2023-09-28 14:46:10 +00:00
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abstract: 'An individual''s experience of COPD is determined by many factors in
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addition to the pathological features of chronic bronchitis and
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emphysema and the symptoms that derive directly from them.
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Multimorbidity is the norm rather than the exception, so most people
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with COPD are living with a range of other medical problems which can
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decrease overall quality of life. COPD is caused by the inhalation of
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noxious particles or gases, in particular tobacco smoke, but also by
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early life disadvantage impairing lung development and by occupations
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where inhaled exposures are common (e.g. industrial, farming and
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cleaning work). Wealthy people are therefore relatively protected from
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developing COPD and people who do develop the condition may have reduced
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resources to cope.
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COPD is also no longer a condition that predominantly affects men. The
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prevalence of COPD among women has equalled that of men since 2008 in
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many high-income countries, due to increased exposure to tobacco, and in
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low-income countries due to biomass fuels. COPD is one of the leading
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causes of death in women in the USA, and death rates attributed to COPD
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in women in some countries are predicted to overtake those of men in the
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next decade. Many factors contribute to this phenomenon, but in addition
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to socioeconomic and occupational factors, there is increasing evidence
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of a higher susceptibility of females to smoking and pollutants. Quality
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of life is also more significantly impaired in women. Although most
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medications (bronchodilators and inhaled corticosteroids) used to treat
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COPD demonstrate similar trends for exacerbation prevention and lung
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function improvement in men and women, this is an understudied area and
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clinical trials frequently have a preponderance of males. A better
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understanding of gender-based predictors of efficacy of all therapeutic
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interventions is crucial for comprehensive patient care. There is an
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urgent need to recognize the increasing burden of COPD in women and to
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facilitate global improvements in disease prevention and management in
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this specific population.
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Many individuals with COPD follow a trajectory of both lung function
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decline and also multimorbidity. Unfavourable lung function trajectories
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throughout life have implications for later development of other chronic
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diseases. An enhanced understanding of the temporal associations
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underlying the development of coexisting diseases is a crucial first
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step in unravelling potential common disease pathways. Lessons can be
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learned from exploring disease trajectories of other NCD as well as
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multimorbidity development. Further research will be essential to
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explain how early life risk factors commonly influence trajectories of
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COPD and other diseases, how different diseases develop in relation to
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each other in a temporal way and how this ultimately leads to different
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multimorbidity patterns in COPD.
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This review integrates new knowledge and ideas pertaining to three broad
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themes (i) the overall burden of disease in COPD, (ii) an unappreciated
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high burden in women and (iii) the contrast of COPD trajectories and
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different multimorbidity patterns with trajectories of other NCD. The
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underlying pathology of COPD is largely irreversible, but many factors
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noted in the review are potentially amenable to intervention. Health and
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social care systems need to ensure that effective treatment is
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accessible to all people with the condition. Preventive strategies and
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treatments that alter the course of disease are crucial, particularly
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for patients with COPD as one of many problems.'
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affiliation: 'Zysman, M (Corresponding Author), CHU Bordeaux, Serv Malad Resp, Ave
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Magellan, F-33604 Pessac, France.
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Hopkinson, NS (Corresponding Author), Imperial Coll, Natl Heart \& Lung Inst, Royal
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Brompton Hosp Campus,Fulham Rd, London SW3 6HP, England.
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Vanfleteren, LEGW (Corresponding Author), Univ Gothenburg, Sahlgrenska Univ Hosp,
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COPD Ctr, Dept Resp Med \& Allergol,Inst Med, Vita Straket 12, SE-41345 Gothenburg,
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Sweden.
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Buttery, Sara C.; Hopkinson, Nicholas S., Imperial Coll London, Natl Heart \& Lung
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Inst, London, England.
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Zysman, Maeva, Univ Bordeaux, Ctr Rech Cardiothorac Bordeaux, Pessac, France.
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Zysman, Maeva, CHU Bordeaux, Serv Malad Resp, Ave Magellan, F-33604 Pessac, France.
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Vikjord, Sigrid A. A., Nord Trondelag Hosp Trust, Levanger Hosp, Dept Med \& Rehabil,
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Levanger, Norway.
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Vikjord, Sigrid A. A., Norwegian Univ Sci \& Technol NTNU, Fac Med \& Hlth Sci,
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HUNT Res Ctr, Dept Publ Hlth \& Nursing, Levanger, Norway.
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Jenkins, Christine, George Inst Global Hlth, Resp Grp, Sydney, NSW, Australia.
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Vanfleteren, Lowie E. G. W., Sahlgrens Univ Hosp, COPD Ctr, Dept Resp Med \& Allergol,
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Gothenburg, Sweden.
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Vanfleteren, Lowie E. G. W., Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Internal
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Med \& Clin Nutr, Gothenburg, Sweden.'
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author: Buttery, Sara C. and Zysman, Maeva and Vikjord, Sigrid A. A. and Hopkinson,
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Nicholas S. and Jenkins, Christine and Vanfleteren, Lowie E. G. W.
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author-email: 'maeva.zysman@chu-bordeaux.fr
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n.hopkinson@ic.ac.uk
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lowie.vanfleteren@gu.se'
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author_list:
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- family: Buttery
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given: Sara C.
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- family: Zysman
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given: Maeva
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- family: Vikjord
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given: Sigrid A. A.
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- family: Hopkinson
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given: Nicholas S.
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- family: Jenkins
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given: Christine
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- family: Vanfleteren
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given: Lowie E. G. W.
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da: '2023-09-28'
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doi: 10.1111/resp.14032
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earlyaccessdate: MAR 2021
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eissn: 1440-1843
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files: []
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issn: 1323-7799
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journal: RESPIROLOGY
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keywords: 'frailty; inequality; patient perspective; patient\&\#8208; reported
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outcome measure; symptoms'
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keywords-plus: 'OBSTRUCTIVE PULMONARY-DISEASE; QUALITY-OF-LIFE; BLOOD-PRESSURE
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TRAJECTORIES; ALL-CAUSE MORTALITY; BODY-MASS INDEX; LUNG-FUNCTION;
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PHYSICAL-ACTIVITY; CHRONIC-BRONCHITIS; PRIMARY-CARE; DEVELOPMENTAL
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ORIGINS'
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language: English
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month: MAY
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number: '5'
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number-of-cited-references: '255'
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orcid-numbers: 'Jenkins, Christine/0000-0003-2717-5647
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ZYSMAN, Maeva/0000-0003-1459-2409
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Buttery, Sara/0000-0001-9410-414X
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Vanfleteren, Lowie/0000-0002-4387-4096'
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pages: 419-441
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papis_id: 2c387d7a48355931411eaf1fc01f7d92
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ref: Buttery2021contemporaryperspect
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researcherid-numbers: 'ZYSMAN, Maéva/ACP-5812-2022
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OMOSIGHO, BLESSING/ISS-7818-2023
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'
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tags:
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- review
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times-cited: '14'
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title: 'Contemporary perspectives in COPD: Patient burden, the role of gender and
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trajectories of multimorbidity'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000626772700001
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usage-count-last-180-days: '4'
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usage-count-since-2013: '17'
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volume: '26'
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web-of-science-categories: Respiratory System
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year: '2021'
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