COPD Patients Reveal Seasonal Trends in Daily Symptoms Using Electronic Reporting Tool.

Abstract

Rationale: Seasonal variability of daily chronic obstructive pulmonary disease (COPD) symptoms has not been demonstrated. Methods: COPD patients enrolled in Pennsylvania Study of COPD exacerbations (PA−Scope) a randomized prospective study using telemedicine to administer algorithm based outpatient therapy in response to changes in daily symptoms and peak expiratory flows versus standard care. Patient enrollment and data collection began 6/05 ending 5/08. Each patient electronically submitted daily self−evaluated symptoms of cough, breathlessness, wheeze, upper respiratory symptoms, sputum quantity, color and consistency for up to 2 years. Severity of daily symptoms was defined using a weighted daily symptom score. Tertiles of score severity were labeled mild, moderate and severe. Seasonal trends in daily respiratory symptoms were determined using smoothed locally weighted regression of daily symptom scores for each tertile of symptom severity. Results: 78 patients (f=46), age 64±7.34 years had a mean FEV1 of 32.85%±14.7. Symptoms were reported on 17,311 out of 23,259 (74.43%) potential patient reporting days. 1.27% reporting days were symptom free, 31.12% mild, 38.02% moderate, 29.61% severe.[figure1]Conclusion: Severe COPD patients self−report moderate and severe respiratory symptoms on 67% of days; very few were ever asymptomatic. Mild, moderate and severe COPD symptoms were most common in December−March and least common in June−August. This abstract is funded by: PA SCOPE PA DOH 02−07−20. Am J Respir Crit Care Med 179;2009:A5353 Internet address: www.atsjournals.org Online Abstracts Issue

Management of Chronic Obstructive Pulmonary Disease with Tiotropium Bromide

“…7,8 In advanced disease patients are rarely symptom free with daily symptoms nearly universal, including one or more element of cough, sputum, wheezing, chest tightness, nasal symptoms and sore throat. 9 Acute exacerbations of COPD (AECOPD) account for substantial morbidity and mortality. Analogous to stoke or myocardial infarction, AECOPDs interrupt the daily symptom burden of COPD with acute, often trajectory changing deterioration of chronic disease.…”