1 / 11

Jesper Lykkegaard Research Unit of General Practice, Institute of Public Health,

Why do patients with severe chronic obstructive pulmonary disease (COPD) need 6-monthly check-ups at their general practitioner?. Jesper Lykkegaard Research Unit of General Practice, Institute of Public Health, University of Southern Denmark jlykkegaard@health.sdu.dk.

megan
Download Presentation

Jesper Lykkegaard Research Unit of General Practice, Institute of Public Health,

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Why do patients with severe chronic obstructive pulmonary disease (COPD) need 6-monthly check-ups at their general practitioner? Jesper Lykkegaard Research Unit of General Practice, Institute of Public Health, University of Southern Denmark jlykkegaard@health.sdu.dk. Jesper Lykkegaard

  2. 9.5% of the adult population 430,000 persons in Denmark have COPD Løkke A, 2007 25,000 have severe COPD: • at least 1 hospitalization • FEV1 35% on average • 10 patients per GP Jesper Lykkegaard

  3. Recommendations: 6-monthly check-ups ? COPD patient Male Female Visits daytime 8 8 Telephone 9 12 Visits afterhours 2 3 Contacts per year 19 23 Bilde L, 2003 • Rehabilitation: • Exercise • Self management • Smoking cessation • Dietary advice Vaccinations 6-monthly check-ups Jesper Lykkegaard 3

  4. 1 year mortality 35% Eriksen N, 2003 - 40% COPD - 30% cardiovasculardisease - 8% pulmonary cancer - 22% other causes Chatila W M, 2008 Jesper Lykkegaard 4

  5. 10 % mortality during admission Eriksen N, 2003 Jesper Lykkegaard 5

  6. Cause of death based on autopsy: 37% cardiac failure 28% pneumonia 21% pulmonary embolism 14% COPD 58% chronic heart failure Zvezdin B, 2009 Jesper Lykkegaard

  7. Screening the patients: …..all diagnoses otherthanpregnancy-relateddiseases Bilde L, 2007 60 % ECG signs of Right ventricular overload 21 % ECG signs of IHD Antonelli et al, 1997 25 % Pulmonary embolism Tillie-Leblond I, 2006 45 % Major depression Ng T P et al, 2007 68 % Osteoporosis Jørgensen N R, 2007 Jesper Lykkegaard

  8. Why comorbidity? COPD predicts: • Depression • Cardiovascular disease • Pulmonary cancer • Osteoporosis • Smoking • Age • Corticosteroids Van den Bemt L et al, 2009 Inflammation Truelsen T et al, 2001 Barnes PJ et al, 2009 • Hypoxia • Immobilisation Mannino DM et al, 2003 Jørgensen NR et al, 2006 Jesper Lykkegaard

  9. Why do patients with severe COPD need 6 monthly check-ups at their general practitioner? Jesper Lykkegaard

  10. Bad prognosis Critical - Hidden - Treatable Comorbidities Depression Cardiovascular Cancer Osteoporosis Jesper Lykkegaard

  11. Thank you for your attention Jesper Lykkegaard

More Related