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The Relationship Between 24-Hour Symptoms and COPD Exacerbations and Healthcare Resource Use : Results from an Observational Study (ASSESS)

Miravitlles, Marc; Worth, Heinrich; Soler-Cataluña, Juan José; Price, David; De Benedetto, Fernando; Roche, Nicolas; Godtfredsen, Nina S.; van der Molen, Thys; Löfdahl, Claes Göran LU and Padullés, Laura, et al. (2016) In COPD: Journal of Chronic Obstructive Pulmonary Disease 13(5). p.561-568
Abstract

This observational study assessed the relationship between nighttime, early-morning and daytime chronic obstructive pulmonary disease (COPD) symptoms and exacerbations and healthcare resource use. COPD symptoms were assessed at baseline in patients with stable COPD using a standardised questionnaire during routine clinical visits. Information was recorded on exacerbations and healthcare resource use during the year before baseline and during a 6-month follow-up period. The main objective of the analysis was to determine the predictive nature of current symptoms for future exacerbations and healthcare resource use. 727 patients were eligible (65.8% male, mean age: 67.2 years, % predicted forced expiratory volume in 1 second: 52.8%); 698... (More)

This observational study assessed the relationship between nighttime, early-morning and daytime chronic obstructive pulmonary disease (COPD) symptoms and exacerbations and healthcare resource use. COPD symptoms were assessed at baseline in patients with stable COPD using a standardised questionnaire during routine clinical visits. Information was recorded on exacerbations and healthcare resource use during the year before baseline and during a 6-month follow-up period. The main objective of the analysis was to determine the predictive nature of current symptoms for future exacerbations and healthcare resource use. 727 patients were eligible (65.8% male, mean age: 67.2 years, % predicted forced expiratory volume in 1 second: 52.8%); 698 patients (96.0%) provided information after 6 months. Symptoms in any part of the day were associated with a prior history of exacerbations (all p <0.05) and nighttime and early-morning symptoms were associated with the frequency of primary care visits in the year before baseline (both p <0.01). During follow-up, patients with baseline symptoms during any part of the 24-hour day had more exacerbations than patients with no symptoms in each period (all p <0.05); there was also an association between 24-hour symptoms and the frequency of primary care visits (all p ≤ 0.01). Although there was a significant association between early-morning and daytime symptoms and exacerbations during follow-up (both p <0.01), significance was not maintained when adjusted for potential confounders. Prior exacerbations were most strongly associated with future risk of exacerbation. The results suggest 24-hour COPD symptoms do not independently predict future exacerbation risk.

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publication status
published
subject
keywords
Cohort, exacerbation risk, morning symptoms, nighttime symptoms, prospective, retrospective, COPD
in
COPD: Journal of Chronic Obstructive Pulmonary Disease
volume
13
issue
5
pages
8 pages
publisher
Taylor & Francis
external identifiers
  • Scopus:84961197661
ISSN
1541-2555
DOI
10.3109/15412555.2016.1150447
language
English
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yes
id
a77f2eb4-3f15-4eec-a75f-3c0ee3c7b88a
date added to LUP
2016-05-18 16:24:26
date last changed
2016-10-21 10:45:39
@misc{a77f2eb4-3f15-4eec-a75f-3c0ee3c7b88a,
  abstract     = {<p>This observational study assessed the relationship between nighttime, early-morning and daytime chronic obstructive pulmonary disease (COPD) symptoms and exacerbations and healthcare resource use. COPD symptoms were assessed at baseline in patients with stable COPD using a standardised questionnaire during routine clinical visits. Information was recorded on exacerbations and healthcare resource use during the year before baseline and during a 6-month follow-up period. The main objective of the analysis was to determine the predictive nature of current symptoms for future exacerbations and healthcare resource use. 727 patients were eligible (65.8% male, mean age: 67.2 years, % predicted forced expiratory volume in 1 second: 52.8%); 698 patients (96.0%) provided information after 6 months. Symptoms in any part of the day were associated with a prior history of exacerbations (all p &lt;0.05) and nighttime and early-morning symptoms were associated with the frequency of primary care visits in the year before baseline (both p &lt;0.01). During follow-up, patients with baseline symptoms during any part of the 24-hour day had more exacerbations than patients with no symptoms in each period (all p &lt;0.05); there was also an association between 24-hour symptoms and the frequency of primary care visits (all p ≤ 0.01). Although there was a significant association between early-morning and daytime symptoms and exacerbations during follow-up (both p &lt;0.01), significance was not maintained when adjusted for potential confounders. Prior exacerbations were most strongly associated with future risk of exacerbation. The results suggest 24-hour COPD symptoms do not independently predict future exacerbation risk.</p>},
  author       = {Miravitlles, Marc and Worth, Heinrich and Soler-Cataluña, Juan José and Price, David and De Benedetto, Fernando and Roche, Nicolas and Godtfredsen, Nina S. and van der Molen, Thys and Löfdahl, Claes Göran and Padullés, Laura and Ribera, Anna},
  issn         = {1541-2555},
  keyword      = {Cohort,exacerbation risk,morning symptoms,nighttime symptoms,prospective,retrospective,COPD},
  language     = {eng},
  month        = {02},
  number       = {5},
  pages        = {561--568},
  publisher    = {ARRAY(0xb7da9f0)},
  series       = {COPD: Journal of Chronic Obstructive Pulmonary Disease},
  title        = {The Relationship Between 24-Hour Symptoms and COPD Exacerbations and Healthcare Resource Use : Results from an Observational Study (ASSESS)},
  url          = {http://dx.doi.org/10.3109/15412555.2016.1150447},
  volume       = {13},
  year         = {2016},
}