COPD management: role of symptom assessment in routine clinical practice

Patients with chronic obstructive pulmonary disease (COPD) present with a variety of symptoms that significantly impair health-related quality of life. Despite this, COPD treatment and its management are mainly based on lung function assessments. There is increasing evidence that conventional lung function measures alone do not correlate well with COPD symptoms and their associated impact on patients’ everyday lives. Instead, symptoms should be assessed routinely, preferably by using patient-centered questionnaires that provide a more accurate guide to the actual burden of COPD. Numerous questionnaires have been developed in an attempt to find a simple and reliable tool to use in everyday clinical practice. In this paper, we review three such patient-reported questionnaires recommended by the latest Global Initiative for Chronic Obstructive Lung Disease guidelines, ie, the modified Medical Research Council questionnaire, the clinical COPD questionnaire, and the COPD Assessment Test, as well as other symptom-specific questionnaires that are currently being developed.

[1]  T. Molen,et al.  Description of a Dutch well-established asthma/COPD service for primary care , 2013 .

[2]  P. Casán,et al.  Spirometry. Spanish Society of Pulmonology and Thoracic Surgery (SEPAR). , 2013, Archivos de bronconeumologia.

[3]  J. Vonk,et al.  Day-to-day measurement of patient-reported outcomes in exacerbations of chronic obstructive pulmonary disease , 2013, International journal of chronic obstructive pulmonary disease.

[4]  R. Negro,et al.  Utility of COPD Assessment Test (CAT) in primary care consultations: a randomised controlled trial , 2013, Primary care respiratory journal : journal of the General Practice Airways Group.

[5]  F. Martinez,et al.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. , 2007, American journal of respiratory and critical care medicine.

[6]  Morten Dahl,et al.  Prediction of the clinical course of chronic obstructive pulmonary disease, using the new GOLD classification: a study of the general population. , 2012, American journal of respiratory and critical care medicine.

[7]  M. Miravitlles,et al.  Beyond FEV1 in COPD: a review of patient-reported outcomes and their measurement , 2012, International journal of chronic obstructive pulmonary disease.

[8]  Joan B. Soriano,et al.  Treatment of COPD by clinical phenotypes: putting old evidence into clinical practice , 2012, European Respiratory Journal.

[9]  M. Miravitlles,et al.  Usefulness of the LCOPD, CAFS and CASIS Scales in Understanding the Impact of COPD on Patients , 2012, Respiration.

[10]  I. Tsiligianni,et al.  Responsiveness of the COPD assessment test: the minimal clinically important difference does matter. , 2012, Chest.

[11]  Pamela Berry,et al.  Tests of the responsiveness of the COPD assessment test following acute exacerbation and pulmonary rehabilitation. , 2012, Chest.

[12]  N. Siafakas,et al.  Assessing health status in COPD. A head-to-head comparison between the COPD assessment test (CAT) and the clinical COPD questionnaire (CCQ) , 2012, BMC Pulmonary Medicine.

[13]  T. Omachi,et al.  Disturbed sleep among COPD patients is longitudinally associated with mortality and adverse COPD outcomes. , 2012, Sleep medicine.

[14]  A. Frølich,et al.  Impact of Exercise Capacity on Dyspnea and Health-Related Quality of Life in Patients With Chronic Obstructive Pulmonary Disease , 2012, Journal of cardiopulmonary rehabilitation and prevention.

[15]  P. Lange,et al.  A Comparison of the Assessment of Quality of Life with CAT, CCQ, and SGRQ in COPD Patients Participating in Pulmonary Rehabilitation , 2012, COPD.

[16]  M. Miravitlles,et al.  Variability of Respiratory Symptoms in Severe COPD , 2012 .

[17]  M. Miravitlles,et al.  Beyond FEV 1 in COPD: a review of patient-reported outcomes and their measurement , 2012 .

[18]  J. Soriano,et al.  Spanish COPD Guidelines (GesEPOC): pharmacological treatment of stable COPD. Spanish Society of Pulmonology and Thoracic Surgery. , 2012, Archivos de bronconeumologia.

[19]  M. Miravitlles,et al.  Variability of Respiratory Symptoms in Severe COPD , 2012 .

[20]  M. Miravitlles,et al.  Cough and sputum production as risk factors for poor outcomes in patients with COPD. , 2011, Respiratory medicine.

[21]  D. Postma,et al.  A new perspective on optimal care for patients with COPD. , 2011, Primary care respiratory journal : journal of the General Practice Airways Group.

[22]  D. Price,et al.  Role of clinical questionnaires in optimizing everyday care of chronic obstructive pulmonary disease , 2011, International journal of chronic obstructive pulmonary disease.

[23]  P. Kardos,et al.  Properties of the COPD assessment test in a cross-sectional European study , 2011, European Respiratory Journal.

[24]  H. Kerstjens,et al.  Functional status measurement in COPD: a review of available methods and their feasibility in primary care. , 2011, Primary care respiratory journal : journal of the General Practice Airways Group.

[25]  M. Polkey,et al.  The COPD assessment test (CAT): response to pulmonary rehabilitation. A multicentre, prospective study , 2011, Thorax.

[26]  H. Reuveni,et al.  Sleep quality predicts quality of life in chronic obstructive pulmonary disease , 2010, International journal of chronic obstructive pulmonary disease.

[27]  M Cazzola,et al.  Symptom variability in patients with severe COPD: a pan-European cross-sectional study , 2010, European Respiratory Journal.

[28]  H. Kerstjens,et al.  Health status in routine clinical practice: validity of the clinical COPD questionnaire at the individual patient level , 2010, Health and quality of life outcomes.

[29]  G. Wesseling,et al.  Reliability and validity of the clinical COPD questionniare and chronic respiratory questionnaire. , 2010, Respiratory medicine.

[30]  Edwin K Silverman,et al.  Characterisation of COPD heterogeneity in the ECLIPSE cohort , 2010, Respiratory research.

[31]  B. Monz,et al.  Responsiveness of the cough and sputum assessment questionnaire in exacerbations of COPD and chronic bronchitis. , 2010, Respiratory medicine.

[32]  T. Welte,et al.  Development and validation of the Capacity of Daily Living during the Morning questionnaire and the Global Chest Symptoms Questionnaire in COPD , 2009, European Respiratory Journal.

[33]  P. Jones,et al.  Development and first validation of the COPD Assessment Test , 2009, European Respiratory Journal.

[34]  A. Menezes,et al.  Health status perception and airflow obstruction in five Latin American cities: the PLATINO study. , 2009, Respiratory medicine.

[35]  M. Partridge,et al.  Patient insight into the impact of chronic obstructive pulmonary disease in the morning: an internet survey , 2009, Current medical research and opinion.

[36]  Christopher B Cooper,et al.  Airflow obstruction and exercise. , 2009, Respiratory medicine.

[37]  B. E. van den Borne,et al.  Diagnostic assessments of spirometry and medical history data by respiratory specialists supporting primary care: are they reliable? , 2009, Primary care respiratory journal : journal of the General Practice Airways Group.

[38]  H. Magnussen,et al.  Physical activity in patients with COPD , 2008, European Respiratory Journal.

[39]  J. Ramsey,et al.  Impact of cough across different chronic respiratory diseases: comparison of two cough-specific health-related quality of life questionnaires. , 2008, Chest.

[40]  M Cazzola,et al.  Outcomes for COPD pharmacological trials: From lung function to biomarkers. , 2008, Revista portuguesa de pneumologia.

[41]  N. Probst-Hensch,et al.  Long-term decline in lung function, utilisation of care and quality of life in modified GOLD stage 1 COPD , 2008, Thorax.

[42]  Y. Lacasse,et al.  Anxiety and depression in end-stage COPD , 2008, European Respiratory Journal.

[43]  Amanda J Lee,et al.  Associations of depression and anxiety with gender, age, health-related quality of life and symptoms in primary care COPD patients. , 2007, Family practice.

[44]  R. Zuwallack.  How Are You Doing? What Are You Doing? Differing Perspectives in the Assessment of Individuals with COPD , 2007, COPD.

[45]  Mary Cruse.  The Impact of Change in Exercise Tolerance on Activities of Daily Living and Quality of Life in COPD: A Patient's Perspective , 2007, COPD.

[46]  D. O’Donnell.  Impacting patient-centred outcomes in COPD: breathlessness and exercise tolerance , 2006, European Respiratory Review.

[47]  R. Zuwallack,et al.  Functional status and quality of life in chronic obstructive pulmonary disease. , 2006, The American journal of medicine.

[48]  A. Ries.  Impact of chronic obstructive pulmonary disease on quality of life: the role of dyspnea. , 2006, The American journal of medicine.

[49]  P. Schnohr,et al.  Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study , 2006, Thorax.

[50]  T. Molen,et al.  Health status measurement in COPD: the minimal clinically important difference of the clinical COPD questionnaire , 2006, Respiratory research.

[51]  Thierry Troosters,et al.  Physical activity and hospitalization for exacerbation of COPD. , 2006, Chest.

[52]  J. Bourbeau,et al.  Dyspnea as clinical indicator in patients with chronic obstructive pulmonary disease , 2005, Chronic respiratory disease.

[53]  Margaret Barnett,et al.  Chronic obstructive pulmonary disease: a phenomenological study of patients' experiences. , 2005, Journal of clinical nursing.

[54]  Thierry Troosters,et al.  Characteristics of physical activities in daily life in chronic obstructive pulmonary disease. , 2005, American journal of respiratory and critical care medicine.

[55]  J. Haughney,et al.  Patient-centred outcomes in primary care management of COPD - what do recent clinical trial data tell us? , 2004, Primary care respiratory journal : journal of the General Practice Airways Group.

[56]  Dirkje S Postma,et al.  Health and Quality of Life Outcomes , 2003 .

[57]  R. Buhl,et al.  Newly Diagnosed Chronic Obstructive Pulmonary Disease , 2003, Respiration.

[58]  D. Mahler,et al.  Minimal important difference of the transition dyspnoea index in a multinational clinical trial , 2003, European Respiratory Journal.

[59]  X. Busquets,et al.  Systemic effects of chronic obstructive pulmonary disease , 2003, European Respiratory Journal.

[60]  R. Buhl,et al.  Newly diagnosed chronic obstructive pulmonary disease. Clinical features and distribution of the novel stages of the Global Initiative for Obstructive Lung Disease. , 2003, Respiration; international review of thoracic diseases.

[61]  M. Decramer,et al.  Impact of COPD in North America and Europe in 2000: subjects' perspective of Confronting COPD International Survey , 2002, European Respiratory Journal.

[62]  Toru Oga,et al.  Dyspnea is a better predictor of 5-year survival than airway obstruction in patients with COPD. , 2002, Chest.

[63]  B. Celli,et al.  Power of outcome measurements to detect clinically significant changes in pulmonary rehabilitation of patients with COPD. , 2002, Chest.

[64]  P. Jones.  Interpreting thresholds for a clinically significant change in health status in asthma and COPD , 2002, European Respiratory Journal.

[65]  P. Jones,et al.  Health status measurement in chronic obstructive pulmonary disease , 2001, Thorax.

[66]  M. Tsukino,et al.  A comparison of the level of dyspnea vs disease severity in indicating the health-related quality of life of patients with COPD. , 1999, Chest.

[67]  P. Jones,et al.  Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease , 1999, Thorax.

[68]  P. Jones,et al.  Issues concerning health-related quality of life in COPD. , 1995, Chest.

[69]  L. Morgan,et al.  From a patient's perspective. , 1995, The Canadian nurse.

[70]  G. Colice,et al.  Impact of dyspnea and physiologic function on general health status in patients with chronic obstructive pulmonary disease. , 1992, Chest.

[71]  P. Jones,et al.  A self-complete measure of health status for chronic airflow limitation. The St. George's Respiratory Questionnaire. , 1992, The American review of respiratory disease.

[72]  P. Jones,et al.  The St George's Respiratory Questionnaire. , 1991, Respiratory medicine.

[73]  G. Guyatt,et al.  Measurement of health status. Ascertaining the minimal clinically important difference. , 1989, Controlled clinical trials.

[74]  C K Wells,et al.  Evaluation of clinical methods for rating dyspnea. , 1988, Chest.

[75]  N. Saunders,et al.  Nocturnal hypoxaemia and quality of sleep in patients with chronic obstructive lung disease. , 1986, Thorax.

[76]  M. Artvinli,et al.  Dyspnoea, disability and distance walked: Comparison of estimates of exercise performance in respiratory disease , 1980, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.