Grant: Travel Awards - Institute Community Support

Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that results in decreasing lung function over time and periods of increased impairment known as exacerbations. COPD is the most common cause of hospitalization among chronic diseases in Canada, and the burden of care is rising so rapidly that it is projected to overwhelm health-care systems within two decades. Unfortunately, nearly two thirds of patients with COPD have not been diagnosed and are not receiving treatment. These patients are likely to experience worse outcomes over the long-term, including reduced quality of life, higher mortality, and increased burden on health-care systems. A key first step to reducing the under-diagnosis of COPD is to identify patient and disease characteristics that are associated with an increased likelihood of having undiagnosed COPD. We conduced a systematic review of existing studies on the differences between patients with diagnosed and undiagnosed COPD in order to generate quantitative estimates for the association between common risk factors and the presence of undiagnosed COPD. We found that patients with undiagnosed COPD tended to have more severe disease, fewer respiratory symptoms, and slightly greater smoking history than diagnosed patients. There was no difference in patient age, sex, and current smoking status between undiagnosed and diagnosed patients. Our results indicate that patients with undiagnosed COPD tend to have a lower disease burden, which may significantly delay a diagnosis of COPD. These results are crucial to identifying patients with COPD while the disease is early in its progression, which is the most important component of treatment.