The COPD Assessment Test (CAT) can screen for fatigue among patients with COPD

Abstract

Background:Fatigue is one of the most common symptoms among subjects with chronic obstructive pulmonary disease (COPD), but is rarely identified in clinical practice. The aim of this study was to evaluate the association between fatigue and health-related quality of life (HRQoL) assessed with clinically useful instruments, both among subjects with and without COPD. Further, to investigate the association between fatigue and the COPD Assessment Test (CAT)-energy question.Methods:Data were collected in 2014 within the population-based OLIN COPD study. Subjects with (n = 367) and without (n = 428) COPD participated in clinical examinations including spirometry and completed questionnaires about fatigue (FACIT-Fatigue, clinically relevant fatigue ⩽43), and HRQoL (EQ-5D-VAS, lower score = worse health; CAT, lower score = fewer symptoms/better health).Results:Subjects with clinically relevant fatigue had worse HRQoL measured with EQ-5D-VAS, regardless of having COPD or not. Decreasing EQ-5D-VAS scores, any respiratory symptoms and anxiety/depression were associated with clinically relevant fatigue also when adjusted for confounders. Among subjects with COPD, clinically relevant fatigue was associated with increasing total CAT score, and CAT score ⩾10. The proportion of subjects with clinically relevant fatigue increased significantly, with a higher score on the CAT-energy question, and nearly 50% of those with a score of 2, and 70% of those with a score of ⩾3, had clinically relevant fatigue.Conclusions:Fatigue was associated with respiratory symptoms, anxiety/depression and worse HRQoL when using the clinically useful instruments EQ-5D-VAS and CAT. The CAT-energy question can be used to screen for fatigue in clinical practice, using a cut-off of ⩾2.

Symptom Clusters and Health-related Quality of Life in Chinese patients with Chronic Obstructive Pulmonary Disease

“…This study examined the relationship between symptom clusters and HRQoL. Psychological and physical symptoms, such as depression, anxiety, panic attacks, and fatigue-related symptoms, were significantly related to QoL in prior studies (Isselt et al, 2014; Pascal et al, 2017; Stridsman et al, 2018). In our study, symptom clusters 1 and 2 were significantly associated with HRQoL and almost all its subdomains, which is consistent with previous research.…”

Fatigue is highly prevalent in patients with COPD and correlates poorly with the degree of airflow limitation

“…Factors such as depressive symptoms may potentially also contribute to the explanation of fatigue in patients with COPD. 12,13,18,50,51 Nevertheless, it may be difficult to distinguish if fatigue is a symptom of the depression itself, or emerges as an adverse effect of antidepressant drugs. Besides depressive symptoms, patients with COPD also often report poor sleep quality.…”

The responsiveness of the Manchester Chronic Obstructive Pulmonary Disease Fatigue Scale to pulmonary rehabilitation

“…Previous studies have shown that increased fatigue was related with frequency of acute exacerbations, hospitalizations, and in-creased length of stay. 21,22,24 Furthermore, elevated fatigue was related with high mental illness burden, which challenged patients coping resources and making fatigue as a symptom difficult to accept. 25 Thus, future studies need to focus on prospective randomized controlled trial to examine the effect of fatigue and healthcare costs in this patient group.…”