A report has been recently published in the journal Multidisciplinary Respiratory Medicine, showing a high prevalence of comorbidities in patients with chronic obstructive pulmonary disease (COPD) and its association with inhalation therapy. The study was entitled “INDACO project: COPD and link between comorbidities, lung function and inhalation therapy.”
COPD is one of the most common lung diseases and a major cause of morbidity and mortality worldwide, being the third leading cause of death in the United States alone. It is a progressive disease in which individuals develop serious problems in breathing. Smoking is considered to be the leading cause of COPD. Patients with obstruction of the airways, shortness of breath (dyspnea) and acute exacerbations are usually prescribed inhalation therapy with bronchodilators and steroids.
COPD has a respiratory and extra-respiratory component related both to systemic complications (such as weight loss and skeletal muscle myopathy) and associated comorbidities affecting several organs and systems (diabetes, osteoporosis, and cardiovascular diseases among others). Such comorbidities can potentially increase the frequency of hospitalization of COPD patients and considerably affect respiratory conditions.
The INDACO project, developed in 2013, aimed at evaluating the prevalence and nature of comorbidities in patients with COPD who attended specific hospitals in Rome, Italy. In this study, a follow-up was made of the 2013 pilot project, including more healthcare units in an extended area of Central and South Italy, in order to determine possible associations among COPD, comorbidities, and inhalation therapy. The relationship between the comorbidities found and parameters such as sex, age, body mass index (BMI), lung function, symptoms and inhalation therapy was also assessed. Data was collected from 569 selected COPD patients (395 males and 174 females with a mean age of 73 years).
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The researchers found that the prevalence of comorbidities in COPD patients was high, around 81.2%. Arterial hypertension was the comorbidity with the highest prevalence in COPD patients. A higher prevalence of diabetes was also found in these particular patients in comparison with the Italian population in general. A higher number of acute exacerbations of COPD, dyspnea and male patients were factors found to be correlated with a higher number of comorbidities. On the other hand, obstructive respiratory dysfunction and age were not associated with the number of comorbidities. It was also found that the prescription of multi-drug inhalation therapy was not correlated with dyspnea, acute exacerbation of COPD, age or BMI, but rather with the obstruction of the bronchia and number of comorbidities.
The team suggests that the assessment of comorbidities to evaluate COPD severity could be suitable and useful in clinical settings, although further studies are required to establish the role of comorbidities and their proper treatment in COPD patients.