Perceptions about COPD by Patients and Physicians

Perceptions about COPD: Survey Results of Patients and Physicians

Background: Little is known whether patients with COPD and physicians have similar or different views about the disease. Study: Dr. Celli and colleagues reported on the results of two similar surveys
Dr. Celli is the first author of the study evaluating perceptions of COPD by patients and physicians

Bartolome Celli, M.D., of Brigham and Women’s Hospital

completed on-line. The aim was to compare potential differences between how COPD patients view their disease and how physicians view the disease that affects their patients. The study was published in the International Journal of COPD 2017; volume 12, pages 2189-2196. Results:  All participants lived in Germany, Italy. or Spain. There were 334 patients with COPD, 333 General Practitioners, and 333 pulmonary specialists. General COPD was regarded as a major health problem by both patients and physicians. Symptoms Physicians generally paid more attention to cough, sputum (coughing up mucus), and shortness of breath of patients, while patients paid more attention to feelings of chest tightness, wheezing, and tiredness. Honesty Almost 90% of patients declared that most of the time they were not completely frank and open with their doctors during visits. A smaller percentage of physicians had the same impression: 53% of general practitioners and 49% of pulmonary specialists thought that most of the time patients were not entirely truthful. Conclusions: The authors concluded about perceptions that: 1. patients should be more frank and honest reporting their symptoms and feelings, and 2. physicians should be more aware of other symptoms as well as the impact of COPD on leisure and social activities. My Comments: The lack of truthfulness by patients is quite puzzling if one assumes the goal of a visit with a physician is to deal with a medical problem and/or to optimize the person’s health. It is possible that patients may not be completely frank and open because of concerns of being judged or possibly disappointing their physician. This may be particularly relevant for someone who has COPD and continues to smoke.  

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.