Original Articles
Treatment of Chronic Obstructive Pulmonary Disease in 5 Latin American Cities: The PLATINO Study
María Victorina López Varelaa,
, Adriana Muiñoa, Rogelio Pérez Padillab, José Roberto Jardimc, Carlos Tálamod, María Montes de Ocad, Gonzalo Valdiviae, Julio Pertuzée, Ron Halbertf, Ana María Menezesg, the PLATINO Group *
Corresponding author
mlopez@chasque.net
Correspondence: Dr MV López Varela Facultad de Medicina, Universidad de la República 21 de Septiembre 2353/301. 11200 Montevideo, Uruguay
Correspondence: Dr MV López Varela Facultad de Medicina, Universidad de la República 21 de Septiembre 2353/301. 11200 Montevideo, Uruguay
a Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
b Instituto de Enfermeades Respiratorias, Ciudad de México, Mexico
c Facultad de Medicina, Universidad Federal de São Paulo, São Paulo, Brazil
d Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela
e Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
f UCLA School of Public Health, Los Angeles, California, USA
g Programa de Posgraduación en Epidemiología, Universidad Federal de Pelotas, Pelotas, Brazil
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"correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr MV López Varela Facultad de Medicina, Universidad de la República 21 de Septiembre 2353/301. 11200 Montevideo, Uruguay" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-01-26" "fechaAceptado" => "2007-06-05" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155150" "palabras" => array:4 [ 0 => "Chronic obstructive pulmonary disease (COPD)" 1 => "Population-based study" 2 => "Preventive treatment" 3 => "Respiratory medication" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155151" "palabras" => array:4 [ 0 => "Enfermedad pulmonar obstructiva crónica (EPOC)" 1 => "Estudio poblacional" 2 => "Tratamiento preventivo" 3 => "Medicación respiratoria" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">PLATINO is a population-based study designed to determine the prevalence of chronic obstructive pulmonary disease (COPD) in São Paulo, Brazil; Mexico City, Mexico; Montevideo, Uruguay; Santiago de Chile, Chile; and Caracas, Venezuela. The objective of this portion of PLATINO was to describe preventive and pharmacological treatment of COPD patients and factors associated with such treatment.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Eligible subjects completed a questionnaire and underwent postbronchodilator spirometry.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Of the total of 5529 individuals who answered items referring to treatment, 758 had COPD (ratio of postbronchodilator forced expiratory volume in 1 second to forced vital capacity of <0.7), and 86 of them had been previously diagnosed by a physician. Among all COPD patients, only half of smokers or former smokers had been advised to quit and 24.7% had received some type of respiratory medication. Only 13.5% had used inhaled corticosteroids, and those were the patients with the most severe disease. In the group of patients who had a prior medical diagnosis of COPD, 69% of the smokers or former smokers had been advised to quit by a physician and 75.6% had received respiratory medication in the preceding year: 43% reported having used inhaled medication and 36% had used bronchodilators. Rates of vaccination against influenza and the use of mucolytic drugs and inhalers varied from one health care facility to another. All drug prescriptions were based on previous spirometry.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Spirometry emerged not only as a diagnostic tool, but also as a factor associated with treatment, against a background of uneven use of available health care resources in these 5 Latin American cities.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">PLATINO es un estudio de base poblacional para medir la prevalencia de la enfermedad pulmonar obstructiva crónica (EPOC) en São Paulo (Brasil), Ciudad de México (México), Montevideo (Uruguay), Santiago de Chile (Chile) y Caracas (Venezuela). El objetivo ha sido describir el tratamiento preventivo y farmacológico en individuos con EPOC y los factores asociados al mismo.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Los sujetos elegibles completaron un cuestionario y realizaron una espirometría posbroncodilatador.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">De un total de 5.529 individuos con datos autorreferidos sobre tratamiento, se identificó como afectados de EPOC (relación volumen espiratorio forzado en el primer segundo/capacidad vital forzada < 0,7 posbroncodilatador) a 758, de los que 86 tenían diagnóstico médico previo. Considerando la totalidad de los pacientes con EPOC, sólo la mitad de los fumadores o exfumadores había recibido consejo antitabáquico y el 24,7% recibió algún tipo de medicación respiratoria. El uso de esteroides inhalados alcanzó un 13,5% de los individuos más graves. En el grupo de EPOC con diagnóstico médico previo, el 69% de los fumadores o exfumadores había recibido consejo médico para dejar de fumar y el 75,6% medicación respiratoria en el último año, un 43% de ellos por vía inhalada y un 36% broncodilatadores. La cobertura de vacunación antigripal y el uso de mucolíticos e inhaladores fueron variables en los distintos centros. Todas las prescripciones terapéuticas se asociaron a espirometría previa.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La espirometría surge no sólo como una herramienta diagnóstica, sino como factor asociado al tratamiento, en un contexto dispar de utilización de los recursos disponibles en estas 5 ciudades de América Latina.</p>" ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara">María Márquez, Pedro Hallal, Dolores Moreno, Fernanda Rosa, Aquiles Camelier.</p>" ] 1 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">Boehringer-Ingelheim financed the study, but had no role in the development of the protocol, the conduct of the study, or the preparation of the present manuscript.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic obstructive pulmonary disease surveillance—United States, 1971–2000" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "DM Mannino" 1 => "DM Homa" 2 => "LJ Akinbami" 3 => "ES Ford" 4 => "SC Redd" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "MMWR Surveill Summ" "fecha" => "2002" "volumen" => "51" "paginaInicial" => "1" "paginaFinal" => "16" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12529087" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Geographic variations in prevalence and underdiagnosis of COPD: results of the IBERPOC multicentre epidemiological study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "VS Pena" 1 => "M Miravitlles" 2 => "R Gabriel" 3 => "CA Jiménez-Ruiz" 4 => "C Villasante" 5 => "JF Masa" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2000" "volumen" => "118" "paginaInicial" => "981" "paginaFinal" => "989" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11035667" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "CJ Murray" 1 => "AD López" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(96)07492-2" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1997" "volumen" => "349" "paginaInicial" => "1498" "paginaFinal" => "1504" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9167458" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic obstructive pulmonary disease in five Latin American cities: The PLATINO study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "AM Menezes" 1 => "R Pérez-Padilla" 2 => "JR Jardim" 3 => "A Muiño" 4 => "MV Lopez" 5 => "G Valdivia" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(05)67632-5" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2005" "volumen" => "366" "paginaInicial" => "1875" "paginaFinal" => "1881" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16310554" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "GOLD Scientific Committee. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 3 | 8 |
| 2024 October | 27 | 17 | 44 |
| 2024 September | 26 | 19 | 45 |
| 2024 August | 38 | 36 | 74 |
| 2024 July | 27 | 23 | 50 |
| 2024 June | 40 | 25 | 65 |
| 2024 May | 37 | 33 | 70 |
| 2024 April | 18 | 23 | 41 |
| 2024 March | 22 | 14 | 36 |
| 2024 February | 16 | 19 | 35 |
| 2023 March | 3 | 4 | 7 |
| 2023 February | 13 | 14 | 27 |
| 2023 January | 16 | 30 | 46 |
| 2022 December | 29 | 45 | 74 |
| 2022 November | 21 | 33 | 54 |
| 2022 October | 21 | 37 | 58 |
| 2022 September | 16 | 28 | 44 |
| 2022 August | 19 | 34 | 53 |
| 2022 July | 14 | 51 | 65 |
| 2022 June | 16 | 40 | 56 |
| 2022 May | 20 | 39 | 59 |
| 2022 April | 23 | 42 | 65 |
| 2022 March | 15 | 44 | 59 |
| 2022 February | 18 | 34 | 52 |
| 2022 January | 13 | 30 | 43 |
| 2021 December | 15 | 51 | 66 |
| 2021 November | 14 | 50 | 64 |
| 2021 October | 23 | 46 | 69 |
| 2021 September | 24 | 55 | 79 |
| 2021 August | 28 | 30 | 58 |
| 2021 July | 13 | 28 | 41 |
| 2021 June | 30 | 21 | 51 |
| 2021 May | 19 | 23 | 42 |
| 2021 April | 32 | 39 | 71 |
| 2021 March | 36 | 30 | 66 |
| 2021 February | 8 | 16 | 24 |
| 2021 January | 13 | 11 | 24 |
| 2020 December | 8 | 8 | 16 |
| 2020 November | 15 | 11 | 26 |
| 2020 October | 8 | 7 | 15 |
| 2020 September | 9 | 7 | 16 |
| 2020 August | 11 | 10 | 21 |
| 2020 July | 15 | 14 | 29 |
| 2020 June | 3 | 4 | 7 |
| 2020 May | 18 | 17 | 35 |
| 2020 April | 15 | 19 | 34 |
| 2020 March | 14 | 9 | 23 |
| 2020 February | 40 | 18 | 58 |
| 2020 January | 33 | 19 | 52 |
| 2019 December | 37 | 11 | 48 |
| 2019 November | 20 | 7 | 27 |
| 2019 October | 5 | 3 | 8 |
| 2019 September | 23 | 12 | 35 |
| 2019 August | 7 | 6 | 13 |
| 2019 July | 10 | 13 | 23 |
| 2019 June | 9 | 7 | 16 |
| 2019 May | 10 | 7 | 17 |
| 2019 April | 23 | 32 | 55 |
| 2019 March | 8 | 13 | 21 |
| 2019 February | 14 | 14 | 28 |
| 2019 January | 8 | 9 | 17 |
| 2018 December | 11 | 17 | 28 |
| 2018 November | 19 | 13 | 32 |
| 2018 October | 27 | 21 | 48 |
| 2018 September | 18 | 11 | 29 |
| 2018 May | 6 | 0 | 6 |
| 2018 April | 7 | 5 | 12 |
| 2018 March | 4 | 4 | 8 |
| 2018 February | 6 | 7 | 13 |
| 2018 January | 7 | 6 | 13 |
| 2017 December | 6 | 10 | 16 |
| 2017 November | 4 | 8 | 12 |
| 2017 October | 7 | 9 | 16 |
| 2017 September | 6 | 8 | 14 |
| 2017 August | 11 | 13 | 24 |
| 2017 July | 15 | 15 | 30 |
| 2017 June | 12 | 11 | 23 |
| 2017 May | 4 | 4 | 8 |
| 2017 April | 4 | 5 | 9 |
| 2017 March | 4 | 26 | 30 |
| 2017 February | 4 | 2 | 6 |
| 2017 January | 2 | 8 | 10 |
| 2016 December | 6 | 4 | 10 |
| 2016 November | 9 | 6 | 15 |
| 2016 October | 11 | 9 | 20 |
| 2016 September | 13 | 11 | 24 |
| 2016 August | 17 | 8 | 25 |
| 2016 July | 17 | 6 | 23 |
| 2016 March | 3 | 0 | 3 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 43 | 13 | 56 |
| 2015 September | 49 | 10 | 59 |
| 2015 August | 41 | 10 | 51 |
| 2015 July | 53 | 9 | 62 |
| 2015 June | 37 | 12 | 49 |
| 2015 May | 50 | 13 | 63 |
| 2015 April | 59 | 13 | 72 |
| 2015 March | 55 | 6 | 61 |
| 2015 February | 38 | 7 | 45 |
| 2015 January | 32 | 5 | 37 |
| 2014 December | 36 | 5 | 41 |
| 2014 November | 48 | 9 | 57 |
| 2014 October | 55 | 10 | 65 |
| 2014 September | 39 | 6 | 45 |
| 2014 August | 33 | 8 | 41 |
| 2014 July | 33 | 9 | 42 |
| 2014 June | 54 | 6 | 60 |
| 2014 May | 47 | 14 | 61 |
| 2014 April | 54 | 5 | 59 |
| 2014 March | 51 | 13 | 64 |
| 2014 February | 50 | 15 | 65 |
| 2014 January | 46 | 6 | 52 |
| 2013 December | 37 | 8 | 45 |
| 2013 November | 41 | 5 | 46 |
| 2013 October | 36 | 10 | 46 |
| 2013 September | 36 | 12 | 48 |
| 2013 August | 42 | 8 | 50 |
| 2013 July | 38 | 9 | 47 |
| 2013 June | 46 | 9 | 55 |
| 2013 May | 37 | 7 | 44 |
| 2013 April | 15 | 9 | 24 |
| 2013 March | 6 | 1 | 7 |
Show all
