Abstract
BackgroundThe incidence of chronic obstructive pulmonary disease (COPD) in China is very high. This study aimed to assess the vulnerability of COPD patients in rural areas outside Xuzhou City, Jiangsu province, in order to provide helpful guidance for future research and public policies.MethodsThe vulnerability of 8,217 COPD patients was evaluated using a face-to-face questionnaire to obtain information on general characteristics, awareness, beliefs, medication usage, acute exacerbation of the disease, and economic burdens. Direct economic burdens were calculated based on the questionnaire, and indirect economic burdens were estimated using local per capita income and life expectancy in 2008. The years of potential life lost were calculated using loss of life years for each age group and multiplying by the number of deaths in a given age group.ResultsOf the 8,217 patients, 7,921 (96.4%) had not heard of COPD, and 2,638 (32.1%) did not understand that smoking was a risk factor for COPD. No patients had used inhalers, nebulizer drugs or oxygen therapy, either regularly or sporadically. No patients had undergone pulmonary rehabilitation or surgical treatment, while 4,215 (51.3%) took theophylline to relieve dyspnea, and 3,418 (41.6%) used antibiotics to treat exacerbations. A total of 2,925 (35.6%) patients had been admitted to hospital during the past year because of respiratory symptoms. The average direct and indirect economic burdens on COPD patients were 1,090 and 20,605 yuan, respectively.ConclusionsThe vulnerability of patients in rural Xuzhou to COPD was high. Their awareness of COPD was poor, their treatment during both the stable and acute exacerbation stages did not meet standards, and the economic burdens were large. Interventions are therefore needed to improve the prevention and management of COPD in this population. Further studies are required to verify these findings.
Highlights
The incidence of chronic obstructive pulmonary disease (COPD) in China is very high
From a total of 1.10 million health records screened by the end of 2007, 24,641 cases of COPD were uncovered according to the COPD diagnosis and treatment guidelines criteria [19]
According to the Global Initiative for Chronic Obstructive Lung Diseases (GOLD), COPD can be divided into levels I–IV [20]
Summary
The incidence of chronic obstructive pulmonary disease (COPD) in China is very high. Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease [1,2], but it remains a significant public health problem. It is a major chronic cause of mortality and morbidity and has been identified as the third leading cause of mortality and morbidity worldwide [3,4,5]. COPD is often accompanied by exacerbation of respiratory symptoms requiring hospitalization [8]. The goals of managing stable COPD include reducing the frequency and severity of exacerbations, as well as controlling baseline symptoms [1,9,10]
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