Geographic differences in clinical characteristics and management of COPD: The EPOCA study

Marc Miravitlles, Cristina Murio, Gema Tirado-Conde, Gur Levy, Hana Muellerova, Joan B. Soriano, Alejandra Ramirez-Venegas, Fanny W.S. Ko, Byron Canelos-Estrella, Eduardo Giugno, Miguel Bergna, Ivan Chérrez, Antonio Anzueto

Research output: Contribution to journalArticlepeer-review

53 Scopus citations


Aims: Data on differences in clinical characteristics and management of COPD in different countries and settings are limited. We aimed to characterize the profile of patients with COPD in a number of countries and their treatment in order to evaluate adherence to recommendations of international guidelines. Method: This was an observational, international, cross-sectional study on patients with physician-diagnosed COPD. Demographic and clinical characteristics, risk factors, and treatment were collected by their physician via an internet web-based questionnaire developed for the study. Results: A total of 77 investigators from 17 countries provided data on 833 patients. The countries with the highest number of patients included were: Argentina (128), Ecuador (134), Spain (162), and Hong Kong (153). Overall, 79.3% were men and 81% former smokers, with a mean FEV1 = 42.7%, ranging from 34.3% in Hong Kong to 58.8% in Ecuador. Patients reported a mean of 1.6 exacerbations the previous year, with this frequency being significantly and negatively correlated with FEV1(%) (r = -0.256; p < 0.0001). Treatment with short-acting bronchodilators and theophyllines was more frequent in Ecuador and Hong Kong compared with Spain and Argentina, and in patients belonging to lower socioeconomic levels (p < 0.0001 for all comparisons). Inadequacy of treatment with inhaled corticosteroids and theophyllines was high, with significant differences among countries. Conclusions: Differences in the clinical characteristics and management of COPD were significant across countries. Adherence to international guidelines appears to be low. Efforts should be made to disseminate and adapt guidelines to the socioeconomic reality of different settings.

Original languageEnglish (US)
Pages (from-to)803-814
Number of pages12
JournalInternational Journal of COPD
Issue number4
StatePublished - 2008


  • COPD
  • Epidemiology
  • Socioeconomics

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Health Policy
  • Public Health, Environmental and Occupational Health


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