Chronic Obstructive Pulmonary Disease Clinical Trial
Official title:
POPE-Study: Phenotypes Of COPD in Central and Eastern Europe Study
The purpose of this study is to assess the representation of COPD patients in terms of categories and phenotypes of the disease in selected countries in Central and Eastern Europe (CEE). The results of The POPE study will allow for evaluation of the differences in clinical approaches and treatment practices. The following countries are represented in The POPE study: Czech Republic, Slovakia, Austria, Poland, Hungary, Russia, Croatia, Serbia, Slovenia, Estonia, Latvia and Bulgaria.
Chronic Obstructive Pulmonary Disease (COPD) is a significant cause of morbidity and
mortality in Europe and a major consumer of resources in both primary and secondary
healthcare (1,2). Both clinical features of disease severity and quality of COPD patient
care may have substantial influence on disease outcomes. Traditionally, COPD has been
categorized using the FEV1 (forced expiratory volume at one second ) - based GOLD (The
Global Initiative for Chronic Obstructive Lung Disease) classification . Other factors
independently associated with survival include age, dyspnoea, health status, hyperinflation,
gas exchange abnormalities, exacerbation frequency, exercise capacity, pulmonary
hemodynamic, and nutritional status (3). Together these factors explain some of the existent
heterogeneity within each GOLD stage in terms of symptoms, exacerbations, quality of life
and exercise capacity (4).
Recently, interest has emerged for the identification of clinical COPD phenotypes, as
defined by ''a single or combination of disease attributes that describe difference between
individuals with COPD as they relate to clinically meaningful outcomes'' (5). Many previous
studies have attempted to identify and quantify the prevalence of different phenotypes of
COPD using populations of various sources, severities, and particularities. Yet there is no
consensus on the number and definition of different phenotypes. However, there must be a
compromise between the oversimplification of the term COPD as a definition that encompasses
the entire spectrum of patients with incompletely reversible airflow obstruction caused
largely by smoking and the complexity of considering each patient individually as an orphan
disease.
The most frequently reported phenotypes are emphysema and chronic bronchitis, along with a
subset of asthma sufferers. Recently, an extended list of proposed phenotypes have been
proposed (6) including: (A) infrequent exacerbators with either chronic bronchitis or
emphysema; (B) overlap COPD-asthma; (C) frequent exacerbators with emphysema predominant;
and (D) frequent exacerbators with chronic bronchitis predominant. While there is consensus
of substantial, but not complete, overlap among these phenotypes, the distribution of these
phenotypes may differ widely between different countries and healthcare systems.
Thus, the objectives of this study are to better understand the patient characteristics and
treatment patterns of those diagnosed with COPD between different CEE countries. Knowledge
of this information may provide insight into the variability of phenotypes between different
healthcare systems and may subsequently contribute to a better understanding of the factors
associated with patient outcomes and have the potential to improve the care of COPD
patients.
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Observational Model: Cohort, Time Perspective: Cross-Sectional
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