Zusammenfassung
Die chronisch obstruktive Lungenkrankheit (COPD) ist eine häufig unterdiagnostizierte Volkskrankheit mit erheblicher Morbidität, Mortalität und volkswirtschaftlicher sowie sozialmedizinischer Bedeutung. Nach den Empfehlungen der Weltgesundheitsorganisation (WHO) sind die Voraussetzungen für die Durchführung eines sinnvollen Screenings für die COPD bei 8 von 10 Kriterien erfüllt. Bei asymptomatischen Erwachsenen liegt allerdings bisher keine Evidenz vor, dass durch ein Screening auf COPD mittels Fragebögen und Lungenfunktionsprüfung Lebensqualität, Morbidität und/oder Prognose der gescreenten Personen verbessert wird. Bei über ein Screening diagnostizierten COPD-Patienten ist durch den Einsatz von Bronchodilatatoren mit und ohne inhalative Kortikosteroide zwar eine Reduktion der Exazerbationsraten zu erwarten, deren klinische Relevanz angesichts niedriger Exazerbationsraten bei Patienten mit gering- und mittelgradiger COPD ist aber fragwürdig. Somit ist ein kostenintensives Screening auf COPD für asymptomatische Patienten derzeit nicht von großem Nutzen.
Abstract
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality throughout the world. Due to widespread underrecognition and underdiagnosis screening for COPD would appear to be of economic and sociomedical benefit. According to the recommendations of the World Health Organization (WHO) the prerequisites for carrying out a meaningful screening for COPD are fulfilled with 8 out of 10 criteria; however, on the basis of the available literature data, there is no evidence that screening for COPD in asymptomatic adults including questionnaires and lung function tests using spirometry improves health-related quality of life, morbidity and mortality. In COPD patients diagnosed by screening, a reduction of the exacerbation rate is to be expected by the use of bronchodilators, with and without inhalative corticosteroids; however, the clinical relevance is questionable in view of the low exacerbation rate in patients with low and moderate grade COPD; therefore, a cost-intensive screening for COPD in asymptomatic persons currently has no net benefit.
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Worth, H., Kardos, P. Ist ein Screening auf COPD sinnvoll?. Pneumologe 14, 149–152 (2017). https://doi.org/10.1007/s10405-017-0106-1
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DOI: https://doi.org/10.1007/s10405-017-0106-1
Schlüsselwörter
- Chronisch obstruktive Lungenerkrankung
- Umfragen und Fragebögen
- Lungenfunktionstests
- Evidenzbasierte Medizin
- Outcome