Gender differences among Swedish COPD patients: results from the ARCTIC, a real-world retrospective cohort study

Karin Lisspers,Björn Ställberg,Bine Kjoeller Bjerregaard,Karen Mezzi,Gunnar Johansson,Kjell Larsson,Ioanna Tsiligianni,Leif Jorgensen,Christer Janson,Florian S Gutzwiller

doi:10.1038/s41533-019-0157-3

Abstract

The present study aimed to generate real-world evidence regarding gender differences among chronic obstructive pulmonary disease (COPD) patients, especially as regards the diagnosis and outcomes in order to identify areas for improvement and management and optimize the associated healthcare resource allocation. ARCTIC is a large, real-world, retrospective cohort study conducted in Swedish COPD patients and a matched reference population from 52 primary care centers in 2000–2014. The incidence of COPD, prevalence of asthma and other comorbidities, risk of exacerbations, mortality rate, COPD drug prescriptions, and healthcare resource utilization were analyzed. In total, 17,479 patients with COPD were included in the study. During the study period, COPD was more frequent among women (53.8%) and women with COPD experienced more exacerbations vs. men (6.66 vs. 4.66). However, the overall mortality rate was higher in men compared with women (45% vs. 38%), but no difference for mortality due to COPD was seen between genders over the study period. Women seemed to have a greater susceptibility to asthma, fractures, osteoporosis, rheumatoid arthritis, rhinitis, depression, and anxiety, but appeared less likely to have diabetes, kidney diseases, and cardiovascular diseases. Furthermore, women had a greater risk of COPD-related hospitalization and were likely to receive a significantly higher number of COPD drug prescriptions compared with men. These results support the need to reduce disease burden among women with COPD and highlight the role of healthcare professionals in primary care who should consider all these parameters in order to properly diagnose and treat women with COPD.

Highlights

Chronic obstructive pulmonary disease (COPD) is a progressive disorder characterized by airflow limitation and is a major cause of chronic morbidity and mortality across the world
Of the identified 18,586 eligible patients with a COPD diagnosis listed in electronic medical records (EMRs), 291 patients were excluded because they were diagnosed with COPD before 40 years of age
The results of this study suggested a closing of the gap in COPD prevalence among both genders

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is a progressive disorder characterized by airflow limitation and is a major cause of chronic morbidity and mortality across the world. According to some of the earlier reports, there was either no gender disparity in undiagnosed COPD3 or women were at the greater risk of undiagnosed COPD.[4,5] recent studies demonstrated that the prevalence of COPD is similar among men and women.[6,7,8,9,10,11] A study by Mamary et al.[12] reported that men were more prone to have underdiagnosis of COPD than women. Several findings suggested that health status and quality of life is more impaired in women than in men with COPD.[14,15,16,17,18,19]

Objectives

Methods

Results

Conclusion