5fe31d78a698f9adb9ebd039674e19fb pmc_9105961.pdf 4d7672643dcc0266400091a862ae2416f7a6968e pmc_9105961.pdf 3b47982e4b427ecc62879af1f35ed71881ed1ccc0cc1db12ff2fe91b83ed4fe4 pmc_9105961.pdf Title: Determinants in the Underdiagnosis of COPD in Spain—CONOCEPOC Study Subject: Factors such as seeking medical attention for respiratory symptoms and health professionals ordering spirometry come into play in the underdiagnosis of chronic obstructive pulmonary disease (COPD). The objective of this study was to analyze seeking medical attention and the use of spirometry in individuals with chronic respiratory symptoms and to compare these results with those obtained in the 2005 and 2011 surveys. Material and Methods: A cross-sectional, observational, epidemiological study was conducted via phone interview in December 2020 in Spain, with a representative sample from 17 autonomous communities. The study design was identical to that of the studies carried out in 2005 and 2011 to evaluate the changes that have occurred in seeking medical attention and performing spirometry in Spain, as well as the variability between autonomous communities. Results: From 89,601 phone contacts, a total of 6534 respondents were obtained. A total of 24.8% reported having some chronic respiratory symptom, and 17.9% reported a respiratory disease. Only 51.6% of those who had some chronic respiratory symptom had seen their doctor, which was less likely among current smokers (OR: 0.599, 95% CI: 0.467–0.769, p < 0.001) and those living in a rural setting (OR: 0.797, 95% CI: 0.651–0.975, p = 0.027). A total of 68.7% of the individuals who saw a doctor reported having undergone spirometry, most frequently males (OR: 1.535, 95% CI: 2.074–1.136, p < 0.005), former smokers (OR: 1.696, 95% CI: 2.407–1.195, p < 0.003), and those seen by a pulmonologist (OR: 6.151, 95% CI: 8.869–4.265, p < 0.001). With respect to the 2005 survey, more frequent use of spirometry has been observed (42.6 vs. 68.7%), without any change in seeking medical attention for respiratory symptoms. There is a clear variability according to the autonomous community (p < 0.05). Conclusions: Many individuals with chronic respiratory symptoms do not seek medical attention and although the use of spirometry has increased in the past 15 years, it is still an important area that needs improving in the primary care setting, especially among women. Both of these factors can be determinants in the underdiagnosis of COPD and its variability between autonomous communities. Keywords: chronic obstructive pulmonary disease (COPD); respiratory symptoms; spirometry; underdiagnosis; autonomous community; Spain Author: Myriam Calle Rubio, Juan Luis Rodríguez Hermosa, Marc Miravitlles and José Luis López-Campos Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue May 10 10:45:43 2022 CEST ModDate: Tue May 10 10:55:47 2022 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1504369 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- EIFDAO+VnURWPalladioL Type 1 Custom yes yes no 10 0 MHTPDB+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 PIFEPV+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 XADWXK+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 XWOCXD+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 49 0 JGMOZW+CMSY10 Type 1 Builtin yes yes no 71 0 EGMGJM+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 81 0 EGMGJO+PalatinoLinotype TrueType WinAnsi yes yes no 84 0 EGMGKA+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 87 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 94 0 EGMGJM+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 107 0 EGMGJO+PalatinoLinotype TrueType WinAnsi yes yes no 110 0 EGMGKA+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 113 0 EGMGJM+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 123 0 EGMGJN+PalatinoLinotype CID TrueType Identity-H yes yes yes 126 0 EGMGJO+PalatinoLinotype TrueType WinAnsi yes yes no 132 0 EGMGKA+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 135 0 EGMJAD+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 138 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-06-11 02:48:59 CEST RepresentationInformation: pmc_9105961.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-05-31 06:21:55 CEST Size: 1504369 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 286 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Data Collection Destination: subsection.2.1 Item: Title: Statistical Analysis Destination: subsection.2.2 Item: Title: Results Destination: section.3 Children: Item: Title: Chronic Respiratory Symptoms and Respiratory Disease Reported Destination: subsection.3.1 Item: Title: Seeking Medical Attention for Respiratory Symptoms. Associated Factors and Situation According to the Autonomous Community Destination: subsection.3.2 Item: Title: Use of Spirometry. Associated Factors, Evolution over Time, and Situation According to the Autonomous Community Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Determinants in the Underdiagnosis of COPD in Spain CONOCEPOC Study Author: Myriam Calle Rubio, Juan Luis Rodríguez Hermosa, Marc Miravitlles and José Luis López-Campos Subject: Factors such as seeking medical attention for respiratory symptoms and health professionals ordering spirometry come into play in the underdiagnosis of chronic obstructive pulmonary disease (COPD). The objective of this study was to analyze seeking medical attention and the use of spirometry in individuals with chronic respiratory symptoms and to compare these results with those obtained in the 2005 and 2011 surveys. Material and Methods: A cross-sectional, observational, epidemiological study was conducted via phone interview in December 2020 in Spain, with a representative sample from 17 autonomous communities. The study design was identical to that of the studies carried out in 2005 and 2011 to evaluate the changes that have occurred in seeking medical attention and performing spirometry in Spain, as well as the variability between autonomous communities. Results: From 89,601 phone contacts, a total of 6534 respondents were obtained. A total of 24.8% reported having some chronic respiratory symptom, and 17.9% reported a respiratory disease. Only 51.6% of those who had some chronic respiratory symptom had seen their doctor, which was less likely among current smokers (OR: 0.599, 95% CI: 0.467 0.769, p < 0.001) and those living in a rural setting (OR: 0.797, 95% CI: 0.651 0.975, p = 0.027). A total of 68.7% of the individuals who saw a doctor reported having undergone spirometry, most frequently males (OR: 1.535, 95% CI: 2.074 1.136, p < 0.005), former smokers (OR: 1.696, 95% CI: 2.407 1.195, p < 0.003), and those seen by a pulmonologist (OR: 6.151, 95% CI: 8.869 4.265, p < 0.001). With respect to the 2005 survey, more frequent use of spirometry has been observed (42.6 vs. 68.7%), without any change in seeking medical attention for respiratory symptoms. There is a clear variability according to the autonomous community (p < 0.05). Conclusions: Many individuals with chronic respiratory symptoms do not seek medical attention and although the use of spirometry has increased in the past 15 years, it is still an important area that needs improving in the primary care setting, especially among women. Both of these factors can be determinants in the underdiagnosis of COPD and its variability between autonomous communities. 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