Prevalence of comorbidities in the general population and

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Transcript Prevalence of comorbidities in the general population and

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The prevalenceofasthma and COPD in Italy
M. Cazzola, E. Puxeddu, G. Bettoncelli, L. Novelli, A. Segreti, C. Cricelli, L.
Calzetta - Respiratory Medicine (2011)
Prevalence of comorbidities in the general
population and in asthmatic patients
Odds ratios and 95% confidence limits of comorbidities in
asthma according to age. p<0.05 vs. general population
Odds ratios and 95% confidence limits of comorbidities in
asthma according to age. p<0.05 vs. general population
Asthma and ComorbidMedicalIllnessMarioCazzolaa,b, Luigino
Calzettaa, Germano Bettoncellic, Lucia Novellia, Claudio Cricellic, Paola
Rogliania (ERJ 2010)
• RESULTS: Apparently, asthma was a weak risk factor for
cardiovascular and hypertensive diseases. Intriguingly,
the OR of acute or old myocardial infarction was 0.84
(95% CI 0.77-0.91). Asthma was a weak risk factor also
of depression, diabetes mellitus, dyslipidaemia,
osteoporosis, and rhinosinusitis. On the contrary, it was
an important risk factor for gastroesophageal reflux
disease and, mainly, allergic rhinitis. Age did not
influence the risk of asthma-induced comorbidities
whereas gender had a different impact according to
the specific comorbidity.
• CONCLUSIONS: Our results indicate that asthma is a
risk factor for these comorbid conditions
Figure 1 – People with and without COPD who reported cardiovascular comorbidities, by age group and gender
(% of the examined population). Without COPD: solid square: total; solid circle:men; solid triangles: women.
With COPD: open square: total;open circle:men;open triangles: women.
cardiac arrhythmia
heart failure
25
20
20
20
15
15
15
%
25
%
25
10
10
10
5
5
5
0
0
0
45-54
55-64
65-74
75-84
45-54
85 >
55-64
age (years)
65-74
75-84
45-54
85 >
55-64
65-74
75-84
Age (years)
Age (years)
other forms of heart disease
diseases of pulmonary circulation
50
4
40
%
3
%
%
ischemic heart disease
2
30
20
1
10
0
0
45-54
55-64
65-74
Age (years)
75-84
85 >
45-54
55-64
65-74
75-84
85 >
Age (years)
Prevalence of Comorbidities in Patients with Chronic Obstructive Pulmonary Disease.
Cazzola M, Bettoncelli G, Sessa E, Cricelli C, Biscione G.Respiration. 2010 Feb 4. [Epub ahead of print
85 >
Figure 2 – People with and without COPD who reported other selected comorbidities, by age group and gender (% of the examined
population). Without COPD: solid square: total; solid circle:men; solid triangles: women.With COPD: open square: total; open
circle:men;open triangles: women.
metabolic syndrome
diabetes mellitus
1.5
osteoporosis
25
40
20
30
15
%
%
%
1.0
20
10
0.5
10
5
0
0.0
45-54
55-64
65-74
75-84
0
45-54
85 >
55-64
neurotic disorders
65-74
75-84
85 >
45-54
65-74
75-84
Age (years)
depressive disorders
malignant neoplasms
85 >
4
15
50
55-64
Age (years)
Age (years)
3
%
%
%
10
25
5
0
1
0
0
45-54
55-64
65-74
Age (years)
75-84
85 >
2
45-54
55-64
65-74
Age (years)
75-84
85 >
45-54
55-64
65-74
75-84
Age (years)
Prevalence of Comorbidities in Patients with Chronic Obstructive Pulmonary Disease.
Cazzola M, Bettoncelli G, Sessa E, Cricelli C, Biscione G.Respiration. 2010 Feb 4. [Epub ahead of print]
85 >
Boyd CM, Darer J, Boult C, et al. Clinicalpractice guidelines and quality of
care for older patients with multiple comorbid diseases: implications for
pay for performance. JAMA 2005; 294: 716-24
Prescriptions of drugsforobstructiveairwaydiseases (ATC code R03).
Drug prescription for asthma and COPD by general practitioners in Italy: is it changing in a very
short time? Mario Cazzola1, Andrea Segreti1, Germano Bettoncelli2, Luigino Calzetta1, Claudio
Cricelli2, Franco Pasqua3, Paola Rogliani1 PCRJ 2011
• Compared to 2006, in 2008 there were increased
prescriptions of ß2-agonist/inhaled corticosteroid
fixed combination in asthma but only 54.5% of all
prescriptions included an inhaled corticosteroid. This
could explain the largeuseofshort-acting ß2-agonists,
a marker of poor asthma control. Remarkably, ß2agonist/inhaled corticosteroid fixed combinations
were prescribed more frequently in COPD than in
asthma. Our data indicate that adherence to
guidelines is still low and patients with asthma and
COPD are undertreatedby Italian GPs, with a trend to
a change mainly in COPD likely driven by new
scientific information
Changes in prescriptions of drugs forobstructiveairwaydiseases (ATC code R03) in COPD
between 2006 and 2008. For each group of drugs, the % of prescriptions considering the total
number of prescriptions for that group and year is reported. ICSs, inhaled corticosteroids