Health status measured by the Clinical COPD Questionnaire (CCQ) improves following post-acute pulmonary rehabilitation in patients with advanced COPD: a prospective observational study

Abstract

Aims:To evaluate outcomes of the Clinical Chronic obstructive pulmonary disease (COPD) Questionnaire (CCQ) in patients with advanced COPD admitted for a post-acute pulmonary rehabilitation (PR) programme and to relate (change in) health status to lung function, degree of dyspnoea and (change in) functional capacity.Methods:This is a prospective observational study in patients with advanced COPD admitted for a post-acute PR programme in a skilled nursing facility. Health status (CCQ) and functional capacity were measured before and after rehabilitation.Results:Health status measured by the CCQ was severely impaired and showed significant and clinically relevant improvement during the post-acute PR programme. Moderate to strong correlations were found between CCQ scores and functional capacity on admission and at discharge. Moderate correlations were found between improvement in CCQ scores and improvement in functional capacity. No correlation was found between CCQ scores and lung function (forced expiratory volume in 1 s % predicted).Conclusions:Health status measured by the CCQ improves following a post-acute PR programme in patients with advanced COPD and correlates with improvement in functional capacity. These results suggest that the CCQ is sensitive to change in response to PR in this specific group of patients.

Evaluating the Clinical COPD Questionnaire: A systematic review

“…Four papers studied CCQ longitudinal validity and the events contained pulmonary rehabilitation (PR) and recovery from an acute exacerbation(Table S6, Supplementary Information). Change in CCQ with PR or recovery correlated significantly with change in SGRQ, CAT and CRQ.…”

“…Research results of the correlation between the CCQ and spirometric parameters varied widely (Table ). Six articles observed no correlation between the total CCQ score and FEV 1 % predicted, while others showed a weak to moderate correlation. The functional domain correlated best with 6‐min walk test (6MWT), but researchers found no significant or weak to moderate correlations between the other two domains and 6MWT .…”

“…Six articles observed no correlation between the total CCQ score and FEV 1 % predicted, while others showed a weak to moderate correlation. The functional domain correlated best with 6‐min walk test (6MWT), but researchers found no significant or weak to moderate correlations between the other two domains and 6MWT . Statistically significant correlations were also observed between the overall CCQ/CCQ functional domain/CCQ symptom domain and the COPD severity by the GOLD grades and BODE (BMI, airflow obstruction, dyspnoea and exercise capacity) index …”

“…Finally, there were 43 studies included in this work (Fig. , Table ), of which 7 studies reported the floor and ceiling effect of the CCQ, internal consistency and test‐retest reliability were evaluated by 12 articles, 33 studies assessed validity, 15 studies examined responsiveness and 3 studies calculated MCID.…”

“…There were moderate to strong correlations between Medical Research Council (MRC) dyspnoea scale and CCQ total score . Besides, both MRC and modified MRC (mMRC) dyspnoea scale correlated best with functional domain of the CCQ, while one study found that mMRC had no significant correlation with the symptom and mental domain of the CCQ . Moreover, moderate to strong correlations were also found between the total CCQ score and the Chronic Respiratory Questionnaire Self‐Reported (CRQ‐SR), Visual Analogue Scale of the EuroQOL‐5D Questionnaire (EQ‐VAS), Short‐Form 36 (SF‐36), Baseline Dyspnoea Index (BDI) as well as Hospital Anxiety and Depression Scale (HADS) .…”