High burden of symptoms reported among patients diagnosed with chronic obstructive pulmonary disease (COPD) in Greenland after introducing the COPD Assessment Test in clinical practice

ABSTRACTThe aim was to test the internal consistency of the Greenlandic version of the COPD Assessment Test (CAT) questionnaire and to estimate the symptom burden in patients with chronic obstructive pulmonary disease (COPD) in Greenland using the CAT questionnaire. A Greenlandic version of the CAT questionnaire was developed including forward translation, reconciliation, backwards translation, and pilot test. Afterwards, a cross-sectional study of patients with COPD was conducted. The internal consistency assessed by the Cronbach α coefficient was 0.823 for the Greenlandic version of the questionnaire (n = 103). The CAT was negatively correlated to spirometry values and current smoking. In the cross-sectional study (n = 250), 81.1% of the patients experienced a high symptom burden (≥10). The main CAT score was 17 (range 0–38). The CAT was used in 9 out of 17 towns in Greenland. The Greenlandic version of the CAT questionnaire demonstrated a good internal consistency. We observed a high burden of symptoms associated with reduced lung function and active smoking status among patient diagnosed with COPD in Greenland. The questionnaire can be used in clinical practice for assessment of symptom burden in patients with COPD in Greenland and may help to increase focus on symptom control and quality of care

Frequent use of primary health care service in Greenland: an opportunity for undiagnosed disease case-finding

Objectives. To estimate the age- and gender-specific consultation rates of patients who availed primary health care service in Greenland and to analyse contact patterns among patients in Nuuk. Design. Observational and cross-sectional register study using data captured from the medical records. Materials and methods. The number of patients specified by age and gender who had contacted the primary health care centres within the last year was identified using a statistic module applied to the electronic medical records system. The population as it was on the 1st of January 2011 was used as the background population. The age- and gender-specific consultation rates were calculated. Review of most recent contact was performed in a subsample of patients from Nuuk, and information of the type of contact and diagnoses was obtained. Results. Eighty-three percent of the population in Greenland had been in contact with the primary health care centre within the last year. Females were more frequent users than males. A subsample of 400 patients in Nuuk was identified. Personal contact was the most frequent type of consultation (75.8%), followed by telephone (14.8%) and e-mail (9.8%) consultations. Musculoskeletal symptoms accounted for the most frequent bases for diagnoses. Conclusion. More than 80% of the whole population has been in contact with the primary health care system within the last year. This indicates that opportunistic case-finding of chronic diseases such as diabetes, hypertension, etc. providing a possible strategy for decreasing the number of undiagnosed cases