The study consists of three sub-studies: A. a descriptive cross-sectional study "The
prevalence of COPD among socially vulnerable individuals who come in contact with a mobile
clinic" followed by study B a cohort study "The effect of opportunistic screening for COPD
among socially vulnerable individuals who come in contact with a mobile clinic", based on a
closed cohort, and study C "A qualitative study of patient experiences with screening and
treatment of COPD.
People in the lower social classes are at increased risk of developing COPD due to their
lifelong accumulation of risk factors, such as smoking, passive smoking and the influence of
lifestyle and the environment. In the group with the socially vulnerable individuals, 70% are
smokers compared to 18% in the general Danish population. The socially vulnerable individuals
are defined here as people affected by homelessness, drug abuse, harmful alcohol consumption,
mental illness and poverty. Despite the socially vulnerable group having an over-consumption
of general practice visits, 25% of socially vulnerable individuals state that they do not
have contact with or use their own doctor. Our hypothesis is therefore that there will be a
higher incidence of COPD among socially vulnerable persons who come in contact with the
mobile clinic. Purpose: To investigate and describe the prevalence of COPD among socially
vulnerable individuals who come in contact with a mobile clinic and to investigate the effect
of opportunistic screening for COPD in these vulnerable citizens, followed by a qualitative
study of patient experiences with COPD treatment.
Data collection:
Baseline data from the cross-sectional study are derived from lung function measurement and
REDCap online-questionnaires completed on inclusion. The data from the cohort study regarding
disease burden and hospital visits originates from the national patient registry (LPR) and
mortality data is retrieved from the Danish Register of Causes of Death. Data regarding
redeemed prescriptions for COPD medicine originates from the Prescription Database. The
patients' connection to the job market and income status are based on extracts from RAS
(Registry-based Labour Force Statistics), which is administered by Statistics Denmark. Data
regarding the highest acquired education (HFAUDD) is from Statistics Denmark.
Variables:
There will be collected the following variables at inclusion: information on demographics,
lung function, selv-reported information on: risk factors, socioeconomic variables and
symptoms of lung disease. Moreover register data on socioeconomic status, morbidity, physical
health by Charlson score, mortality, hospital visits and prescriptions for COPD Medicine will
be retrieved after a 1 year follow-up.
Sample size:
To detect a difference between the patient group and the Danish population of minimum 100% a
total of 511 participants are needed in the study (power of 80%, p-values=0,05, an estimated
COPD prevalence of 4,3% in the Danish population). The collected data will be kept in
accordance to the Data Protection Agency guidelines. The studies are carried out in
accordance with the principles of the Helsinki Declaration.