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lObservational study to characterise 24-hour COPD symptoms and their relationship with patient-reported outcomes: results from the ASSESS study

Miravitlles, Marc; Worth, Heinrich; Soler Cataluna, Juan Jose; Price, David; De Benedetto, Fernando; Roche, Nicolas; Godtfredsen, Nina Skavlan; van der Molen, Thys; Löfdahl, Claes-Göran LU and Padulles, Laura, et al. (2014) In Respiratory Research 15.
Abstract
Background: Few studies have investigated the 24-hour symptom profile in patients with COPD or how symptoms during the 24-hour day are inter-related. This observational study assessed the prevalence, severity and relationship between night-time, early morning and daytime COPD symptoms and explored the relationship between 24-hour symptoms and other patient-reported outcomes. Methods: The study enrolled patients with stable COPD in clinical practice. Baseline night-time, early morning and daytime symptoms (symptom questionnaire), severity of airflow obstruction (FEV1), dyspnoea (modified Medical Research Council Dyspnoea Scale), health status (COPD Assessment Test), anxiety and depression levels (Hospital Anxiety and Depression Scale),... (More)
Background: Few studies have investigated the 24-hour symptom profile in patients with COPD or how symptoms during the 24-hour day are inter-related. This observational study assessed the prevalence, severity and relationship between night-time, early morning and daytime COPD symptoms and explored the relationship between 24-hour symptoms and other patient-reported outcomes. Methods: The study enrolled patients with stable COPD in clinical practice. Baseline night-time, early morning and daytime symptoms (symptom questionnaire), severity of airflow obstruction (FEV1), dyspnoea (modified Medical Research Council Dyspnoea Scale), health status (COPD Assessment Test), anxiety and depression levels (Hospital Anxiety and Depression Scale), sleep quality (COPD and Asthma Sleep Impact Scale) and physical activity level (sedentary, moderately active or active) were recorded. Results: The full analysis set included 727 patients: 65.8% male, mean +/- standard deviation age 67.2 +/- 8.8 years, % predicted FEV1 52.8 +/- 20.5%. In each part of the 24-hour day, > 60% of patients reported experiencing >= 1 symptom in the week before baseline. Symptoms were more common in the early morning and daytime versus night-time (81.4%, 82.7% and 63.0%, respectively). Symptom severity was comparable for each period assessed. Overall, in the week before baseline, 56.7% of patients had symptoms throughout the whole 24-hour day (3 parts of the day); 79.9% had symptoms in >= 2 parts of the 24-hour day. Symptoms during each part of the day were inter-related, irrespective of disease severity (all p < 0.001). Early morning and daytime symptoms were associated with the severity of airflow obstruction (p < 0.05 for both). Nighttime, early morning and daytime symptoms were all associated with worse dyspnoea, health status and sleep quality, and higher anxiety and depression levels (all p < 0.001 versus patients without symptoms in each corresponding period). In each part of the 24-hour day, there was also an association between symptoms and a patient's physical activity level (p < 0.05 for each period). Conclusions: More than half of patients experienced COPD symptoms throughout the whole 24-hour day. There was a significant relationship between night-time, early morning and daytime symptoms. In each period, symptoms were associated with worse patient-reported outcomes, suggesting that improving 24-hour symptoms should be an important consideration in the management of COPD. (Less)
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publication status
published
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keywords
Anxiety, ASSESS, COPD, Depression, Dyspnoea, Health status, Observational, Relationship, Sleep quality, Symptoms
in
Respiratory Research
volume
15
publisher
BioMed Central
external identifiers
  • wos:000346528900001
  • scopus:84978160689
ISSN
1465-9921
DOI
10.1186/s12931-014-0122-1
language
English
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yes
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0cc77c92-91ad-4565-a8c6-603e17aca841 (old id 4947681)
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2015-02-03 07:06:04
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2017-10-22 03:18:51
@article{0cc77c92-91ad-4565-a8c6-603e17aca841,
  abstract     = {Background: Few studies have investigated the 24-hour symptom profile in patients with COPD or how symptoms during the 24-hour day are inter-related. This observational study assessed the prevalence, severity and relationship between night-time, early morning and daytime COPD symptoms and explored the relationship between 24-hour symptoms and other patient-reported outcomes. Methods: The study enrolled patients with stable COPD in clinical practice. Baseline night-time, early morning and daytime symptoms (symptom questionnaire), severity of airflow obstruction (FEV1), dyspnoea (modified Medical Research Council Dyspnoea Scale), health status (COPD Assessment Test), anxiety and depression levels (Hospital Anxiety and Depression Scale), sleep quality (COPD and Asthma Sleep Impact Scale) and physical activity level (sedentary, moderately active or active) were recorded. Results: The full analysis set included 727 patients: 65.8% male, mean +/- standard deviation age 67.2 +/- 8.8 years, % predicted FEV1 52.8 +/- 20.5%. In each part of the 24-hour day, &gt; 60% of patients reported experiencing &gt;= 1 symptom in the week before baseline. Symptoms were more common in the early morning and daytime versus night-time (81.4%, 82.7% and 63.0%, respectively). Symptom severity was comparable for each period assessed. Overall, in the week before baseline, 56.7% of patients had symptoms throughout the whole 24-hour day (3 parts of the day); 79.9% had symptoms in &gt;= 2 parts of the 24-hour day. Symptoms during each part of the day were inter-related, irrespective of disease severity (all p &lt; 0.001). Early morning and daytime symptoms were associated with the severity of airflow obstruction (p &lt; 0.05 for both). Nighttime, early morning and daytime symptoms were all associated with worse dyspnoea, health status and sleep quality, and higher anxiety and depression levels (all p &lt; 0.001 versus patients without symptoms in each corresponding period). In each part of the 24-hour day, there was also an association between symptoms and a patient's physical activity level (p &lt; 0.05 for each period). Conclusions: More than half of patients experienced COPD symptoms throughout the whole 24-hour day. There was a significant relationship between night-time, early morning and daytime symptoms. In each period, symptoms were associated with worse patient-reported outcomes, suggesting that improving 24-hour symptoms should be an important consideration in the management of COPD.},
  articleno    = {122},
  author       = {Miravitlles, Marc and Worth, Heinrich and Soler Cataluna, Juan Jose and Price, David and De Benedetto, Fernando and Roche, Nicolas and Godtfredsen, Nina Skavlan and van der Molen, Thys and Löfdahl, Claes-Göran and Padulles, Laura and Ribera, Anna},
  issn         = {1465-9921},
  keyword      = {Anxiety,ASSESS,COPD,Depression,Dyspnoea,Health status,Observational,Relationship,Sleep quality,Symptoms},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {Respiratory Research},
  title        = {lObservational study to characterise 24-hour COPD symptoms and their relationship with patient-reported outcomes: results from the ASSESS study},
  url          = {http://dx.doi.org/10.1186/s12931-014-0122-1},
  volume       = {15},
  year         = {2014},
}