Title |
What pulmonologists think about the asthma–COPD overlap syndrome
|
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Published in |
International Journal of Chronic Obstructive Pulmonary Disease, July 2015
|
DOI | 10.2147/copd.s88667 |
Pubmed ID | |
Authors |
Marc Miravitlles, Bernardino Alcázar, Francisco Javier Alvarez, Teresa Bazús, Myriam Calle, Ciro Casanova, Carolina Cisneros, Juan P de-Torres, Luis M Entrenas, Cristóbal Esteban, Patricia García-Sidro, Borja G Cosio, Arturo Huerta, Milagros Iriberri, José Luis Izquierdo, Antolín López-Viña, José Luis López-Campos, Eva Martínez-Moragón, Luis Pérez de Llano, Miguel Perpiñá, José Antonio Ros, José Serrano, Juan José Soler-Cataluña, Alfons Torrego, Isabel Urrutia, Vicente Plaza |
Abstract |
Some patients with COPD may share characteristics of asthma; this is the so-called asthma-COPD overlap syndrome (ACOS). There are no universally accepted criteria for ACOS, and most treatments for asthma and COPD have not been adequately tested in this population. We performed a survey among pulmonology specialists in asthma and COPD aimed at collecting their opinions about ACOS and their attitudes in regard to some case scenarios of ACOS patients. The participants answered a structured questionnaire and attended a face-to-face meeting with the Metaplan methodology to discuss different aspects of ACOS. A total of 26 pulmonologists with a mean age of 49.7 years participated in the survey (13 specialists in asthma and 13 in COPD). Among these, 84.6% recognized the existence of ACOS and stated that a mean of 12.6% of their patients might have this syndrome. In addition, 80.8% agreed that the diagnostic criteria for ACOS are not yet well defined. The most frequently mentioned characteristics of ACOS were a history of asthma (88.5%), significant smoking exposure (73.1%), and postbronchodilator forced expiratory volume in 1 second/forced vital capacity <0.7 (69.2%). The most accepted diagnostic criteria were eosinophilia in sputum (80.8%), a very positive bronchodilator test (69.2%), and a history of asthma before 40 years of age (65.4%). Up to 96.2% agreed that first-line treatment for ACOS was the combination of a long-acting β2-agonist and inhaled steroid, with a long-acting antimuscarinic agent (triple therapy) for severe ACOS. Most Spanish specialists in asthma and COPD agree that ACOS exists, but the diagnostic criteria are not yet well defined. A previous history of asthma, smoking, and not fully reversible airflow limitation are considered the main characteristics of ACOS, with the most accepted first-line treatment being long-acting β2-agonist/inhaled corticosteroids. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 3 | 100% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Scientists | 1 | 33% |
Members of the public | 1 | 33% |
Practitioners (doctors, other healthcare professionals) | 1 | 33% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 1 | 1% |
Unknown | 72 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 12 | 16% |
Professor | 11 | 15% |
Other | 10 | 14% |
Professor > Associate Professor | 6 | 8% |
Student > Master | 5 | 7% |
Other | 13 | 18% |
Unknown | 16 | 22% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 38 | 52% |
Pharmacology, Toxicology and Pharmaceutical Science | 7 | 10% |
Nursing and Health Professions | 5 | 7% |
Biochemistry, Genetics and Molecular Biology | 1 | 1% |
Agricultural and Biological Sciences | 1 | 1% |
Other | 3 | 4% |
Unknown | 18 | 25% |