Prevalence of Asthma Characteristics in COPD Patients in a Dutch Well-Established Asthma/COPD Service for Primary Care

• Published in: International journal of chronic obstructive pulmonary disease Vol. 15; pp. 1601 - 1611
• Main Authors: Baron, Anna Jetske, Flokstra-de Blok, Bertine M J, van Heijst, Ellen, Riemersma, Roland A, Sonnenschein-van der Voort, Agnes M M, Metting, Esther I, Kocks, Janwillem W H
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2020; Dove Medical Press Ltd; Dove; Dove Medical Press
• Subjects: Asthma; Asthma - diagnosis; Asthma - drug therapy; Asthma - epidemiology; asthma characteristics; asthma copd overlap; Care and treatment; Chronic obstructive pulmonary disease; Cross-Sectional Studies; Datasets; guidelines; Humans; Medical diagnosis; Medical research; Mortality; Original Research; Patients; Pneumonia; Prevalence; Primary care; Primary Health Care; Prospective Studies; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - drug therapy; Pulmonary Disease, Chronic Obstructive - epidemiology; Questionnaires; Retrospective Studies; Netherlands; Sweden; Europe; asthma COPD overlap; guidelines; asthma characteristics; chronic obstructive pulmonary disease
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/copd.s247819

Primary care COPD guidelines indicate that COPD patients with asthma characteristics should be treated as having asthma. This study aims to describe the prevalence of asthma characteristics in patients with a pulmonologist-confirmed working diagnosis of COPD or ACO.
This retrospective cross-sectional study used real-life data (collected between 2007 and 2017) from a Dutch asthma/COPD-service, a structured web-based system in which pulmonologists support general practitioners in their diagnosis of patients with suspicion of obstructive lung disease. The prevalence of asthma characteristics (history of asthma, atopy, symptoms, and reversibility) and blood eosinophil (Eos) counts were assessed in patients with a working diagnosis of COPD or ACO.
Of the 14,141 patients, ≥40 years in the dataset, 4475 (31.6%) were diagnosed with asthma, 3532 (25.0%) with COPD, and 1276 (9.0%) with ACO. Asthma characteristics were present in 65.6% (n=1956) of the COPD and 90.9% (n=1059) of the ACO patients. Eos counts of ≥ 300 cells per μL were found in 35.7% (n=924) of the COPD patients and 35.3% (n=341) of the ACO patients.
In this group of COPD and ACO patients remotely diagnosed by pulmonologists, a substantial proportion would be considered to have asthma characteristics according to the guidelines. This may explain the high number of inhaled corticosteroid (ICS) prescriptions found in primary care COPD patients. Prospective studies are necessary to identify patients who may or may not benefit from ICS containing treatment. Hence, personalized care in primary care can be optimized.