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Longitudinal changes in patient-reported dyspnea in patients with COPD
Donald A Mahler1, Joseph Ward, Laurie A Waterman
1Section of Pulmonary & Critical Care Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH 03756-0001, USA. Donald.a.mahler@hitchcock.org
COPD
|August 11, 2012
Summary
Patient-reported dyspnea (PRD) worsened over two years in COPD patients, despite stable lung function. Multidimensional instruments effectively captured this decline, offering valuable clinical insights beyond spirometry.
Area of Science:
- Pulmonary Medicine
- Clinical Research
- Patient-Reported Outcomes
Background:
- Guidelines recommend symptom monitoring in COPD patients.
- Limited data exists on longitudinal changes in patient-reported dyspnea (PRD) during daily activities.
- Hypothesized PRD progression over two years using mMRC, SAC TDI, and UCSD SOBQ scales.
Purpose of the Study:
- To assess longitudinal changes in PRD in stable COPD patients over two years.
- To evaluate the utility of mMRC, SAC TDI, and UCSD SOBQ in capturing PRD progression.
- To determine if PRD changes correlate with lung function over time.
Main Methods:
- Observational cohort study of symptomatic, stable COPD patients.
- Evaluations conducted every six months for two years.
- Patients completed mMRC, SAC TDI, and UCSD SOBQ; post-bronchodilator spirometry was performed.
Main Results:
- Seventy patients (66 ± 9 years, FEV1 51 ± 16% predicted) participated.
- Significant worsening observed in SAC TDI (p=0.03) and UCSD SOBQ (p=0.001) scores.
- No significant change in mMRC scores (p=0.52) or lung function (pBD FEV1, p=0.19; pBD FVC, p=0.65).
Conclusions:
- Multidimensional instruments (SAC TDI, UCSD SOBQ) revealed PRD decline in COPD patients.
- PRD progression occurred independently of stable lung function.
- Monitoring PRD offers unique clinical information for assessing COPD patient status over time.
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