Epidemiological survey in primary care patients with chronic obstructive pulmonary disease in Greece; The EPIPTOSI study
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Department of Internal Medicine, “Kyanous Stavros” Medical Centre, Athens, Greece
Medical Department, AstraZeneca SA, Greece
Christos P. Carvounis   

Department of Internal Medicine, “Kyanous Stavros” Medical Centre, 102 V. Sophia Ave., 115 28 Athens, Greece
Pneumon 2012;25(4):386–394
Chronic obstructive pulmonary disease (COPD) is a chronic disease, with significant extrapulmonary effects, associated with high morbidity and mortality. The current study aimed at evaluating the characteristics, health status, management and use of health care resources of primary care patients with COPD in Greece.

EPIPTOSI was an observational, descriptive, cross-sectional study of primary care patients diagnosed with COPD. Data were collected during a single visit via a structured questionnaire. Smoking status, severity, symptoms, treatment, health care resource utilization and the patients’ perceptions of health status and treatment were recorded.

The 930 study patients (Male 66.5%, age 64.9±10.8 years) were classified with mild (22%), moderate (52%) and severe COPD (26%) respectively, based on the Global Initiative for Obstructive Lung Disease (GOLD) criteria, of whom 49.8% were smokers (average pack years 41.2). The average Clinical COPD Questionnaire (CCQ) score was 1.87± 1 (mild: 1.1±0.7, moderate: 1.6±0.8, severe: 2.9±1.5, p<0.01). The Geriatric Depression Scale (GDS) mean score for patients ≥65 years was 7.8±0.9, with a close correlation between CCQ score and severity of COPD. Treatment was with inhaled corticosteroids/long-acting β2-agonists combination (ICS/LABA) for 35.2% of patients and ICS/LABA plus anticholinergics for 27.0%. A total of 48.7% had visited an emergency care unit (ECU) while 26.4% required hospitalization at least once, during the last year. A significant association between COPD severity and hospitalization (OR 7.4 95% CI: 5.3-10.3, p<0.01) and ECU visits (OR 7.51 95% CI: 5.16-10.9, p<0.01) was found.

Most primary care patients with COPD had disease of moderate severity. Although their health status was relatively satisfactory, a considerable number each year visited the ECU of hospitals and were hospitalized for respiratory problems, illustrating the significant burden associated with COPD.

The authors would like to thank Vassilis Vaskantiras for the study delivery, George Kraniou from Pharmassist Ltd, who provided medical writing support and Associate Professor Elias Zintzaras who provided support in the statistical analysis. The study was supported by AstraZeneca.
Dr Christos P. Carvounis has received honoraria from Mount Sinai Medical Center and has received research grants as National Coordinator of four Phase IV local studies. He has received grants and acted as a consultant for AstraZeneca. Mr. Nikos Nikas and Dr. Elena Panitti are AstraZeneca employees.
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