Asthma-COPD Overlap in Primary Care: Prevalence and Characteristics
One in five adults diagnosed with asthma, chronic obstructive pulmonary disease (COPD), or both in a primary care setting have asthma-COPD overlap (ACO) based on the criteria established by the Respiratory Effectiveness Group (REG) ACO Working Group, according to a study published in Annals of the American Thoracic Society.
To overcome the scarcity of information about individuals with ACO in primary care, the workgroup conducted a cross-sectional study of patients 40 years old and older with two or more primary care visits during a two-year period.
The data came from the United Kingdom’s Optimum Patient Care Research Database and was used to estimate disease prevalence and describe the characteristics of the condition in patients with COPD, asthma or ACO. The study also compared symptoms among the three.
The study included 2,165 patients (1,015 with COPD, 755 with asthma and 395 with ACO). The overall ACO prevalence was 20% among a patient population with a mean age of 70 among which:
- 40% were women
- 66% were obese or overweight
- 73% were former smokers
- 27% were current smokers.
- 53% had diabetes,
- 36% had cardiovascular disease,
- 30% had hypertension,
- 23% had eczema, and
- 21% had rhinitis.
According to the study, comorbid conditions -- the simultaneous presence of two chronic diseases or conditions in a patient -- were common in patients with ACO:
ACO prevalence was higher in patients diagnosed with both asthma and COPD (32%) compared with patients diagnosed with asthma only (14%) or COPD only (20%). Investigators also found that the significant variation in characteristics of patients with ACO and in the patterns of some of the comorbid conditions suggests that ACO as defined likely comprises a diverse group.
They wrote: “While the use of information recorded by clinicians in primary care offered the opportunity for our results to be more generalizable, our study also highlights the disadvantage of relying on clinical documentation.”
Click here to read the complete article in Pulmonology Advisor.
