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Primary care burden and treatment of patients with heart failure and chronic obstructive pulmonary disease in Scotland


Hawkins, NM and Jhund, PS and Simpson, CR and Petrie, MC and MacDonald, MR and Dunn, FG and Macintyre, K and McMurray, JJV, Primary care burden and treatment of patients with heart failure and chronic obstructive pulmonary disease in Scotland, The European Journal of Heart Failure, 12, (1) pp. 17-24. ISSN 1388-9842 (2010) [Refereed Article]

Copyright Statement

Copyright 2010 Elsevier

DOI: doi:10.1093/eurjhf/hfp160


AIMS: Heart failure (HF) and chronic obstructive pulmonary disease (COPD) frequently coexist and present major challenges to healthcare providers. The epidemiology, consultation rate, and treatment of patients with HF and COPD in primary care are ill-defined.

METHODS AND RESULTS: This was an analysis of cross-sectional data from 61 primary care practices (377 439 patients) participating in the Scottish Continuous Morbidity Recording scheme. The prevalence of COPD in patients with HF increased from 19.8% in 1999 to 23.8% in 2004. In 2004, the prevalence was similar in men and women (24.8% vs. 22.9%, P = 0.09), increased with age up to 75 years, and increased with greater socioeconomic deprivation (most deprived 31.3% vs. least deprived 18.6%, P = 0.01). Contact rates for HF or COPD in those with both conditions were greater than disease-specific contact rates in patients with either condition alone. Although overall beta-blocker prescribing increased over time; the adjusted odds of beta-blocker prescription in patients with COPD was low and failed to improve [odds ratio 0.30 (0.28-0.32), P < 0.001]. In 2004, only 18% of individuals with HF and COPD were prescribed beta-blockers vs. 41% in those without COPD.

CONCLUSION: Chronic obstructive pulmonary disease is a frequent comorbidity in patients with HF and represents a significant healthcare burden to primary care. Although beta-blocker prescribing in the community has increased, less than a fifth of patients with HF and COPD received beta-blockers.

Item Details

Item Type:Refereed Article
Keywords:Beta-blockers; Chronic obstructive pulmonary disease; Heart failure
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Macintyre, K (Dr Kate Macintyre)
ID Code:95687
Year Published:2010
Web of Science® Times Cited:73
Deposited By:Medicine
Deposited On:2014-10-07
Last Modified:2014-11-11

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