GPs based Swiss chronic obstructive pulmonary disease (COPD) cohort: Disease management in primary care: Descriptive data

Background: COPD is known to be a progressive disease and a major burden in health system. Our objective was to analyze the progression of the disease and disease management under primary care setting over long term period. Methods: COPD patients were screened by GPS and enrolled into our cohort. Demographic data was collected; medical treatment, spirometric parameters, exacerbation history, treatment and disease progression were recorded every six months. Results: 1160 patients with chronic bronchitis (61% male, 47% current smoker) were screened at baseline. Only 60% of patients at baseline have COPD (50% in GOLD II and GOLD III). Most of the patients have combined therapy of min. 2 medication, ; fewer than 10% of the subjects have pulmonary rehab. The longest observation period lasted over 30 month. 51% of our patients have a medium risk for exacerbation. We registered 962 exacerbation and 36 death events 15 of them were due to an exacerbation. We recorded 456 events, which went from healthy to an exacerbation, besides more than 200 incidents the second exacerbation occurs immediately after the first one. Conclusion: our data shows that COPD is often under- and misdiagnosed in primary care and often treated poorly. This is probably due to poor knowledge of guidelines.