Are we missing lifetime COPD diagnosis among people with COPD recorded death?
File(s)
Published version
Author(s)
Gayle, Alicia
Lenoir, Alexandra
Minelli, cosetta
Quint, jennifer
Type
Journal Article
Abstract
Background: The British Lung Foundation previously estimated that 2.2 million symptomatic but undiagnosed people with COPD live in the UK.
Aim: This study investigates the proportion of patients with a missed COPD diagnosis among those with COPD as the cause of death on their death certificate and how this has changed over the past 17 years.
Design and Setting: We linked Clinical Practice Research Datalink Aurum and GOLD primary care data with Office for National Statistics mortality data and Hospital Episode Statistics data. We included adults who died between 2000 and 2017 with COPD as their main cause of death.
Method: Using a range of diagnostic COPD criteria, we estimated the proportion of patients with a missed COPD diagnosis, and described the demographic and clinical characteristics of patients with and without prior COPD diagnosis using a mixed effect logistic regression model.
Results: Depending on the COPD definition used, between 96% and 27% of the 78,621 patients included received a diagnosis of COPD prior to death. Using presence of a COPD Read or SNOMED CT code and performed spirometry as a main definition, just over half of the patients (52%) had received a COPD diagnosis overall, with a proportion of those who did not decreasing from 91% in 2000 to 31% in 2017 (p-trend <0.001).
Conclusion: The proportion of people with COPD-recorded death who had received a diagnosis of COPD has improved over time and currently represents the majority of them, suggesting that few patients are being missed.
Aim: This study investigates the proportion of patients with a missed COPD diagnosis among those with COPD as the cause of death on their death certificate and how this has changed over the past 17 years.
Design and Setting: We linked Clinical Practice Research Datalink Aurum and GOLD primary care data with Office for National Statistics mortality data and Hospital Episode Statistics data. We included adults who died between 2000 and 2017 with COPD as their main cause of death.
Method: Using a range of diagnostic COPD criteria, we estimated the proportion of patients with a missed COPD diagnosis, and described the demographic and clinical characteristics of patients with and without prior COPD diagnosis using a mixed effect logistic regression model.
Results: Depending on the COPD definition used, between 96% and 27% of the 78,621 patients included received a diagnosis of COPD prior to death. Using presence of a COPD Read or SNOMED CT code and performed spirometry as a main definition, just over half of the patients (52%) had received a COPD diagnosis overall, with a proportion of those who did not decreasing from 91% in 2000 to 31% in 2017 (p-trend <0.001).
Conclusion: The proportion of people with COPD-recorded death who had received a diagnosis of COPD has improved over time and currently represents the majority of them, suggesting that few patients are being missed.
Date Issued
2022-12-01
Date Acceptance
2022-06-16
Citation
British Journal of General Practice Open, 2022, 6 (4)
ISSN
2398-3795
Publisher
Royal College of General Practitioners
Journal / Book Title
British Journal of General Practice Open
Volume
6
Issue
4
Copyright Statement
© 2022, The Authors This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)
License URL
Publication Status
Published
Date Publish Online
2022-12-10