RT Journal Article
SR Electronic
T1 Impact of morning symptoms experienced by COPD patients on exacerbation risk, rescue inhaler usage and normal daily activities
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3476
VO 40
IS Suppl 56
A1 Mark Small
A1 Sarah Broomfield
A1 Ryan Pollard
A1 Steve Fermer
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P3476.abstract
AB BackgroundPatients consider the impact of COPD on morning activities to be substantial. Evidence of the association of morning symptoms and the impact on the entire day with poor breathing control contributes to the understanding of their importance for managing COPD patients.ObjectivesTo quantify the impact of morning symptoms experienced by patients receiving inhaled corticosteroid plus long-acting β2-agonist (ICS/LABA) by association with exacerbation frequency, rescue usage and impact on daily activities.MethodsData were drawn from a real world study of consulting COPD patients in the USA and Europe in 2011. Results were tested for significance (p<0.05) using Mann-Whitney and negative binomial regressions. Confounders included age, gender, BMI, comorbidities, severity, smoking status and adherence.ResultsOf the 3790 patients in the study, 593 were receiving ICS/LABA-only (+/- rescue). Of the 177 patients reported to experience morning symptoms, cough (65.5%) and excess sputum (53.1%) were the most common. Compared with patients without morning symptoms, these patients were associated with higher mean exacerbation frequency in the last 12 months (1.04 vs 0.63 p<0.001), rescue usage per day (0.58 vs 0.46 p=0.025) and daytime impact on a 7-point Likert scale where 7 represents a constant impact (3.61 vs 3.00 p<0.001).ConclusionMorning symptoms were associated with significantly more impaired breathing control for patients treated with ICS/LABA-only therapy. The association implies morning symptoms are an important indicator when assessing the impact of COPD and their presence suggests that further therapeutic intervention may be necessary.