Abstract
AIMS To estimate the prevalence of chronic obstructive pulmonary disease (COPD) and related risk factors in persons in opioid agonist treatment (OAT), to compare airflow limitation severity and age-specific COPD prevalence rates with those in the general population, and to assess the OAT patients' willingness to adopt lifestyle changes and to use therapeutic offers for COPD management.
DESIGN Cross-sectional study in a random sample of OAT patients.
SETTING Outpatient centres for substance addiction medicine in Zurich, Switzerland.
PARTICIPANTS A total of 125 participants, recruited from November 2016 to April 2017 through invitation letters followed by phone or personal contact.
MEASUREMENTS Standardised questionnaires about drug use, smoking habits, and medical history, filled in during face-to-face interviews or from medical records. Spirometry without and-depending on the result-with bronchodilation.
FINDINGS Almost one third (30.3%; 95% CI: 22.6%-39.0%) of the 119 participants with valid spirometry tests were diagnosed with COPD. Among males of 30-59 years, the age-adjusted prevalence of at least moderate airflow limitation (GOLD grade ≥ 2) was 2.4 (95% CI: 1.3-4.4) times as high as in the ever-smoking Swiss population in the same age group. Smoking tobacco (92.0%) and substance inhalation (cannabis: 97.6%, cocaine: 69.6%, heroin: 68.0%) were highly prevalent among all participants. The participants expressed considerable interest in lifestyle changes and use of therapeutic offers for COPD management, with smoking cessation being least (20.2% of tobacco smokers interested), and pharmacological treatment to alleviate COPD symptoms most popular.
CONCLUSIONS In Switzerland, chronic obstructive pulmonary disease (COPD) and multiple risk factors for COPD appear to be high among people in opioid agonist treatment (OAT) compared with the general population. OAT patients appear to develop COPD at a younger average age compared with the general population and are open to lifestyle changes and other COPD management approaches.
Grischott, Thomas