Methods:A total of 1892 newly diagnosed adult patients (1116 asthmatic, 776 COPD) from 136 secondary or tertiary centers of different geographic locations took part in this study, and a standard web-based questionnaire including items related with demographic, clinical, laboratory and pharmacological parameters was applied from July 2012 to May 2014.
Results:Asthmatic patients were mostly female (64.4%), while the male patients were higher (88.1%) in COPD. The percentage of patients whose age is ≥65 years was significantly higher in COPD patients compared to asthmatic patients (30.4% and 7.1%, respectively) (p<0.001). Evaluation of the disease severity showed that nearly half of the asthmatic patients were in “moderate persistent” category (45.0%) and more than half of the COPD patients (54.4%) were in “GOLD B”. More than half of both asthmatic and COPD patients had at least one accompanying disease (53.9% and 52.8%, respectively) and hypertension was the most seen disease in both asthmatic and COPD patients (13.9% and 21.1%, respectively) (p<0.0001). Nearly half of the asthmatic patients (45.5%) stated asthma and 13.7% stated COPD in their family history, while nearly ¼ of COPD patients stated COPD (22.2%) and 8.2% stated asthma. Evaluation of smoking anamnesis showed that there was a significant difference between asthmatic and COPD patients by means of “currently smoking" status; percentages were 27.9% and 56.3%, respectively (p<0.001). It is found that the percentage of COPD patients (37.0%) who have been exposed to dust, gas and/or vapor in work place was significantly higher than asthmatic patients (25.2%) (p<0.001). Evaluation of trigger factors showed that air pollution was the most common trigger in both asthma (54.1%) and COPD (54.6%) groups. Evaluation of adherence to the study visits showed that percentage of the patients coming to one control visit was higher in asthmatics compared to COPD patients (61.6% and 55.9%, respectively) (p=0.014). However, when groups were compared in terms of 3rd follow-up visit, adherence was low in both groups (20.3% and 18.7% for asthma and COPD). Compliance to the treatment in percentages of regular medication use was significantly better in COPD patients compared to asthmatic patients (p=0.021).
Conclusion: COPD and asthma are associated with significant economic burden. Identification and reduction of exposure to risk factors are important in the treatment and prevention. Patient compliance may be the key to better disease management. We need new strategies to improve adherence in patients.