Prevalence and Perception of 24-h Symptom Patterns in Patients With Stable Chronic Obstructive Pulmonary Disease in Spain

Daytime symptoms of chronic obstructive pulmonary disease: a systematic review

“…Daytime COPD symptoms: prevalence, variability, and burden Information on the prevalence (number of patients reporting symptoms) of common daytime symptoms of COPD was collated from 18 articles that had extractable data ( Supplementary Table 4). 2,4,12,[14][15][16][23][24][25][26][27][28][29][30][31][32][33][34] In nine articles, the relative prevalence rates of COPD symptoms (both for all symptoms and for individual symptoms) were generally higher in the morning and/or daytime (when defined, this was usually the time between the morning period and when the patient goes to bed) compared with at night ( Supplementary Table 4). 4 33 (71 versus 48%).…”

“…Moreover, where prevalence rates were provided separately for morning and daytime, they were usually relatively similar. 4,26,29,32 However, one study based on physician reports (not patient self-reporting) went against this trend. 15 In this study by Roche et al, physicians reported morning symptoms for only 40% of their patients with COPD, compared with daytime symptoms for 97% of patients and night-time symptoms for 58% of patients.…”

“…Breathlessness, cough, and increased sputum usually made up the top three most prevalent COPD symptoms reported for both morning and daytime, though relative proportions varied based on differences in populations and study designs ( Supplementary Table 4). 4,12,14,[23][24][25][26][27]29,30 Wheezing and chest tightness/congestion were usually less commonly reported for morning and daytime. Variability (variation in symptom prevalence across a 24-h period) of common daytime symptoms of COPD were reported in ten articles ( Supplementary Table 4).…”

“…Variability (variation in symptom prevalence across a 24-h period) of common daytime symptoms of COPD were reported in ten articles ( Supplementary Table 4). 4,[13][14][15][16]23,26,[28][29][30] Accumulated evidence from nine of these articles indicates that the prevalence of COPD symptoms tends to fluctuate over the course of the day. 4,[14][15][16]23,26,[28][29][30] This is also demonstrated in a large study by Kessler et al, 13 where 44.7% of symptomatic patients perceived variability in one or more of their COPD symptoms throughout the day, with breathlessness and chest tightness varying the most.…”

“…12,17,30,39 Data from seven studies on the effects of daytime COPD symptoms on health status and/or QOL showed that there were raised levels of anxiety, depression, distress, and social inhibition/ embarrassment among patients ( Supplementary Table 6). 4,12,15,17,29,30,35 Stephenson et al, 30 for example, noted that 54% of study patients with early morning symptoms reported feeling anxious (slightly to extremely), whereas O'Hagan and Chavannes 17 found that 53% of surveyed participants had experienced social inhibition or embarrassment because of their morning symptoms. Of note, this relationship was based not only on subjective patient/physician reporting, but also on scores from validated measures, e.g., the COPD Assessment Tool (CAT), Clinical COPD Questionnaire (CCQ), Hospital, Anxiety and Depression Scale (HADS), and EuroQol Five Dimensions Questionnaire (EQ-5D).…”