Washington, Mar 10: Social and demographic inequalities may play a significant role in determining how severely patients are affected by chronic obstructive pulmonary disease (COPD), according to a large study conducted in the United States.
The research, which analysed clinical records of nearly 60,000 adults aged between 50 and 80 years diagnosed with COPD, found that patients can be grouped into distinct disease patterns, or phenotypes, that are strongly associated with healthcare use and survival outcomes.
COPD is a long-term respiratory condition that causes persistent breathing difficulties and is typically diagnosed through lung function tests.
However, researchers say patients with similar levels of airflow limitation often experience very different symptoms, complications and risks.Using a statistical method known as latent class analysis, researchers identified five different COPD phenotypes based on indicators such as emergency department visits, hospital admissions, existing health conditions and use of intensive inhaled therapies.
Most patients were classified in minimal or mild disease categories. However, nearly one in ten patients fell into a very severe phenotype group characterised by frequent reliance on emergency and inpatient care.
Patients in this very severe group also had significantly poorer survival outcomes. Even after adjusting for clinical and demographic factors, they were found to have almost three times the risk of death compared with those in the minimal disease group.
The study also revealed strong links between COPD severity and social determinants of health. Black and Hispanic patients were more likely to belong to the very severe phenotype group than non-Hispanic White patients.
Higher risks were also observed among individuals living in lower-income neighbourhoods, people residing in rural areas and those who currently smoke.Researchers said the findings suggest that social and structural factors may influence how COPD progresses and how patients access and use healthcare services, beyond what can be explained by lung function tests alone.
The study highlights the potential of using routinely collected clinical data to identify high-risk COPD patients and improve treatment strategies.Experts say the results also underline the importance of addressing broader health inequalities through measures such as improving access to healthcare, strengthening smoking cessation programmes and directing resources to disadvantaged and rural communities to reduce the burden of severe COPD.
