the PLATINO study

Author Nascimento, Oliver Augusto Autor UNIFESP Google Scholar
Camelier, Aquiles Assunção Autor UNIFESP Google Scholar
Rosa, Fernanda Warken Autor UNIFESP Google Scholar
Menezes, Ana Maria Baptista Google Scholar
Pérez-Padilla, Rogelio Google Scholar
Jardim, José Roberto Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade Federal da Bahia
Universidade Católica de Salvador Faculdade de Tecnologia e Ciências
Universidade Federal de Pelotas Programa de Pós-graduação em Epidemiologia
National Institute of Respiratory Diseases
PLATINO Group
Abstract Chronic obstructive pulmonary disease (COPD) is a common disease in adults over 40 years of age and has a great social and economic impact. It remains little recognized and undertreated even in developed countries. However, there are no data about its diagnosis and treatment in Brazil. The objectives of the present study were to evaluate the proportion of COPD patients who had never been diagnosed and to determine if the COPD patients who had been identified were receiving appropriate treatment. The Latin American Project for the Investigation of Obstructive Lung Disease (PLATINO) was a randomized epidemiological study of adults over 40 years living in five metropolitan areas, including São Paulo. The studied sample was randomly selected from the population after a division of the metropolitan area of São Paulo in clusters according to social characteristics. All subjects answered a standardized questionnaire on respiratory symptoms, history of smoking, previous diagnosis of lung disease, and treatments. All subjects performed spirometry. The criterion for the diagnosis of COPD was defined by a post-bronchodilator FEV1/FVC ratio lower than 0.7. A total of 918 subjects were evaluated and 144 (15.8%) met the diagnostic criterion for COPD. However, 126 individuals (87.5%) had never been diagnosed. This undiagnosed group of COPD patients had a lower proportion of subjects with respiratory symptoms than the previously diagnosed patients (88.9 vs 54.8%) and showed better lung function with greater FEV1 (86.8 ± 20.8 vs 68.5 ± 23.6% predicted) and FVC (106.6 ± 22.4 vs 92.0 ± 24.1% predicted). Among the COPD patients, only 57.3% were advised to stop smoking and 30.6% received the influenza vaccine. In addition, 82.3% did not receive any pharmacological treatment. In conclusion, COPD is underdiagnosed and a large number of COPD patients are not treated appropriately.
Keywords Chronic obstructive pulmonary disease
Diagnosis
Treatment
Vaccination
Smoking
Latin American Project for the Investigation of Obstructive Lung Disease
Language English
Date 2007-07-01
Published in Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 40, n. 7, p. 887-895, 2007.
ISSN 0100-879X (Sherpa/Romeo, impact factor)
Publisher Associação Brasileira de Divulgação Científica
Extent 887-895
Origin http://dx.doi.org/10.1590/S0100-879X2006005000133
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000248411200001
SciELO ID S0100-879X2007000700001 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/3797

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