Trends in self-rated health status and health services use in COPD patients (2006-2012). A Spanish population-based survey

Changing perceptions of general health in the Kayseri Province, Turkey in 2004 and 2017: A population-based study

Aim

Self-rated health (SRH) and health-related quality of life (HRQoL) have closely related outcomes in measuring general health status in community-based studies. The aim of this study is to determine changes in the self-perceived overall health of people and affected factors by comparing the findings of two studies conducted in the same research area.

Methods

Both studies were conducted using the same measurement tools in households determined by random sampling techniques in the same research areas. The first and second studies were conducted with 1,304 and 1,533 people residing in 501 and 801 households in 2004 and 2017, respectively. The demographic data form, the Nottingham Health Profile (NHP), and a single-item SRH questionnaire were used for data collection.

Results

The rate of good SRH increased from 56% to 70% while the average NHP score decreased from 30.87 to 20.34. The predictors of negative health perceptions were the presence of chronic diseases (OR 3.4-2.7-times higher), being female (OR.1.4-1.5 times higher), and the completion of primary education only (OR. 2.7-2.8 times higher) both 2004 and 2017. Living 500-1,000 m from the nearest healthcare facility was the main protective variable against poor SRH.

Conclusions

Good SRH and HRQoL have increased significantly over time. Chronic diseases, education, and gender are the strongest predictors of poor SRH.

Common Mental Disorders, Functional Limitation and Diet Quality Trends and Related Factors among COPD Patients in Spain, 2006-2017: Evidence from Spanish National Health Surveys

Certain conditions such as common mental disorders (CMDs), functional limitation (FL) and poor diet quality may affect the lives of individuals who suffer from chronic obstructive pulmonary disease (COPD). This study sought to examine time trends in the prevalence of CMDs, FL and diet quality among male and female COPD patients living in Spain from 2006 to 2017 and to identify which factors were related to CMDs, FL and a poor/improvable diet quality in these patients. We performed a cross-sectional study among COPD patients aged ≥ 40 years old using data from the Spanish National Health Surveys conducted in 2006, 2011 and 2017, identifying a total of 2572 COPD patients. Binary logistic regressions were performed to determine the characteristics related to CMDs, FL and poor/improvable diet quality. Over the years of the study, the prevalence of FL among female COPD patients increased (p for trend <0.001). In addition, CMDs were associated to body mass index (BMI), educational level, physical activity, smoking status, occupation, chronic conditions and alcohol consumption; FL was related to age, living with a partner, educational level, physical activity and chronic conditions; and poor/improvable diet quality was associated to age, smoking status, BMI and physical activity.

Application Value of Broadband 3-Dimensional Impulse Oscillometry in COPD

Objective

To explore the correlation of respiratory resistance in stable COPD patients measured by broadband 3-dimensional impulse oscillometry (3D-IOS) and traditional pulmonary function test (PFT). To access the diagnostic value of 3D-IOS in COPD.

Methods

A total of 107 COPD patients and 61 healthy subjects as controls were chosen to collect and statistically analyze the data of R5, R5–R20, R20, X5 and Fres measured by broadband 3D-IOS and FEV1%pred, FVC%pred and FEV1/FVC by PFTs. The diagnostic value of broadband 3D-IOS parameters in COPD was evaluated by receiver operating characteristic curve (ROC). 3D-colored images used to show dynamic changes of respiratory resistance in COPD.

Results

The COPD group showed significant increases in R5, R20, R5–R20 and Fres, and a decrease in X5 (P<0.05). With the increase of GOLD grade, R5, R5–R20 and Fres increased whereas X5 decreased (P<0.05). Compared with FEV1%pred, FVC%pred and FEV1/FVC in the COPD group, R5, R5–R20 and Fres were negatively collated (P<0.05), whereas X5 was positively collated (P<0.01). R20 was uncorrelated with the traditional lung function parameters (P>0.05). Fres and FEV1/FVC (r=−0.467), and X5 and FEV1%pred (r=0.412) showed the strongest correlation. The AUC of R5, R5–R20, X5 and Fres was 0.7808, 0.7659, 0.8947 and 0.9095, respectively. Typical 3D-colored images of COPD displayed a green pattern in the inhalation phase and yellow–red–blue graduation in the expiration phase.

Conclusion

R5, R5-R20, X5 and Fres measured by broadband 3D-IOS can reflect the change of respiratory resistance in COPD. And they have good correlation with the traditional lung function parameters (FEV1%pred, FVC%pred, FEV1/FVC). Fres has the highest diagnostic accuracy. Comprehensive analysis of R5, R5–R20, Fres and X5 helps to determine the degree of respiratory obstruction in COPD. X5 and Fres can reflect changes in lung tissue compliance. 3D-colored images can visually show the change of respiratory resistance and reactance in COPD.

Prevalence of Pain in COPD Patients and Associated Factors: Report From a Population-based Study

OBJECTIVES

To assess the prevalence of chronic neck pain (CNP), chronic low back pain (CLBP), and migraine among Spanish adults with chronic obstructive pulmonary disease (COPD) compared with non-COPD patients matched by age and sex; and to identify predictors for each of these types of pains among COPD sufferers.

MATERIALS AND METHODS

A cross-sectional study conducted with data collected from the European Health Interview Surveys for Spain (EHSS) conducted in years 2009/2010 (n=22,188) and 2014 (n=22,842). Data were analyzed using multivariable logistic models.

RESULTS

The prevalence of COPD among patients aged 35 years or above were 7.6% (n=1328) for the EHSS 2009 and 5.4% (n=1008) for the EHSS 2014. We matched 2251 COPD patients with age and sex controls. The prevalence of all types of pain were significantly higher among those suffering COPD than those without COPD. For CNP the figures were 40.5% versus 26.1%, for CLBP 44.8% versus 28.4%, and for migraine 22.5% versus 13.2%. Multivariable analysis showed that COPD was associated to a 1.21 (95% confidence interval [CI], 1.02-1.45) higher risk of CNP, 1.38 (95% CI, 1.16-1.64) of CLBP, and 1.36 (95% CI, 1.12-1.65) of migraine. Associated factors with the presence of these types of pain among COPD patients included younger age (not for CLBP), female sex (not for CLBP), "fair/poor/very poor" self-rated health (not for migraine), high blood pressure (not for CNP), mental disorders, obesity (not for migraine), and use of pain medication.

DISCUSSION

The prevalence of CNP, CLBP, and migraine was significantly higher among COPD patients in comparison with controls. Associated factors to suffering these types of pain in patients with COPD included age, sex, self-rated health, certain comorbidities including mental disorders, obesity, and using pain medication.

COPD and the risk of mild cognitive impairment and dementia: a cohort study based on the Chinese Longitudinal Health Longevity Survey

Background

COPD may lead to cognitive impairment or even dementia. However, the current conclusions are inconsistent with little evidence from prospective, large-sample studies. This study was designed to explore the association of COPD with mild cognitive impairment (MCI) and dementia risk based on a cohort study.

Patients and methods

All participants were from the Chinese Longitudinal Health Longevity Survey (CLHLS) 2011/2012 waves. The follow-up survey was conducted in 2014 and the incidence of MCI and dementia were recorded.

Results

During the 3-year follow-up period, 712 new cases of MCI and 83 new cases of dementia were diagnosed. The incidence of MCI and dementia were higher in those with COPD than those without COPD at baseline. Cox analysis showed that the HRs of COPD for MCI and dementia incidence were 1.486 (95% CI: 1.207-1.855) and 1.896 (95% CI: 1.079-3.330), respectively after adjusting for related covariates. For different baseline smoking status, those who were current smokers had the highest HRs of COPD for MCI and dementia.

Conclusion

Baseline COPD was independently associated with increased risk of MCI and dementia incidence among Chinese elderly, and the association was more pronounced among those who were current smokers.

Self-reported walking and associated factors in the Spanish population with chronic obstructive pulmonary disease

Background

The level of physical activity among individuals with chronic obstructive pulmonary disease (COPD) is associated with the disease severity and prognosis. The aim of this study was to describe the prevalence of self-reported walking at least 150 min per week and the associated factors among the Spanish population with COPD.

Methods

Analyses were based on data drawn from the 2009 European Health Interview Survey in Spain (2009 EHIS). Twenty-two thousand one hundred eighty-eight subjects participated in the survey (response rate of 96.5%). Participants were classified according to international physical activity recommendations. The prevalence of walking among participants with and without COPD (≥40 years old) was described. Univariate and multivariate logistic regression models were used to study the association of walking with socio-demographic and health outcome variables.

Results

Of the participants with COPD, 55.0% reached the minimum walking recommendations compared to 59.9% of the general population. The level of walking physical activity of the participants with COPD differed according to sex, age, educational level, area of residence, living as a couple, self-rated health status, mental health, body mass index and hospital admissions. In the multivariate analysis, being male, < 65 years old, living in an area with ≥50,000 inhabitants, no diagnosed depression or anxiety and self-reported good to very good health were factors significantly associated with walking ≥150 min per week.

Conclusions

Sex, age, area of residence, mental disorders and self-rated health are associated with weekly walking time in the Spanish population with COPD.

Effect of the economic crisis on the use of health and home care services among Spanish COPD patients

Background

Chronic obstructive pulmonary disease (COPD) is a major cause of disability and death worldwide. Consequently, COPD patients are frequent users of health and social resources. Therefore, they are highly vulnerable to decreases in investment in healthcare services. We aimed to describe the utilization of health and home care services among Spanish COPD patients during the economic crisis to identify factors independently associated with changes in the utilization of these services and to study the time trends from 2009 to 2014.

Methods

We used data from the European Health Interview Surveys for Spain (EHSS) conducted between 2009/2010 (n=22,188) and 2014 (n=22,842). We included responses from adults with COPD aged 40 years or over. Dependent variables included self-reported hospitalizations during the previous year, general practitioner (GP) visits during the last 4 weeks, other health care services used during the previous year (nursing, rehabilitation, and psychological services), and home care services use during the previous year. Independent variables included demographic and socioeconomic characteristics, health status variables, and lifestyles.

Results

We identified 1,328 and 1,008 COPD patients from EHSS 2009 and EHSS 2014, respectively. We observed a significant increase in non-GP services use (30.6% in 2009 vs 39.11% in 2014; p<0.001). No changes were found for hospitalizations, GP visits, and home care services use over time. Multivariable models showed that associated factors with a higher use included any chronic comorbidity and worse self-rated health. Physical activity was a strong predictor of fewer hospitalizations and less home care service use. Female sex was associated with significantly fewer hospitalizations (OR 0.72; 95% CI 0.58-0.89).

Conclusion

We found an increase in the use of non-GP services (nursing, rehabilitation, and psychological) but not in other health and home care services. The only differences in hospitalizations were observed according to sex. Therefore, the effect of the economic crisis, if any, seems to have been of small magnitude.