267082 Chronic obstructive pulmonary disease in the United States: Recent estimates of disease prevalence, diagnosis, and treatment patterns

Wednesday, October 31, 2012

Ryne Paulose, PhD , Division of Health & Nutrition Examination Surveys, CDC National Center for Health Statistics, Hyattsville, MD
Sean Candrilli, PhD , Health Economics, RTI Health Solutions, Research Triangle Park, NC
Margaret McDonald, PhD , Global Market Access -- Primary Care Business Unit, Pfizer, Inc., New York, NY
Timothy Tilert, BS , Division of Health & Nutrition Examination Surveys, CDC National Center for Health Statistics, Hyattsville, MD
Jun Su, MD , Respiratory Therapeutic Lead, Health Economics & Outcomes Research, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT
Objectives: To update estimates of the prevalence of chronic obstructive pulmonary disease (COPD) and respiratory medication use among US adults. Methods: Data were from the 2007-2008 National Health and Nutrition Examination Survey (NHANES), a nationally representative survey of the non-institutionalized US population. Participants aged 20-79 years with valid spirometry data and height measurement (required for COPD severity staging) (n=4,065) were categorized into severity stages based on pre-bronchodilator spirometric assessment: mild (forced expired volume in 1 second [FEV1]/forced vital capacity [FVC]<0.7 and FEV1>=80% predicted), moderate (FEV1/FVC<0.7 and 50%<=EV1<80% predicted), and severe/very severe (FEV1/FVC<0.7 and FEV1<50% predicted). Restrictive lung disease was defined based on FEV1/FVC>=0.7 and FEV1<80% predicted. Self-report of physician diagnosed emphysema and/or current chronic bronchitis was also determined. Treatment was based on self-reported use in the past month of long- and short-acting bronchodilators and other respiratory medications. Adjusted examination sample weights were used to generate nationally representative estimates. Results: In 2007-2008, 14% (95%CI: 12%-16%) of US adults aged 20-79 years had COPD based on lung function (FEV1/FVC<0.7). An additional 10% had restrictive lung disease and 19% had respiratory symptoms alone. Among COPD participants, most had mild (53%) or moderate (40%) disease; 7% had severe/very severe disease. About 9% of adults with COPD reported a physician diagnosis (95%CI: 5%-13%); among these, 51% (95%CI: 34%-68%) used a respiratory medication in the past month. Conclusions: The prevalence of COPD among US adults remains significant. Over half of adults with COPD who reported being diagnosed were currently treated. However, a significant proportion of adults remain undiagnosed and untreated.

Learning Areas:
Public health or related research

Learning Objectives:
Describe the recent prevalence estimates of chronic obstructive pulmonary disease among US adults from the National Health and Nutrition Examination Survey.

Keywords: Public Health, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My academic and professional experiences over the last 10+ years have included work in epidemiology and public health-related research areas. My current and previous positions with the CDC have afforded me the opportunity to work closely with the data used for this study. Additionally, my research focus over the last several years has been in the area of respiratory illness, particularly chronic obstructive pulmonary disease.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Pfizer, Inc. General Employment (includes retainer) and Stock Ownership

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.