Clinical significance in COPD patients followed in a real practice

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is an important public health issue in many countries which is estimated to become the fifth cause of disability and the third cause of mortality in the world within 2020. The objective of this study was to identify the clinical characteristics in the real clinical practice of a sample of patients with COPD followed in a pulmonology clinic. Methods: The initial sample contained 207 subjects with respiratory claims that searched for specialized treatment and initiated regular monitoring between 2004 and 2009 in a private clinic localized in Cascavel, in the state of Parana, Brazil. Demographic data (weight, height, body mass index - BMI), history of comorbidities, use of respiratory and non respiratory drugs were also registered. Results: The main cause related to the development of COPD was current or prior smoking (92.0%); the most frequently reported symptom was dyspnea (95.0%), followed by cough (86.1%), wheezing (69.4%) and sputum production (40.0%). During the follow up, 51 patients developed the need for oxygen therapy (28.3%). In 96 patients, there were periods of acute exacerbation, resulting in 37 hospitalizations. In addition to COPD, a significant number of comorbidities were identified, being cardiovascular disease and neurological disorders the most prevalent ones. Conclusions: Based on the data collected, we could outline the profile of patients with COPD, showing characteristics of an elderly population, with multiple comorbidities, suggesting a health related quality of life lower than expected.

Impact of baseline symptoms and health status on COPD exacerbations in the FLAME study

“…While all COPD symptoms can predict long-term treatment response, breathlessness (dyspnoea) is one of the best predictors [6]. Dyspnoea is a cardinal feature and the key symptom of COPD, causing distress that contributes significantly to the disease burden [7][8][9]. Dyspnoea grade is closely linked to exacerbation risk [9], and severity of dyspnoea is also a significant predictor of mortality [7].…”

“…Dyspnoea grade is closely linked to exacerbation risk [9], and severity of dyspnoea is also a significant predictor of mortality [7]. Consequently, as dyspnoea severity increases, so do the healthcare costs of managing patients with COPD [8,10].…”

Efficacy of unsupervised exercise in adults with obstructive lung disease: a systematic review and meta-analysis

“…6MWT was the most commonly reported measure of exercise capacity (14,15,17,18,20,22,25,26). Based on a minimal clinically important difference (MCID) of 30 metres (32) the 22 metre 6MWT improvement with unsupervised exercise cannot be considered clinically meaningful for people with COPD.…”

“…However, the magnitude of effect did not meet the threshold of 30m for clinically important improvement (30). Four further trials reported 6MWT as an outcome (14)(15)(16)20) in a COPD population but data could not be obtained from one study (16) and in another three studies (14,15,20) data could only be retrieved from previous systematic reviews (1,30,31). Extraction of trial data from previous reviews is not a widely accepted approach but analysis with the additional three studies is provided in the supplementary material (Figure S1).…”