Misdiagnosis of patients receiving inhaled therapies in primary care

Abstract

José Luis Izquierdo1, Antonio Martín2, Pilar de Lucas3, José Miguel Rodríguez-González-Moro3, Carlos Almonacid1, Alexandra Paravisini21Pneumology Department, University Hospital of Guadalajara, 2Pfizer Medical Department, 3Pneumology Department, University Hospital Gregorio Marañón, Madrid, SpainAim: To analyze the accuracy of diagnosis in a population receiving inhaled therapies due to respiratory diseases in a primary care setting.Method: Noninterventional, multicenter, cross-sectional, observational epidemiologic study methodology.Results: A total of 9752 subjects were evaluated. Of these, 4188 (42.9%) patients were ¬diagnosed with asthma, 4175 (42.8%) with chronic obstructive pulmonary disease (COPD), and 1389 had a diagnosis of disease of unknown origin. Of those over the age of 40 years, 4079 (50.9%) had COPD and 2877 (35.9%) had asthma. Sixty percent of the subjects were men, and the proportion of men was higher in patients with COPD (83.2%) than in the group with asthma (39.8%, P < 0.0001). Of subjects with COPD, 17.3% had mild, 55.3% had moderate, 24.1% had severe, and 3.2% had very severe disease. With regard to the level of severity of asthma, 34.9% of subjects had intermittent, 34.6% had mild persistent, 27.1% had moderate persistent, and 3.5% had severe persistent disease. Only 13.9% of patients in the COPD group had all the characteristics of COPD based on the Global Initiative for Chronic Obstructive Lung Disease criteria and an absence of the characteristics of asthma.Conclusions: The majority of patients receiving inhaled therapy in primary care did not have an accurate diagnosis according to current international guidelines for COPD and asthma. More initiatives for improving diagnostic accuracy in respiratory diseases must be implemented in primary care.Keywords: respiratory disease, COPD, primary care, asthma, diagnosis