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Published online before print August 22, 2007
Eur Respir J 2007, doi:10.1183/09031936.00166606
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ORIGINAL ARTICLE

Impact on Patient's Health Status following early identification of a COPD Exacerbation

J. Bourbeau 1*, G. Ford 2, H. Zackon 3, N. Pinsky 4, J. Lee 5, G. Ruberto 5

1 Respiratory Epidemiology and Clinical Research Unit, Montréal Chest Institute of the Royal Victoria Hospital, McGill University Health Centre, Montréal, Québec, Canada
2 Dept of Medicine, University of Calgary, Calgary, Canada
3 Dept of Medicine, St Mary's Hospital, McGill University Health Center, Montréal, Québec, Canada
4 Family Medicine, Halifax, Nova Scotia
5 AstraZeneca Canada Inc., Ontario, Canada

* To whom correspondence should be addressed. E-mail: jean.bourbeau{at}mcgill.ca.


  Abstract

This study aimed to assess impact on patient health status during AECOPD. COPD patients (421) were enrolled in a multicentre, single-arm study with a 6-month observational follow-up period. Patients received 2 inhalations of Symbicort 200 Turbuhaler twice a day. Patients were assessed before the run-in period, at baseline, 1, 3 and 6 months. Patients were instructed to call upon a change in respiratory symptoms (24 hours +). This defined AECOPD. In addition to the initial call, SGRQ, CCQ, MRC and ADL were completed at 5–7 and 12–14 days. Patients (176) reported at least one AECOPD. Exacerbations were associated with statistically significant mean changes (worsening) in the SGRQ activity and impact domains at onset (12.1, SD 18.1 and 14.0, SD 15.2), during the first (9.8, SD 19.0 and 9.4, SD 16.6) and second weeks (3.1, SD 15.5 and 3.3, SD 14.7). Clinically significant deterioration in SGRQ impact scores was shown in 71% of patients following early identification, 55% and 37% during the first and second week of an AECOPD. Acute exacerbation severely impact on health status. This study provides valuable information on the change in health status during an AECOPD that can be utilized for future trials evaluating therapeutic intervention.

Keywords:  COPD, exacerbation, health-related quality of life




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