Extent and impact of late vs early stage COPD diagnosis in the Swedish ARCTIC study

Abstract

Background: Early chronic obstructive pulmonary disease (COPD) diagnosis may lead to improved disease management and reduced costs. Objective: To assess the clinical and economic impact of early vs late stage COPD diagnosis. Methods: Medical records data were collected from COPD patients in Swedish primary care centers and then linked to primary and secondary care national registries for prescriptions, deaths, hospital care and social characteristics data. Five years of data prior to patients9 first COPD diagnosis were examined for early COPD signs i.e. pneumonia, respiratory diseases, use of oral corticosteroids, prescriptions for respiratory symptoms and spirometry measures. Patients were dichotomized as receiving either an early (ED; 0–2 early signs) or late (LD; ≥3 early signs) COPD diagnosis. A sensitivity analysis was conducted excluding patients with a comorbid asthma diagnosis pre-first COPD diagnosis. Results: 9,160 (72.2%) patients had a LD (mean age=69.4 yrs) and 3,537 (27.8%) had ED (mean age=68.8 yrs). LD was associated with higher prevalence of asthma (21.5% vs 3.5%, p 2/year) exacerbations (12.5% vs 5.0%, p Conclusion: Late COPD diagnosis is associated with increased COPD disease burden, comorbidities and costs.