The Relationship Between 24-Hour Symptoms and COPD Exacerbations and Healthcare Resource Use: Results from an Observational Study (ASSESS)
Por:
Miravitlles M, Worth H, Soler-Cataluña JJ, Price D, De Benedetto F, Roche N, Godtfredsen NS, van der Molen T, Löfdahl CG, Padullés L and Ribera A
Publicada:
1 ene 2016
Resumen:
This observational study assessed the relationship between nighttime, early-morning and daytime chronic obstructive pulmonary disease (COPD) symptoms and exacerbations and healthcare resource use. COPD symptoms were assessed at baseline in patients with stable COPD using a standardised questionnaire during routine clinical visits. Information was recorded on exacerbations and healthcare resource use during the year before baseline and during a 6-month follow-up period. The main objective of the analysis was to determine the predictive nature of current symptoms for future exacerbations and healthcare resource use. 727 patients were eligible (65.8% male, mean age: 67.2 years, % predicted forced expiratory volume in 1 second: 52.8%); 698 patients (96.0%) provided information after 6 months. Symptoms in any part of the day were associated with a prior history of exacerbations (all p < 0.05) and nighttime and early-morning symptoms were associated with the frequency of primary care visits in the year before baseline (both p < 0.01). During follow-up, patients with baseline symptoms during any part of the 24-hour day had more exacerbations than patients with no symptoms in each period (all p < 0.05); there was also an association between 24-hour symptoms and the frequency of primary care visits (all p <= 0.01). Although there was a significant association between early-morning and daytime symptoms and exacerbations during follow-up (both p < 0.01), significance was not maintained when adjusted for potential confounders. Prior exacerbations were most strongly associated with future risk of exacerbation. The results suggest 24-hour COPD symptoms do not independently predict future exacerbation risk.
Filiaciones:
Miravitlles M:
a Pneumology Department , Hospital Universitari Vall d'Hebron, Ciber de Enfermedades Respiratorias (CIBERES) , Barcelona , Spain
Worth H:
b Facharztforum Fürth , Fürth , Germany
:
c Servicio de Neumología, Hospital Arnau de Vilanova , Valencia , Spain
Price D:
d Centre of Academic Primary Care, University of Aberdeen , Aberdeen , UK
De Benedetto F:
e Specialization School in Internal Medicine , G. D'Annunzio, University of Chieti , Chieti , Italy
Roche N:
f Cochin Hospital, AP-HP, Paris Descartes University (EA2511) EA2511 , Paris , France
Godtfredsen NS:
g Department of Respiratory Medicine , Hvidovre University Hospital , Hvidovre , Denmark
van der Molen T:
h Department of Primary care , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
Löfdahl CG:
i Department of Respiratory Medicine and Allergology , Lund University Hospital , Lund , Sweden
Padullés L:
j Medical Affairs, Almirall S.A. , Barcelona , Spain
Ribera A:
k Medical Affairs, AstraZeneca PLC , Barcelona , Spain
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