PT  - JOURNAL ARTICLE
AU  - Sean Sullivan
AU  - Qian Cai
AU  - Judith Stephenson
AU  - Hiangkiat Tan
AU  - Abhishek Kavati
AU  - Michelle Mocarski
AU  - Jalpa Doshi
TI  - Identification of COPD patient factors associated with nighttime and early morning symptoms
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P717
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P717.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P717.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - INTRODUCTIONPatients with COPD often report poor sleep quality and consider morning as the worst time for symptoms. This study identified factors associated with nighttime (NT) and early morning (EM) symptoms in COPD patients.METHODSHealthCore Integrated Research Database claims data (9/1/10 to 8/31/11) were used to identify patients ≥40 years with ≥1 ICD-9-CM COPD diagnosis code medical claim or ≥1 COPD maintenance medication pharmacy claim. Respondents (N=752) completed a survey with questions from the COPD Assessment Test (CAT), modified Medical Research Council Dyspnea (mMRC) scale, and Morisky Medication Adherence Scale (MMAS). Respondents were classified based on NT and/or EM symptom experience in the past week, and enrollment was stratified based on NT/EM symptoms. Multinomial logistic regression identified factors associated with symptoms.RESULTSPatients reported having both (42.3%), either (32.7%), or neither NT/EM symptoms (25.0%). Compared to patients without NT/EM symptoms (OR; 95% CI), those with both were more likely to be a current smoker (2.61; 1.18-5.78), have used oxygen in the past week (2.20; 1.02-4.71), and have dyspnea (2.73; 1.56-4.76), worse health status (8.03; 4.33-14.89), or low (2.58; 1.34-4.93) or moderate (2.04; 1.13-3.67) COPD medication adherence; in contrast, only worse health status (2.78; 1.70-4.54) was a significant factor for patients with either NT/EM symptoms vs those without symptoms.CONCLUSIONSHealth status, dyspnea, smoking status, medication adherence, and oxygen use were associated with NT and EM symptoms among COPD patients. Targeting these factors may lead to more successful treatment strategies for COPD patients.