Advanced

Relationship between respiratory symptoms and medical treatment in exacerbations of COPD

Calverley, P; Pauwels Dagger, R; Löfdahl, Claes-Göran LU ; Svensson, K; Higenbottam, T; Carlsson, L-G and Ståhl, Erik LU (2005) In European Respiratory Journal 26(3). p.406-413
Abstract
Exacerbations of chronic obstructive pulmonary disease (COPD) can be defined symptomatically or by healthcare contacts, yet the relationship between these events is unknown. Data were collected during a 1-yr study of the budesonide/formoterol combination in COPD patients, where exacerbations, defined by increases in treatment, were compared with daily records of respiratory symptoms, rescue medication use and peak expiratory flow (PEF). The relationship between changes in these variables and the medical event was examined using different modelling approaches. Data from the first exacerbation treated with oral corticosteroids and/or antibiotics and/or hospitalisation (event based) were available in 468 patients. Patients exacerbating were... (More)
Exacerbations of chronic obstructive pulmonary disease (COPD) can be defined symptomatically or by healthcare contacts, yet the relationship between these events is unknown. Data were collected during a 1-yr study of the budesonide/formoterol combination in COPD patients, where exacerbations, defined by increases in treatment, were compared with daily records of respiratory symptoms, rescue medication use and peak expiratory flow (PEF). The relationship between changes in these variables and the medical event was examined using different modelling approaches. Data from the first exacerbation treated with oral corticosteroids and/or antibiotics and/or hospitalisation (event based) were available in 468 patients. Patients exacerbating were significantly more breathless and more likely to report cough than healthy patients, but did not differ in baseline spirometry. Exacerbations defined by changes in individual symptoms were only weakly related to event-based exacerbations; however, defined with 63% of such events being predicted from symptom changes. Changes in rescue medication use or PEF were poor predictors of event-based exacerbations. The mean peak change in symptoms was closely related to the onset of therapy. In conclusion, event-based exacerbations are a valid way of identifying acute symptom change in a chronic obstructive pulmonary disease population. However, daily symptom monitoring is too variable using the current diary cards to make individual management decisions. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Chronic obstructive pulmonary disease, concurrence, events, exacerbations, symptoms
in
European Respiratory Journal
volume
26
issue
3
pages
406 - 413
publisher
Eur Respiratory Soc
external identifiers
  • pmid:16135720
  • wos:000231844000008
  • scopus:24644458820
ISSN
1399-3003
DOI
10.1183/09031936.05.00143404
language
English
LU publication?
yes
id
794f562f-c9ad-46fe-a17d-036d617d0d8f (old id 1133430)
date added to LUP
2008-06-24 15:05:02
date last changed
2017-10-29 03:32:35
@article{794f562f-c9ad-46fe-a17d-036d617d0d8f,
  abstract     = {Exacerbations of chronic obstructive pulmonary disease (COPD) can be defined symptomatically or by healthcare contacts, yet the relationship between these events is unknown. Data were collected during a 1-yr study of the budesonide/formoterol combination in COPD patients, where exacerbations, defined by increases in treatment, were compared with daily records of respiratory symptoms, rescue medication use and peak expiratory flow (PEF). The relationship between changes in these variables and the medical event was examined using different modelling approaches. Data from the first exacerbation treated with oral corticosteroids and/or antibiotics and/or hospitalisation (event based) were available in 468 patients. Patients exacerbating were significantly more breathless and more likely to report cough than healthy patients, but did not differ in baseline spirometry. Exacerbations defined by changes in individual symptoms were only weakly related to event-based exacerbations; however, defined with 63% of such events being predicted from symptom changes. Changes in rescue medication use or PEF were poor predictors of event-based exacerbations. The mean peak change in symptoms was closely related to the onset of therapy. In conclusion, event-based exacerbations are a valid way of identifying acute symptom change in a chronic obstructive pulmonary disease population. However, daily symptom monitoring is too variable using the current diary cards to make individual management decisions.},
  author       = {Calverley, P and Pauwels Dagger, R and Löfdahl, Claes-Göran and Svensson, K and Higenbottam, T and Carlsson, L-G and Ståhl, Erik},
  issn         = {1399-3003},
  keyword      = {Chronic obstructive pulmonary disease,concurrence,events,exacerbations,symptoms},
  language     = {eng},
  number       = {3},
  pages        = {406--413},
  publisher    = {Eur Respiratory Soc},
  series       = {European Respiratory Journal},
  title        = {Relationship between respiratory symptoms and medical treatment in exacerbations of COPD},
  url          = {http://dx.doi.org/10.1183/09031936.05.00143404},
  volume       = {26},
  year         = {2005},
}