OBJECTIVE: To determine diurnal variability of symptoms in chronic obstructive pulmonary disease (COPD) and to assess the impact of COPD upon patients' morning activities and routines. RESEARCH DESIGN AND METHODS: Quantitative internet interviews with 803 COPD patients from Europe and the USA, including 289 patients with severe COPD. Severe COPD was defined according to regular use of COPD medication, third level of breathlessness or above using the modified Medical Research Council (MRC) dyspnoea scale (MRC dyspnoea score > or =3) and one or more COPD exacerbations in the preceding 12 months. RESULTS: Morning was the worst time of day for COPD symptoms, particularly in patients with severe COPD (reported by 46% of severe patients). In these patients, shortness of breath was the most frequently reported symptom, correlating strongly with problems experienced with morning activities. Morning activities most affected by COPD were walking up and down stairs, putting on shoes and socks, making the bed, dressing, showering or bathing and drying. The majority of patients were not taking their medication in time for it to exert its optimal effect. CONCLUSIONS: Many patients consider the impact of COPD on morning activities to be substantial. Physicians should question patients about morning activities to assess disease impact and to advise regarding the optimal time to use therapy. This was an internet-based questionnaire survey and possible bias in patient selection and self-reported diagnosis of COPD and its severity should be taken into account.
OBJECTIVE: To determine diurnal variability of symptoms in chronic obstructive pulmonary disease (COPD) and to assess the impact of COPD upon patients' morning activities and routines. RESEARCH DESIGN AND METHODS: Quantitative internet interviews with 803 COPDpatients from Europe and the USA, including 289 patients with severe COPD. Severe COPD was defined according to regular use of COPD medication, third level of breathlessness or above using the modified Medical Research Council (MRC) dyspnoea scale (MRC dyspnoea score > or =3) and one or more COPD exacerbations in the preceding 12 months. RESULTS: Morning was the worst time of day for COPD symptoms, particularly in patients with severe COPD (reported by 46% of severe patients). In these patients, shortness of breath was the most frequently reported symptom, correlating strongly with problems experienced with morning activities. Morning activities most affected by COPD were walking up and down stairs, putting on shoes and socks, making the bed, dressing, showering or bathing and drying. The majority of patients were not taking their medication in time for it to exert its optimal effect. CONCLUSIONS: Many patients consider the impact of COPD on morning activities to be substantial. Physicians should question patients about morning activities to assess disease impact and to advise regarding the optimal time to use therapy. This was an internet-based questionnaire survey and possible bias in patient selection and self-reported diagnosis of COPD and its severity should be taken into account.
Authors: S Vamsee Raju; Hyunki Kim; Stephen A Byzek; Li Ping Tang; John E Trombley; Patricia Jackson; Lawrence Rasmussen; J Michael Wells; Emily Falk Libby; Erik Dohm; Lindy Winter; Sharon L Samuel; Kurt R Zinn; J Edwin Blalock; Trenton R Schoeb; Mark T Dransfield; Steven M Rowe Journal: JCI Insight Date: 2016-09-22
Authors: Maarten van den Berge; Wim C J Hop; Thys van der Molen; Jan A van Noord; Jacques P H M Creemers; Ad J M Schreurs; Emiel F M Wouters; Dirkje S Postma Journal: Respir Res Date: 2012-06-06
Authors: Edward Kerwin; Jacques Hébert; Nicola Gallagher; Carmen Martin; Tim Overend; Vijay K T Alagappan; Yimeng Lu; Donald Banerji Journal: Eur Respir J Date: 2012-07-26 Impact factor: 16.671