Prevalence of Asthma Characteristics in COPD Patients in a Dutch Well-Established Asthma/COPD Service for Primary Care

Figures & data

Box 1 Asthma Characteristics as Defined in the Dutch GP COPD Guideline and the Operationalization Based on the Available AC-Service Data

According to Dutch GP COPD guideline6	Data available in AC-service data
History of asthma “Anamnestic suspicion of asthma: a history of asthma”	Patient-reported history of asthma
Symptom pattern “Anamnestic suspicion of asthma: the nature of the symptom pattern”	Question 1 of the Asthma Control Questionnaire is regarded as the most typical asthma sign: “Nighttime awakenings”
Atopy of the patient or in first-degree family members “Anamnestic suspicion of asthma: Atopy of the patient or in first-degree family members”	A combination of different variables of the data set: Self-reported atopy: Patient-reported responsiveness for the following triggers: House-dust mites, food, grass pollen, tree pollen, animal dander, and seasonal change. Self-reported history of atopy: History of: Allergic Rhinitis Allergy Eczema Atopy of first-degree family members: Not available in this data set
Reversibility “Increase in FEV1 of ≥ 12% and ≥ 200 mL compared to the FEV1 prior to bronchodilatation suggestive for asthma”	Increase in FEV1 of ≥ 12% and ≥ 200mL compared to the FEV1 prior to bronchodilatation

Abbreviations: GP, general practitioner; COPD, chronic obstructive pulmonary disease; AC service, asthma/COPD service; GOLD, Global Initiative for Chronic Obstructive Lung Disease; FEV1, forced expiratory volume in 1 second.

Figure 1 In- and exclusion flowchart 

Table 1 Baseline Characteristics

	COPD (N= 3532)	ACO (N= 1276)
Age, median [IQR]	66.0 [59–74]	60.0 [53–69]
Gender (% male (n))	57.2% (n=2020)	49.8% (n=636)
BMI, median [IQR]	26.0 [23–29]	27.0 [24–30]
Age at which lung complaints started^a, median [IQR]	57 [45–66]	40 [12–55]
Age < 5 years, %(n)	18.6% (n=657)	19.9% (n=254)
Age 5–40 years, %(n)	10.3% (n=364)	33.5% (n=428)
Age ≥ 40 years	71.1% (n=2511)	46.6% (n=594)
GOLD category^b, %(n)
A	30.3% (n=1067)	26.4% (n=335)
B	50.7% (n=1792)	51.3% (n=651)
C	4.9% (n=171)	5.4% (n=68)
D	14.0% (n=495)	16.9% (n=214)
Data available	99.8% (n=3525)	99.4% (n=1268)
Lung function, mean ± sd
FEV1 (L)^c	1.96 ± 0.71	2.17 ± 0.69
FVC (L)^c	3.51 ± 1.02	3.66 ± 1.03
FEV1/FVC ratio^c	55.87 ± 11.35	59.54 ± 9.88
FEV1% predicted^c	66.22 ± 17.40	70.13 ± 15.19
Data available, %(n)	99.6% (n=3518)	99.5% (n=1270)
Respiratory medication^d, %(n)
ICS containing treatment	36.5% (n=1289)	49.6% (n=636)
LAMA only (no ICS treatment)	10.8% (n=383)	1.6% (n=20)
LABA only (no ICS treatment)	1.4% (n=49)	4.9% (n=63)
LABA/LAMA (no ICS treatment)	0.5% (n=18)	0.6% (n=8)
Self-reported exacerbations, %(n)
None in the last 12 months	57.1% (n=2015)	52.4% (n=667)
At least one in the last 12 months	42.9% (n=1511)	47.6% (n=607)
At least two in the last 12 months	18.9% (n=666)	22.1% (n=282)
Data available	99.8% (n=3526)	99.8% (n=1274)
Smoking status, %(n)
Yes, currently smoking	48.5% (n=1710)	45.9% (n=585)
Yes, but quit ≥12 months ago	47.8% (n=1686)	46.2% (n=589)
Never smoked	3.6% (n=128)	7.9% (n=101)
Data available	99.8% (n=3524)	99.9% (n=1275)
Triggers causing symptoms, %(n)
Atopy	16.4% (n=581)	40.5% (n= 517)
Hyperreactivity	35.5% (n=1255)	59.0% (n= 753)
No triggers	37.5% (n=1323)	19.7% (n=252)
Specific IgE, %(n)
Positive screening aero allergens^e	18.9% (n=94)	28.4% (n=75)
Data available	14.2% (n=498)	20.7% (n=264)

Notes: The percentage of data available was not provided if the percentage data available was 100%; ^abased on the following question “At what age did you experience lung complaints for the first time (coughing, wheezing, breathlessness)”; ^bbased on GOLD 2019 – CCQ; ^cpost-bronchodilator; ^dshort acting bronchodilator use is not taken into account; ^ePhadiaTop.

Abbreviations: COPD, chronic obstructive pulmonary disease; ACO, asthma COPD overlap; IQR, interquartile range; BMI, body mass index; GOLD, Global Initiative for Chronic Obstructive Lung Disease; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; ICS, inhaled corticosteroids; LAMA, long-acting muscarinic antagonist; LABA, long-acting beta 2 agonist; IgE, immunoglobulin.

Figure 2 Prevalence of number of asthma characteristics in patients with COPD or ACO.

Note: The reported percentages are rounded to whole numbers.

Figure 3 Prevalence of the individual asthma characteristics ((A) history of asthma, (B) symptom pattern typical for asthma, (C) atopy, (D) reversibility) in COPD or ACO patients.

Note: The reported percentages are rounded to whole numbers.

Figure 4 Prevalence of the individual asthma characteristics in COPD or ACO patients with one asthma characteristic.

Note: The reported percentages are rounded to whole numbers.

Figure 5 Prevalence of Eos counts in COPD or ACO patients.

Note: The reported percentages are rounded to whole numbers.
Abbreviation: Eos, blood eosinophils; all blood Eos counts are reported in cells per µL.

Figure 6 Prevalence of asthma characteristics in COPD (A) or ACO (B) patients sorted by Eos counts.

Note: The reported percentages are rounded to whole numbers.
Abbreviation: Eos, blood eosinophils; all blood Eos cells per µL.

Snoeck-StrobandJB, SchermerTRJ, Van SchayckCP, et al. NHG-Standaard COPD (Derde Herziening). 2015.

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