Open Access Highly Accessed Research article

Comorbidity in patients with chronic obstructive pulmonary disease in family practice: a cross sectional study

Luis García-Olmos1*, Ángel Alberquilla2, Victoria Ayala3, Pilar García-Sagredo4, Leticia Morales1, Montserrat Carmona5, María José de Tena-Dávila4, Mario Pascual4, Adolfo Muñoz4, Carlos H Salvador4 and Jose L Monteagudo4

Author Affiliations

1 Multiprofessional Education Unit for Family and Community Care (South-east), Hacienda de Pavones, 271, Madrid, 28030, Spain

2 Multiprofessional Education Unit for Family and Community Care (Centre), Alberto Palacios, 22, Madrid, 28021, Spain

3 Medical Department, Praxair España, Orense, 11, Madrid, 28020, Spain

4 Telemedicine and e-Health Unit, Carlos III Institute of Health, Avda. Monforte de Lemos, 5, Madrid, 28029, Spain

5 Bioengineering and Telemedicine Unit, Puerta de Hierro University Teaching Hospital, Majadahonda, Madrid, Spain

For all author emails, please log on.

BMC Family Practice 2013, 14:11  doi:10.1186/1471-2296-14-11

Published: 16 January 2013

Abstract

Background

Chronic obstructive pulmonary disease (COPD) is frequent and often coexists with other diseases. The aim of this study was to quantify the prevalence of COPD and related chronic comorbidity among patients aged over 40 years visiting family practices in an area of Madrid.

Methods

An observational, descriptive, cross-sectional study was conducted in a health area of the Madrid Autonomous Region (Comunidad Autónoma de Madrid). The practice population totalled 198,670 persons attended by 129 Family Physicians (FPs), and the study population was made up of persons over the age of 40 years drawn from this practice population. Patients were deemed to have COPD if this diagnosis appeared on their clinical histories. Prevalence of COPD; prevalence of a further 25 chronic diseases in patients with COPD; and standardised prevalence ratios, were calculated.

Results

Prevalence of COPD in family medicine was 3.2% (95% CI 3.0–3.3) overall, 5.3% among men and 1.4% among women; 90% of patients presented with comorbidity, with a mean of 4 ± 2.04 chronic diseases per patient, with the most prevalent related diseases being arterial hypertension (52%), disorders of lipid metabolism (34%), obesity (25%), diabetes (20%) and arrhythmia (15%). After controlling for age and sex, the observed prevalence of the following ten chronic diseases was higher than expected: heart failure; chronic liver disease; asthma; generalised artherosclerosis; osteoporosis; ischaemic heart disease; thyroid disease; anxiety/depression; arrhythmia; and obesity.

Conclusions

Patients with COPD, who are frequent in family practice, have a complex profile and pose a clinical and organisational challenge to FPs.

Keywords:
COPD; Comorbidity; Family practice; Epidemiology