Abstract
Aim:
To examine the burden of respiratory symptoms, quality of life and co-morbid illness in COPD patients receiving maintenance treatment in a real world setting.
Methods:
In a single visit, patients with a physician's diagnosis of COPD who were receiving monotherapy with a long-acting bronchodilator (LABD) performed spirometry, completed symptom questionnaires, and reported their treatments, history of exacerbations and co-morbidities.
Results:
We enrolled 1084 patients of whom 1072 had acceptable spirometry. 689 (64%) had airflow obstruction (FEV1/FVC≤0.70) while 383 (36%) failed to meet spirometric criteria for COPD despite receiving maintenance therapy and having comparable symptoms and co-morbid illness. Among those with confirmed COPD, dyspnoea was worse in those with more severe airflow limitation though exacerbation frequency was comparable across COPD stages.
Conclusions:
COPD is commonly diagnosed and treated in patients without airflow obstruction. Many COPD patients receiving LABD monotherapy continue to suffer significant symptoms, exacerbations and poor quality of life.
Keywords: COPD, long-acting bronchodilator, spirometry, quality of life, disease severity, symptoms, monotherapy
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Footnotes
Mark Dransfield has received COPD-related research funding from the NHLBI as well as Aeris, Altana/Nycomed/Forest, AstraZeneca, Boehringer Ingelheim, GSK, Novartis, Pfizer, and Roche. He has served on an advisory board for GSK and BI and has received speakers' honoraria from GSK and BI for COPD-related talks.
William Bailey has received research contracts from drug companies as sponsors of investigational drug research projects as well as speakers and advisory board honoraria. He has also received grants from the NIH which occasionally uses therapy/drugs from pharmaceutical companies. The pharmaceutical companies are: GlaxoSmithKline, AstraZeneca, Boehringer Ingelheim, Schering-Plough, Merck, Inspire, Pfizer, Aventis, Nycomed and Novartis.
Glenn Crater, Amanda Emmett, and Dianne O'Dell are GSK employees and own stock in the company.
Barbara Yawn has received research grants from GSK, Novartis and BI/Pfizer in the area of COPD screening and has served on the advisory committee for COPD related studies of GSK and BI-Pfizer.