Factors Associated with Patient Education in Patients with Chronic Obstructive Pulmonary Disease (COPD) – A Primary Health Care Register-Based Study

Abstract

Purpose

Patient education in chronic obstructive pulmonary disease (COPD) is recommended in treatment strategy documents, since it can improve the ability to cope with the disease. Our aim was to identify the extent of and factors associated with patient education in patients with COPD in a primary health care setting.

Patients and Methods

In this nationwide study, we identified 29,692 COPD patients with a registration in the Swedish National Airway Register (SNAR) in 2019. Data on patient education and other clinical variables of interest were collected from SNAR. The database was linked to additional national registers to obtain data about pharmacological treatment, exacerbations and educational level.

Results

Patient education had been received by 44% of COPD patients, 72% of whom had received education on pharmacological treatment including inhalation technique. A higher proportion of patients who had received education were offered smoking cessation support, had performed spirometry and answered the COPD Assessment Test (CAT), compared with patients without patient education. In the adjusted analysis, GOLD grade 2 (OR 1.29, 95% CI 1.18–1.42), grade 3 (OR 1.41, 95% CI 1.27–1.57) and grade 4 (OR 1.79, 95% CI 1.48–2.15), as well as GOLD group E (OR 1.17, 95% CI 1.06–1.29), ex-smoking (OR 1.70, 95% CI 1.56–1.84) and current smoking (OR 1.45, 95% CI 1.33–1.58) were positively associated with having received patient education, while cardiovascular disease (OR 0.92, 95% CI 0.87–0.98) and diabetes (OR 0.93, 95% CI 0.87–1.00) were negatively associated with receipt of patient education.

Conclusion

Fewer than half of the patients had received patient education, and the education had mostly been given to those with more severe COPD, ex- and current smokers and patients with fewer comorbidities. Our study highlights the need to enhance patient education at an earlier stage of the disease.

Keywords:

• chronic obstructive pulmonary disease
• inhaler use
• patient education
• primary health care
• register study

Acknowledgment

Acknowledgement is given to all the patients and health care professionals who contribute with registrations in SNAR. Further acknowledgements are given to the SNAR steering committee and register coordinators.

Disclosure

CS reports personal fees from AstraZeneca, and institutional fees from Chiesi and TEVA outside the submitted work. MG reports personal fees from AstraZeneca, Boehringer Ingelheim and OrionPharma outside the submitted work. AL reports personal fees from GlaxoSmithKline, outside the submitted work. KT, ABZ, EW have no conflicts of interest to disclose in this work.

Additional information

Funding

This work was supported by the Swedish Heart-Lung Foundation under Grant 20200548.