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REG in COPD

REG in COPD

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REG in COPD

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  1. REG in COPD Marc Miravitlles Pneumology Department. Hospital Universitari Vall d’Hebron. Barcelona, Spain. (marcm@separ.es)

  2. Diagnosis of respiratory symptoms in general population Respondents6,758 No respiratory symptoms4,314 (64%) Respiratory symptoms2,444 (36%) Did not consult physician1,073 (44%) Consult physician1,371 (56%) No spirometry786 (57.4%) Spirometry585 (42.6%) Miravitlles et al. Respir Med 2006; 100: 1973-1980

  3. Knowledge of COPD % Survey in 6,758 subjects >40 years. Up to 24% reported having at least one chronic respiratory symptom Miravitlles et al. Respir Med 2006; 100: 1973-1980

  4. Spirometry in Primary Care Miravitlles et al. Arch Bronconeumol 2000; 36: 500-5

  5. COPD-6 (FEV1/FEV6) Represas et al. Arch Bronconeumol 2010; 46: 426-432

  6. Questionnaires and COPD Martinez et al. COPD 2008; 5: 85-95

  7. Questionnaires and COPD Cut-off: 4 units Sensibility: 93.6% Specificity: 64.8% PPV: 69.5% NPV: 92.2% Classified: 78.1% Miravitlles et al. Med Clin 2012; 139: 522-530

  8. Venn diagram of COPD The large rectangle represents the full study group. The clear circles represent the proportion of subjects with COPD (FEV1/FVC < 70%). Adults older than 50 years in New Zealand (n= 469) Marsh et al. Thorax 2008; 63: 761-767

  9. Han et al. Lancet Infect Dis 2012; online

  10. Clasificación GOLD Han et al. Lancet Infect Dis 2012; online

  11. Clasificación GOLD Lange et al. AJRCCM 2012; 186: 975-981

  12. Soriano et al. Chest 2012; online first

  13. Clasificación GOLD Mortalidad a los 10 años de seguimiento en pacientes GOLD D Soriano et al. Chest 2012; online first

  14. Clasificación GOLD Soriano et al. Chest 2012; online first

  15. Phenotype diagnosis Step 2 Overlap COPD-asthmaphenotype Phenotype characterisation (C) (D) Exacerbator phenotype(2 or more ex/yr) (B) No exacerbations< 2 ex/yr Emphysema phenotype Chronic bronchitisphenotype (A) Miravitlles et al. Arch Bronconeumol 2012; 48: 247-257

  16. Phenotypes of COPD AJRCCM 2010; 182: 598-604

  17. Br J Gen Pract 2012: DOI:10.3399

  18. Phenotypes of COPD Unpublished

  19. Phenotypes of COPD Unpublished

  20. Phenotype-guided treatment CEx. with emphysema DEx. with CB BOverlap ANo exacerbator Bronchodilators ICS Muc/NAC Roflumilast Antibiotics Miravitlles et al. ERJ 2012; online

  21. Costs of COPD €/year Miravitlles et al. Chest 2003; 123: 784-791

  22. Costs of COPD Drugs Visits and diagnostic tests 16 42 42 Hospital costs Miravitlles et al. Chest 2003; 123: 784-791

  23. Costs of treatment of COPD Miravitlles et al. Respir Med 2009;103:714-721

  24. Thorax 2013;68:4-6 BMJ 2012;345: e7390

  25. SIDIAP Bolivar et al. Med Clin 2012; 138: 617-621

  26. SIDIAP Bolivar et al. Med Clin 2012; 138: 617-621

  27. REG in COPD • Diagnosis of COPD in Primary Care. • Validation of guidelines • Compliance with guidelines. • Cost of illness, cost-effectiveness • Validation of phenotypes • Safety of treatments.