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

Respiratory Research

Anna Ribera²  Laura Padullés²  Claes-Göran Löfdahl³  Thys van der Molen¹  Nina Skavlan Godtfredsen⁵  Nicolas Roche⁶  Fernando De Benedetto^1,10  David Price⁷  Juan José Soler Cataluña⁹  Heinrich Worth⁴  Marc Miravitlles⁸ 

[1] University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;Medical Affairs, Almirall, Barcelona, Spain;Department of Respiratory Medicine and Allergology, Lund University Hospital, Lund, Sweden;Medical Department I, Fürth Hospital, Fürth, Germany;Department of Respiratory Medicine, Bispebjerg University Hospital, Copenhagen, Denmark;Cochin Hospital, Paris Descartes University, Paris, France;Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK;Pneumology Department, Hospital Universitari Vall d’Hebron, Ciber de Enfermedades Respiratorias (CIBERES), P. de la Vall d’Hebron, 119–129, Barcelona, Spain;Servicio de Neumología, Hospital Arnau de Vilanova, Valencia, Spain;Pneumology Unit, Ospedale Clinicizzato SS. Annunziata, Chieti, Italy

关键词: Symptoms;    Sleep quality;    Relationship;    Observational;    Health status;    Dyspnoea;    Depression;    COPD;    ASSESS;    Anxiety;   

Others  :  1137251
DOI  :  10.1186/s12931-014-0122-1

 received in 2014-07-14, accepted in 2014-09-30,  发布年份 2014

【 摘 要 】

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). Night-time, 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.

【 授权许可】

   
2014 Miravitlles et al.; licensee BioMed Central Ltd.

【 图 表 】

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