Ilaria Baiardini1, Marco Contoli2, Angelo Guido Corsico3, Carla Scognamillo4, Fabio Ferri5, Nicola Scichilone6, Paola Rogliani7, Fabiano Di Marco8, Pierachille Santus9, Fulvio Braido10. 1. Respiratory Unit for Continuity of Care, Department of Internal Medicine, University of Genova, Genoa, Italy, ilaria.baiardini@libero.it. 2. Respiratory Diseases Department of Morphology, Surgery and Experimental Medicine-Università di Ferrara- Ferrara, Ferrara, Italy. 3. Respiratory Diseases Division, Medical Sciences and Infectious Diseases Department, IRCCS Policlinico San Matteo Foundation, and Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy. 4. Boehringer Ingelheim, Milan, Italy. 5. MediNeos Observational Research, Modena, Italy. 6. Dipartimento Universitario PROMISE, Università di Palermo, UOC di Pneumologia, Policlinico Universitario P. Giaccone, Palermo, Italy. 7. Respiratory Medicine, Department of Experimental Medicine Università di Roma Tor Vergata,", Rome, Italy. 8. Department of Health Sciences, Università degli Studi di Milano, Respiratory Unit, ASST Papa Giovanni XXIII, Bergamo, Italy. 9. Department of Biomedical and Clinical Sciences (DIBIC), Università degli Studi di Milano. Division of Respiratory Diseases, University Hospital "L. Sacco," ASST Fatebenefratelli-Sacco, Milan, Italy. 10. Respiratory Unit for Continuity of Care, Department of Internal Medicine, University of Genova, Genoa, Italy.
Abstract
BACKGROUND: Disease awareness is a challenge in the management of chronic obstructive pulmonary disease (COPD). OBJECTIVES: The aim of this analysis was to explore the association between COPD optimal and suboptimal awareness, clinical parameters, and the following patient-reported outcomes: modified Medical Research Council (mMRC), Treatment Satisfaction Questionnaire (TSQM-9), COPD Assessment Test (CAT), Morisky Medication-Taking Adherence Scale (MMAS-4), and Brief Illness Perception Questionnaire (B-IPQ). METHODS: This post hoc analysis of the SAT study included all enrolled patients for whom awareness (Disease Awareness in COPD Questionnaire - DACQ) was assessed at baseline and 12 months. DACQ scores ≥80 were considered an indicator of an optimal awareness. RESULTS: 367 patients (25.8% women, median age 72 years) were included in the analysis. At enrollment, 74 patients (20.2%) had a DACQ score ≥80. Patients with suboptimal awareness, compared to those in which awareness was optimal, had higher median scores for CAT (p = 0.0001) and mMRC (p = 0.0031), a lower median TSQM-9 global score (p < 0.0001), and higher median B-IPQ score (p < 0.0001). The proportion of patients who had exacerbations during the previous year was higher in patients with suboptimal COPD awareness than in those with DACQ score ≥80 (42.8 vs. 21.4%, p = 0.0009). During the 12-month observation period, illness perception, adherence, and treatment satisfaction were found to be independent factors significantly associated with level of disease awareness. CONCLUSION: The results of our post hoc analysis suggest that patients' awareness of their COPD disease is related to both clinical outcomes and how they perceive and manage their condition.
BACKGROUND: Disease awareness is a challenge in the management of chronic obstructive pulmonary disease (COPD). OBJECTIVES: The aim of this analysis was to explore the association between COPD optimal and suboptimal awareness, clinical parameters, and the following patient-reported outcomes: modified Medical Research Council (mMRC), Treatment Satisfaction Questionnaire (TSQM-9), COPD Assessment Test (CAT), Morisky Medication-Taking Adherence Scale (MMAS-4), and Brief Illness Perception Questionnaire (B-IPQ). METHODS: This post hoc analysis of the SAT study included all enrolled patients for whom awareness (Disease Awareness in COPD Questionnaire - DACQ) was assessed at baseline and 12 months. DACQ scores ≥80 were considered an indicator of an optimal awareness. RESULTS: 367 patients (25.8% women, median age 72 years) were included in the analysis. At enrollment, 74 patients (20.2%) had a DACQ score ≥80. Patients with suboptimal awareness, compared to those in which awareness was optimal, had higher median scores for CAT (p = 0.0001) and mMRC (p = 0.0031), a lower median TSQM-9 global score (p < 0.0001), and higher median B-IPQ score (p < 0.0001). The proportion of patients who had exacerbations during the previous year was higher in patients with suboptimal COPD awareness than in those with DACQ score ≥80 (42.8 vs. 21.4%, p = 0.0009). During the 12-month observation period, illness perception, adherence, and treatment satisfaction were found to be independent factors significantly associated with level of disease awareness. CONCLUSION: The results of our post hoc analysis suggest that patients' awareness of their COPD disease is related to both clinical outcomes and how they perceive and manage their condition.
Authors: Mark J Atkinson; Anusha Sinha; Steven L Hass; Shoshana S Colman; Ritesh N Kumar; Meryl Brod; Clayton R Rowland Journal: Health Qual Life Outcomes Date: 2004-02-26 Impact factor: 3.186