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Patient understanding, detection, and experience of COPD exacerbations - An observational, interview-based study

Kessler, Romain ; Stahl, Elisabeth ; Vogelmeier, Claus ; Haughney, John ; Trudeau, Elyse and Löfdahl, Claes-Göran LU (2006) In Chest 130(1). p.133-142
Abstract
Study objectives: This study was conducted to gain insight into patients' comprehension, recognition, and experience of exacerbations of COPD, and to explore the patient burden associated with these events. Design: A qualitative, multinational, cross-sectional, interview-based study. Setting: Patients' homes. Patients: Patients (n = 125) with predominantly moderate-to-very severe COPD (age >= 50 years; with two or more exacerbations during the previous year). Interventions: Patients underwent a 1-h face-to-face interview with a trained interviewer. Measurements and results: During the preceding year, patients experienced a mean +/- SD of 4.6 +/- 5.4 exacerbations, after which 19.2% (n = 24) believed they had not fully recovered.... (More)
Study objectives: This study was conducted to gain insight into patients' comprehension, recognition, and experience of exacerbations of COPD, and to explore the patient burden associated with these events. Design: A qualitative, multinational, cross-sectional, interview-based study. Setting: Patients' homes. Patients: Patients (n = 125) with predominantly moderate-to-very severe COPD (age >= 50 years; with two or more exacerbations during the previous year). Interventions: Patients underwent a 1-h face-to-face interview with a trained interviewer. Measurements and results: During the preceding year, patients experienced a mean +/- SD of 4.6 +/- 5.4 exacerbations, after which 19.2% (n = 24) believed they had not fully recovered. Although commonly used by physicians, only 1.6% (n = 2) of patients understood the term exacerbation, preferring to use simpler terms, such as chest infection (16.0%; n = 20) or crisis (16.0%; n = 20) instead. Approximately two thirds of patients stated that they were aware of when an exacerbation was imminent and, in most cases, patients recounted that symptoms were consistent from one exacerbation to another. Some patients (32.8%; n = 41), however, reported no recognizable warning signs. At the onset of an exacerbation, 32.8% of patients (n = 41) stated that they reacted by self-administering their medication. Some patients spontaneously mentioned a fear of dying (12.0%; n = 15) or suffocating (9.6%; n = 12) during exacerbations, and effects on activities, mood, and personal/family relationships were frequently reported. Physicians tended to underestimate the psychological impact of exacerbations compared with patient reports. Conclusions: This study shows that patients with frequent exacerbations have a poor understanding of the term exacerbation. Patient recollections suggest that exacerbation profiles vary enormously between patients but that symptoms/warning signs are fairly consistent within individuals, and are generally recognizable. Exacerbations appear to have a significant impact on patient well-being, including psychological well-being, and this may be underestimated by physicians. (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
COPD, exacerbation, burden, patient's perspective
in
Chest
volume
130
issue
1
pages
133 - 142
publisher
American College of Chest Physicians
external identifiers
  • pmid:16840393
  • wos:000239219300023
  • scopus:33746345878
ISSN
1931-3543
DOI
10.1378/chest.130.1.133
language
English
LU publication?
yes
id
963b988a-8e25-4895-83a2-95ef870e5e97 (old id 401412)
alternative location
http://www.chestjournal.org/cgi/content/abstract/130/1/133
date added to LUP
2016-04-01 16:47:09
date last changed
2019-12-04 05:27:20
@article{963b988a-8e25-4895-83a2-95ef870e5e97,
  abstract     = {Study objectives: This study was conducted to gain insight into patients' comprehension, recognition, and experience of exacerbations of COPD, and to explore the patient burden associated with these events. Design: A qualitative, multinational, cross-sectional, interview-based study. Setting: Patients' homes. Patients: Patients (n = 125) with predominantly moderate-to-very severe COPD (age >= 50 years; with two or more exacerbations during the previous year). Interventions: Patients underwent a 1-h face-to-face interview with a trained interviewer. Measurements and results: During the preceding year, patients experienced a mean +/- SD of 4.6 +/- 5.4 exacerbations, after which 19.2% (n = 24) believed they had not fully recovered. Although commonly used by physicians, only 1.6% (n = 2) of patients understood the term exacerbation, preferring to use simpler terms, such as chest infection (16.0%; n = 20) or crisis (16.0%; n = 20) instead. Approximately two thirds of patients stated that they were aware of when an exacerbation was imminent and, in most cases, patients recounted that symptoms were consistent from one exacerbation to another. Some patients (32.8%; n = 41), however, reported no recognizable warning signs. At the onset of an exacerbation, 32.8% of patients (n = 41) stated that they reacted by self-administering their medication. Some patients spontaneously mentioned a fear of dying (12.0%; n = 15) or suffocating (9.6%; n = 12) during exacerbations, and effects on activities, mood, and personal/family relationships were frequently reported. Physicians tended to underestimate the psychological impact of exacerbations compared with patient reports. Conclusions: This study shows that patients with frequent exacerbations have a poor understanding of the term exacerbation. Patient recollections suggest that exacerbation profiles vary enormously between patients but that symptoms/warning signs are fairly consistent within individuals, and are generally recognizable. Exacerbations appear to have a significant impact on patient well-being, including psychological well-being, and this may be underestimated by physicians.},
  author       = {Kessler, Romain and Stahl, Elisabeth and Vogelmeier, Claus and Haughney, John and Trudeau, Elyse and Löfdahl, Claes-Göran},
  issn         = {1931-3543},
  language     = {eng},
  number       = {1},
  pages        = {133--142},
  publisher    = {American College of Chest Physicians},
  series       = {Chest},
  title        = {Patient understanding, detection, and experience of COPD exacerbations - An observational, interview-based study},
  url          = {http://dx.doi.org/10.1378/chest.130.1.133},
  doi          = {10.1378/chest.130.1.133},
  volume       = {130},
  year         = {2006},
}