Chronic Bronchitis

Although It Has A Negative Impact on Their Quality of Life, Many Seem To Be Resigned To Their Condition. Almost 2 in 5 Have Never Seen A Doctor or No Longer Do So When The Symptoms Present. They Say They Have Been Coughing For So Long - More Than 8 Years On Average - That They Have Become Used To It (80%) And They Believe, In Any Case, That There Is Not Much A Doctor Can Do (72%)

Toronto, ON - The results of an Ipsos-Reid/Janssen-Ortho Inc survey released today show that chronic bronchitis, which is a largely preventable disease since most sufferers are current or ex-smokers, has a very negative effect on quality of life. Most experience shortness of breath when they "climb a hill" (77%), walk faster than normal (68%) and even climb just a few steps (54%). Many find that their condition interferes with their sleep (71%) and family activities (40%). Some have found that their symptoms were severe enough on occasion to prevent them from leaving their homes (24%). One in six (17%) have lost time from work because of their cough. A surprisingly high percentage (9%) have even had to change their jobs because of it. Despite this, many do not appear to believe that doctors can do much for them.

These are the findings of an Ipsos-Reid/Janssen-Ortho survey; conducted between January 22nd to February 4th, 2001. The poll is based on a randomly selected sample of 400 sufferers of the symptoms of chronic bronchitis aged 40 to 75. Chronic bronchitis is defined as having had, for 2 years or more, periods of persistent cough, that occur on a daily or almost daily basis, that usually brings up mucous, and lasts 3 months or more. With a sample of this size, the results are considered accurate to within 177 4.9 percentage points, 19 times out of 20, of what they would have been had the entire adult Canadian population been polled. The sample was balanced regionally, using 1996 Census data to ensure that each of the major regions of the country was reflected proportionately.

Prior to this study, a survey of 2,000 randomly selected Canadians aged 18 and over was conducted to measure the prevalence of chronic bronchitis in the general population. The field dates for this survey were January 23rd to February 1st, 2001. The data were weighted by gender, age and region to match 1996 Census data. With a sample of this size, the results are considered accurate to within 1772.2 percentage points, 19 times out of 20, of what they would have been had the entire adult Canadian population been polled.

The following are the survey highlights.

"Chronic" Is Apt Terminology...

Sufferers tend to be current or ex-smokers. Two in three say they are exposed in their daily lives to dust, smoke or fumes (57%). They have suffered the symptoms for nearly ten years on average (9.8). In addition to chronic bronchitis, many have heart problems, such as high blood pressure or angina (46%). Most have breathing difficulties when climbing a hill (77%), when accelerating from "normal pace of walking", (68%), and when "climbing stairs or steps at your normal pace" (54%). Many also experience shortness of breath when doing chores at home such as vacuuming or putting out garbage (39%).

Skepticism About Doctors' Role is Rife...

One in three sufferers say they see their doctor regularly for their cough (31%) and 30 percent "still consult but not regularly". However 21 percent say they have consulted a doctor about these persistent coughs in the past, but do not do so anymore and 18 percent have "never consulted" a doctor. This means that nearly two in five (39%) sufferers do not see a doctor for their bronchitis symptoms.

Complacency appears to be the main reason for never having seen a doctor. Three in ten (31%) say they have "just a smoker's cough" (31%), 27 percent say it is "not that bad" and 17 percent say they have "stopped worrying about it". On the other hand, the perception that their doctor "was not helpful" (31%) is the major reason why 21 percent are lapsed consulters.

It's One Thing To Advise Smokers To Quit, Quite Another To Comply...

The sufferers who had seen a doctor were questioned about how they were first treated for their cough. Most said they were prescribed medication (70%) and almost all complied with this (97%). Almost half were advised to quit smoking (44%), however less than two in five (37%) followed this advice. Although most expressed satisfaction with the help their doctor gave them (79%), 20 percent felt that their doctor could have done more, such as conduct or order more tests, or refer them to a specialist.

Access To A Doctor is Another Problem...

Just over half said that they can generally see a doctor "right away" for their cough (55%), however the remainder estimated that it took three days. One-quarter (26%) of the entire sample expressed dissatisfaction with the length of time it takes for them to see their doctor. Moreover, 17 percent said that in the past they had, on at least one occasion, to go to a walk-in clinic or hospital ER because they were unable to get an appointment with their doctor quickly enough.

Self-Medicating is Common...

On the most recent visit to a doctor, 80 percent were prescribed medication, of these 50 percent were prescribed an antibiotic, 24 percent a bronchodilator and 21 percent a steroid. For the most part they felt that their medication was effective (78% - 80% depending on the medication). Two in five (41%) stated that they bought an over-the-counter (OTC) remedy independent of their doctor, when they last had an outbreak of symptoms. They gave a qualified endorsement of OTC medications; while the majority claimed that this had been effective (80%), the emphasis was on "somewhat" effective (59%), as opposed to "very" effective (21%).

Those taking an OTC medicine estimated spending close to $70.00 in the past 12 months on these remedies ($69.30) and those taking prescription medicine estimated spending $165.20 on this over the same time period.

Chronic Bronchitis Has an Economic As Well As Social Cost...

The impact on work and lifestyle of chronic bronchitis can be summarized as follows:

Go to work on one or more occasions:

• Unable at all: 17%
• Ability affected: 20%

Carry out daily activities at home on one or more occasions:

• Unable at all: 23%
• Ability affected: 32%

Leave the house on one or more occasions:

• Unable at all: 24%
• Ability affected: 26%

Attend social or family events on one or more occasions:

• Unable at all: 21%
• Ability affected: 26%

It should be noted that 9% claimed to have changed their job largely as a result of their persistent cough.

The respondents were read a list of statements and for each asked if they agreed or disagreed with it, strongly or moderately. The following conclusions about the mind-set of sufferers of chronic bronchitis may be drawn. The results below show the percentages (in brackets) of those who agree strongly or moderately with each statement.

Complacency is Evident...

• I have been coughing like this for so long I am used to it (72%)
• I am so used to coughing that it doesn't really bother me (52%)

Many Misunderstand the Seriousness of Their Condition...

• It is just a cough caused by smoke, dust and pollution in the environment, not a medical problem as such (48%).
• I am not worried about my cough because it is just a smoker's cough (26%).
• I have found that there are non-prescription medicines that effectively treat my cough (38%).

On the Other Hand, Many Underscore the Earlier Findings That Chronic Bronchitis Has A Negative Effect on Quality of Life...

• My coughing negatively affects my quality of life (54%).
• When in company I am embarrassed sometimes by my coughing (53%).

And Many, Moreover, Feel Concerned About Their Condition Themselves, or Admit That Family Members are Concerned About Their Condition...

• My cough worries me (51%).
• I should go more frequently to my doctor for check ups (40%).
• Close family members or friends tend to nag me to see a doctor about my cough (40%).
• Close family members or friends tend to nag me to quit smoking (33%).

However There is Considerable Reluctance To Go See A Doctor and Skepticism About How Helpful A Doctor Can Be in Any Case...

• I try to avoid taking medications for my cough, unless I absolutely have to (81%).
• There is not much a doctor can do for my cough (58%).
• I don't like to ask a doctor for help with my cough (42%).
• Doctors are too busy to spend time to really get to know their patient's medical problems (45%).

Working Up the Numbers...

The following extrapolations use the survey data to estimate the number of sufferers in the general population aged 40 to 75. They are based on an assumption of ~12,000,000 Canadians aged 40 to 75 (Statistics Canada 2000 estimates).

• There are 1,080,000 sufferers aged 40 to 75.
• There are 421,000 non-consulting sufferers, 231,000 of whom will not see their physicians about the persistent coughs they suffer.
• There have been approximately 112,000 visits to clinics/emergency departments due to not getting a doctor's appointment quickly enough.
• Hospitals have allocated approximately 390,000 days to these sufferers.
• 442,000 sufferers used an OTC product.
• Sufferers have spent approximately $30,000,000 on OTC medications in the past 12 months.
• Sufferers have spent approximately $34,000,000 on prescription drugs in the past 12 months.
• 97,000 sufferers have changed their jobs due to their cough.

For more information on this news release, please contact:

Alistair Cosby
Vice President
Health Care
Ipsos-Reid
(514) 877-5550