Asthma COPD overlap versus COPD alone in Australian primary care

Michael Abramson, Gabriel Izbicki, Valerie Teo, Jenifer Liang, Grant Russell, Anne Holland, Nicholas Zwar, Billie Bonevski, Ajay Mahal, Paula Eustace, Eldho Paul, Kirsten Phillips, Sally Wilson, J George

Research output: Contribution to journalMeeting Abstractpeer-review


Introduction: Many older adults with a history of smoking and asthma develop clinical features of both asthma and COPD, an entity now named Asthma-COPD Overlap (ACO) syndrome. People with ACO are at higher risk of poor health outcomes than patients with asthma or COPD alone. However understanding of ACO is limited, and more information is needed about its clinical and physiological characteristics to better inform patient management. Aim: We aimed to compare the demographic characteristics, self-reported dyspnoea, quality of life and lung function between ACO and COPD, in adult long-term smokers or former smokers (≥10 pack years) from Australian general practices participating in a trial of an interdisciplinary community-based model of care.Methods: We used data from the RADICALS (Review of Airway Dysfunction and Interdisciplinary Community-based care of Adult Long-term Smokers) trial. Baseline characteristics, pre- and post-bronchodilator spirometry, dyspnoea scores and St. George's Respiratory Questionnaire scores were compared between 60 ACO patients and 212 with COPD alone. ACO was defined by bronchodilator reversibility.Results: Pre-bronchodilator values of FEV1 (mean±SD 58.4 ± 14.3 vs 67.5 ± 20.1 %predicted) and FVC (mean 82.1 ± 16.9 vs 91.9 ± 17.2 %predicted) were significantly lower in the ACO group (P < 0.001), but no difference was found in post-bronchodilator spirometry. Demographic and clinical characteristics, dyspnoea, quality of life, comorbidities and treatment prescribed did not differ significantly between groups.Conclusion: This study has described ACO in Australian general practices. Our finding of lower pre-bronchodilator lung function in ACO patients compared to COPD, provides further reinforcement to the importance of spirometry in primary care to inform the selection of pharmacotherapy/ management.
Original languageEnglish
Pages (from-to)36
Number of pages1
Issue numberS1
Publication statusPublished - Mar 2019
Externally publishedYes
EventAustralia and New Zealand Society of Respiratory Science and Thoracic Society of Australia and New Zealand (ANZSRS/TSANZ) Annual Scientific Meeting 2019 - Gold Coast Convention and Exhibition Centre, Gold Coast, Australia
Duration: 29 Mar 20192 Apr 2019


  • Asthma-COPD Overlap (ACO) syndrome
  • Asthma
  • COPD
  • long-term smokers


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