Health status perception and airflow obstruction in five Latin American cities: The PLATINO study

Summary Background COPD is a highly prevalent disease but underdiagnosed, undertreated and possibly under-recognized by patients. Limited information exists regarding patients' perception of COPD severity. We compared patients' general health status perception, degree of breathlessness and...

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Bibliographic Details
Published in:Respiratory medicine 2009-09, Vol.103 (9), p.1376-1382
Main Authors: Montes de Oca, Maria, Tálamo, Carlos, Halbert, Ronald J, Perez-Padilla, Rogelio, Lopez, Maria Victorina, Muiño, Adriana, Jardim, José Roberto B, Valdivia, Gonzalo, Pertuzé, Julio, Moreno, Dolores, Menezes, Ana Maria B
Format: Article
Language:English
Subjects:
Airway management
Airway Obstruction - diagnosis
Airway Obstruction - physiopathology
Biological and medical sciences
Chronic obstructive pulmonary disease
Cities
Diabetes
Dyspnea
Dyspnea - diagnosis
Dyspnea - physiopathology
Epidemiology
Female
Health Knowledge, Attitudes, Practice
Health Status
Humans
Latin America
Male
Medical sciences
Middle Aged
Pneumology
Prevalence
Pulmonary Disease, Chronic Obstructive - diagnosis
Pulmonary Disease, Chronic Obstructive - physiopathology
Pulmonary/Respiratory
Respiratory system : syndromes and miscellaneous diseases
Risk Factors
Self Concept
Severity of Illness Index
Spirometry
Studies
Surveys and Questionnaires
Ulcers
Urban Health
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Summary:Summary Background COPD is a highly prevalent disease but underdiagnosed, undertreated and possibly under-recognized by patients. Limited information exists regarding patients' perception of COPD severity. We compared patients' general health status perception, degree of breathlessness and physical activity limitation with the severity of their respiratory condition measured by airway obstruction, in a population-based sample. Methods We used postbronchodilator FEV1 /FVC < 0.70 to define COPD. Patients' perception of their general health status was derived from the question “in general you would say that your health is: excellent, very good, good, fair or poor?” Results Spirometry was performed in 5314 subjects: an FEV1 /FVC ratio below 0.70 was found in 759 subjects. In persons with COPD, general health status decreased with increasing GOLD stages. Over one-half of subjects with stage 2 and one third of those with stages 3 and 4 reported their health status as good to excellent. There was also a disparity between airway obstruction severity and breathlessness intensity. Although the more severe COPD stages were frequently associated with significant compromise of work and everyday activities, patients often tended to provide an optimistic self evaluation of their health status. Conclusions The discrepancy observed between general health status, dyspnea severity, physical activity limitation and airway obstruction most likely reflect patients' underperception of disease severity, emphasizing the need for improving case-finding measures and multi-component evaluation of COPD subjects.
ISSN:0954-6111
1532-3064
DOI:10.1016/j.rmed.2009.03.005