Abstract
Background: Guidelines advice to measure health status (HS) in COPD patients. In secondary care (SC) this is more common than in primary care (PC). Problems in HS in PC might be underestimated resulting in inadequate treatment.
Aim: To investigate the proportion of COPD patients in PC with severe problems in HS.
Methods: 314 PC COPD patients were included. Eight sub-domains of HS were measured by the Nijmegen Clinical Screening Instrument (NCSI) covering Functional impairment, Symptoms and Quality of Life. Data from 303 SC COPD patients were available to compare the meaning of the incidence and severity of problems in PC patients.
Results: Patients in PC did not differ on sex (59 vs 70% male) and age (mean 66 vs 67 years), but had less severe COPD compared to SC (stageI: 28 vs 16%; II: 59 vs 45%; III: 13 vs 32%; IV: 0 vs 8%). Lower proportions of patients with severe problems were found on the domain Functional impairment and the sub-domain Subjective symptoms in PC as compared to SC (Table 1). GOLD was not predictive for experienced problems in any of the sub-domains in PC.
Conclusion: Severe problems in many sub-domains of HS were substantial in PC patients. In 5 of 8 sub-domains of HS similar percentages of COPD patients in PC and SC experience severe problems. This implies that screening for problems in HS is needed in PC to warrant patient tailored treatment.
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