Clinical characteristics, treatment patterns, and socio-economic burden of COPD in Bulgaria

Figures & data

Table 1. Demographics of the Bulgarian COPD study population (n = 426).

Category	Sub-group	Number/distribution [%]
Аge	40–50	13 [3.05%]
	51–60	96 [22.54%]
	61–70	165 [38.73%]
	71–80	128 [30.05%]
	81–90	23 [5.40%]
	>91	1 [0.23%]
Gender	Male	296 [69.48%]
	Female	130 [30.52%]
Region	Sofia city	143 [33.6%]
	Northwest	38 [8.9%]
	Northeast	76 [17.8%]
	Southwest	58 [13.6%]
	Southeast	111 [26.1%]
Working status	Working	249 [58.45%]
	Early retirement due to COPD	48 [11.27%]
	Men	21 [4.93%]
	Women	108 [25.35%]
	Retired
Smoking status	Non-smoker	111 [26.06%]
	Current smoker	138 [32.39%]
	Men	103 [74.64%]
	Women	35 [25.36%]
	Former smoker	177 [41.55%]
	Men	135 [76.27%]
	Women	42 [23.73%]
	Mean pack years	38.16 (SD =16.75)
Occupational risk factors	Yes	170 [39.91%]
	No	247 [57.98%]
	Missing data	9 [2.11%]

SD: standard deviation.

Table 2. Clinical characteristics of COPD patients in Bulgaria.

Category	Sub-group	Number/distribution
Clinical data
Duration of COPD (years)	≤10	254 [59.6%]
	11–20	156 [36.6]
	21–30	14 [3.3%]
	≥31	2 [0.5%]
FEV1% predicted	>80% (mild)	2 [0.5%]
	80–50% (moderate)	187 [43.90%]
	50–30% (severe)	191 [44.84%]
	<30% (very severe)	46 [10.80%]
Severity on the basis of combined  assessment of COPD	A	30 [7.06%]
	B	149 [35.06%]
	C	65 [15.29%]
	D	182 [42.59%]
Patient reported outcomes
Dyspnea (mMRC score)	0–1	84 [19.72%]
	≥2	342 [80.28%]
CAT scores	<10 (n, %)	9 (2.12%)
	Average score, mean (SD)	6.33 (2.60)
	≥10 (n, %)	416 (97.88%)
	Average score, mean (SD)	22.99 (6.56)

CAT: COPD Assessment Test; COPD: chronic obstructive pulmonary disease; FEV₁P: Forced expiratory volume in 1 s; mMRC: modified Medical Research Council; SD: standard deviation.

Figure 1. Concomitant diseases in Bulgarian patients with COPD.

Table 3. Concomitant diseases in patients with COPD (n = 426).

Concomitant diseases	Total [%]	GOLD A (n = 30)	GOLD B (n = 149)	GOLD C (n = 65)	GOLD D (n = 182)
No	54 [12.7%]	5	22	11	16
Yes	372 [87.3%]
≥2 diseases	291 [78.2%]	15 [50.0%]	99 [66.4%]	38 [58.5%]	139 [76.4%]
Only 1 disease	81 [21.8%]	10 [33.3%]	28 [18.8%]	16 [24.6%]	27 [14.8%]

Figure 2. COPD pharmacotherapy in Bulgaria by GOLD classification.

Figure 3. Yearly costs for COPD pharmacotherapy in Bulgaria by GOLD classification.

Table 4. Healthcare resource use, direct, and indirect costs (€) per Bulgarian COPD patient per year.

	Patients, n (%)	Number, mean (SD)	Per patient cost, mean (SD)
I. Direct medical costs			1,271.68
1. Medication	426 (100%)	—	692.81
2. Hospitalization (days)	227 (53%)	12.0 (8.73)	545 (393.91)
3. GP visits	280 (66%)	2.4 (1.31)	10.70 (8.76)
4. Specialist visits	421 (99%)	2.2 (1.8)	23.17 (12.85)
II. Indirect non-medical costs			4,543.49
1. Lost productivity	84	24 (17)	546.63 (381.46)
2. Reduced productivity	133	—	3,996.86

SD: standard deviation.

Figure 4. Distribution of direct and indirect costs for COPD in Bulgaria.

Table

Region in Bulgaria	Town(s)	Target number of COPD patients		Actual number of COPD patients
Sofia – town	Sofia	180		143
Northwestern	Vidin	10	30	38
	Vratsa	10
	Pleven	10
Northeastern	Rouse	22	77	76
	Shumen	11
	Varna	44
Southwest	Pernik	13	29	58
	Kjustendil	6
	Blagoevgrad	10
Southeast	Haskovo	11	89	111
	Plovdiv	45
	Burgas	33