Perception of symptoms and quality of life – comparison of patients’ and physicians’ views in the COPD MIRROR study

Abstract

ObjectivesThe aim of this study was to compare potential differences between the perception that COPD patients have of their disease and the perception that physicians have of how the disease affects their patients.MethodsSurveys in COPD patients and physicians caring for COPD patients were conducted in Spain, Italy, and Germany. Online questionnaires mirrored to explore the same domains, were administered to patients and physicians. Physicians were asked to respond to the questionnaire taking a recently seen patient who represents the majority of COPD patients usually managed, as a reference. Patients with COPD completed a survey containing the same questions offered to the physicians (Medical Investigation of Respiratory COPD Perception [MIRROR] survey). Comparisons between the responses of patients and general practitioners (GPs) and between patients and pulmonologists (PULs) were run separately using the chi-square, Fisher’s exact, or Student’s t-tests.ResultsA total of 334 COPD patients, 333 GPs, and 333 PULs participated in the surveys. The typical perception that PULs have of the COPD patient was that of an older man with more severe disease and less likely to be a smoker, than the included COPD patients. COPD was regarded as a major health problem by patients and physicians, but its impact on overall quality of life among more severe patients was less strongly perceived by physicians than by patients. Instead, physicians paid more attention to domains related to clinical features (cough, phlegm, and dyspnea), while underestimating COPD impact on leisure and social activities. The majority of patients stated not being completely frank with their doctors during visits. Both GPs and PULs seemed to recognize this issue but underestimated its extent.ConclusionTo improve the doctor–patient communication, a more frank reporting by the patients of their symptoms and feelings and an increased awareness of physicians about the impact on nonconventional domains that patients perceive as importantly affected by COPD should be encouraged.

Psychosocial issues need more attention in COPD self-management education

“…Despite good management, COPD is highly symptomatic, especially in the advanced phases of the disease [19], and fatigue is one of the most prevalent symptoms [20,21]. Our results are consistent with previous studies showing that fatigue often goes unnoticed by family members as well as healthcare professionals [22,23].…”

Relationship of Patient Self-Administered COPD Assessment Test to Physician Standard Assessment of Chronic Obstructive Pulmonary Disease in a Family Medicine Residency Training Program

“…Patients with COPD have been shown to experience a higher mental health burden than patients with other chronic health conditions, and the correlation between COPD and mental health has been linked to negative effects on mortality, increased risk of exacerbations, longer hospital stays, and poorer quality of life with decreased functional status. 16,17 During a general patient encounter, the patient may not report psychological symptoms when asked about the impact of COPD on daily life because of a lack of knowledge related to symptom-disease relationship. 18 Clinically, there are significant implications for patients to underestimating the impact of COPD, including potential undertreatment of symptoms that could lead to acute exacerbations, further decreasing quality of life.…”

Enlightening chronic obstructive pulmonary disease through patients’ and caregivers’ narratives

“…Several multiperspective studies have recently highlighted the importance of the doctor–patient communication to improve the physicians’ deeper understanding of the impact of the COPD on patients’ life. 35 , 36 Although the importance of the caregiver has been demonstrated to be crucial in COPD, 37 there is still an urgent need to examine the effectiveness of strategies to assist caregivers to provide direct care, encourage adherence to health care provider recommendations, act as a health care advocate, and provide emotional and psychosocial support to individuals with COPD. No other study in the Italian context has already investigated the caregivers’ point of view.…”