Relationship Between Clinical Control, Respiratory Symptoms and Quality of Life for Patients with COPD

Abstract

Background

The concept of clinical control has been proposed as an instrument for evaluating patients with COPD. However, the possible association between clinical control, reduced symptom severity and HRQoL has yet to be confirmed.

Methods

This multicentre, prospective and observational study was carried out in 15 pulmonology clinics in Spain. The patients were followed up for six months, with a baseline visit (V0), followed by visits at three months (V1) and six months (V2). Clinical control was determined at V1, with the application of both clinical criteria and the COPD assessment test (CAT). All patients reported their symptoms by a validated symptom diary (E-RS) using a portable device, and their HRQoL was assessed using the EQ5D questionnaire. The relationship between clinical control and E-RS and HRQoL during follow-up was assessed with t-test.

Results

A total of 126 patients were screened. After application of the inclusion/exclusion criteria, 93 were finally included (mean age 66 ± 8 years, 84.9% male), with a mean FEV ₁ predicted of 49.8% ± 16.5%. Of these patients, 44 (47.3%) achieved clinical control at V1, according to CAT criteria, and 50 (53.8%), according to clinical criteria. The E-RS scores differed between controlled and uncontrolled patients at all time points, both according to CAT (mean differences of −4.6, −5.6 and −6.2 units at V0, V1 and V2, respectively, p<0.005 for all comparisons) and to clinical criteria (mean differences of −3.3, −5-6 and −4.99 units, respectively, p<0.005 for all comparisons). The controlled patients also presented a significantly better HRQoL, measured by the EQ5D questionnaire (mean difference 0.13 and 0.10 at V2 by CAT or clinical criteria, respectively, p<0.05).

Conclusion

Clinical control in patients with COPD, whether measured by CAT or by clinical criteria, is associated with a lower symptom load and a better HRQoL.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): copd

Journal ID (pmc): copd

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date (Electronic): 28 October 2020

Publication date Collection: 2020

Volume: 15

Pages: 2683-2693

Affiliations

[1 ]AIG De Medicina. Hospital De Alta Resolución De Loja. Agencia Sanitaria Hospital De Poniente , Loja, Granada, Spain

[2 ]CIBERES. Instituto De Salud Carlos III , Madrid, Spain

[3 ]Servicio De Neumología. Hospital Universitario De Son Llatzer , Palma De Mallorca, Spain

[4 ]Servicio De Neumología. Hospital De La Plana , Castellón, Spain

[5 ]Servicio De Neumología. Hospital De Laredo , Laredo, Spain

[6 ]Servicio De Neumología. Hospital Universitario Marqués De Valdecilla , Santander, Spain

[7 ]Servicio De Neumología. Hospital Universitario Alvaro Cunqueiro , Vigo, Spain

[8 ]Unidad Médico-Quirúrgica De Enfermedades Respiratorias. Hospital Virgen Del Rocío , Sevilla, Spain

[9 ]UGC De Neumología. HU Virgen Macarena , Sevilla, Spain

[10 ]Servicio De Neumología. Hospital Royo Villanova , Zaragoza, Spain

[11 ]Servicio De Neumología. Complejo Hospitalario Universitario De Albacete , Albacete, Spain

[12 ]Servicio De Neumología. Hospital De Sagunto , Sagunto, Spain

[13 ]Servicio De Neumología. Hospital San Pedro De Alcántara , Cáceres, Spain

[14 ]Servicio De Neumología. Hospital Universitario Lucus Augusti , Lugo, Spain

[15 ]Servicio De Neumología. Hospital Arnau De Villanova- Lliria , Valencia, Spain

[16 ]Servicio De Neumología. Hospital Universitari Vall De Hebron/Vall d’Hebron Institut De Recerca , Barcelona, Spain

Author notes

Correspondence: Bernardino Alcazar-Navarrete Hospital De Alta Resolución De Loja. Agencia Sanitaria Hospital De Poniente. Avda Tierno Galván s/n , Loja18300, Granada, Spain Email [e-mail]

Article

Publisher ID: 265470

DOI: 10.2147/COPD.S265470

PMC ID: 7604255

Copyright statement: © 2020 Alcazar-Navarrete et al.

License:

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Page count

Figures: 4, Tables: 9, References: 29, Pages: 11

Funding

Funded by: Novartis Spain;

This study was funded by an unrestricted grant from Novartis Spain. This company did not intervene in the development of the study, data collection, analysis of results or drafting of the manuscript.

Categories

Subject: Original Research