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Obstructive Lung Diseases |

COPD Patients With Nighttime and/or Early Morning Symptoms: Quality of Life and Dyspnea

Sean Sullivan, PhD; Michelle Mocarski, MPH; Qian Cai, MS; Judith Stephenson, MS; Hiangkiat Tan, MS; Jalpa Doshi, PhD
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University of Washington, Seattle, WA


Chest. 2013;144(4_MeetingAbstracts):694A. doi:10.1378/chest.1703187
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Abstract

SESSION TITLE: COPD Diagnosis & Evaluation Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: To assess quality of life (QoL) and dyspnea among chronic obstructive pulmonary disease (COPD) patients with/without nighttime (NT) and/or early morning (EM) symptoms.

METHODS: This study consisted of a cross-sectional patient survey. Administrative claims from the HealthCore Integrated Research Database were utilized to identify commercially insured patients, aged ≥40 years, with ≥1 medical claim with an ICD-9-CM diagnosis code of COPD or ≥1 pharmacy claim for COPD maintenance medication between 09/01/2010-08/31/2011. Consenting respondents completed a 25-minute survey including screening questions which classified them as having NT/EM symptoms based on whether they experienced symptoms ≥3 nights/mornings in the past week. Survey recruitment was stratified based on NT/EM symptoms to maximize balance across groups. Respondents completed the Short Form-12 version 2 (SF-12v2), the COPD Assessment Test (CAT), and the modified Medical Research Council (mMRC) dyspnea scale. Analysis of variance and chi-square tests were used to evaluate differences among groups.

RESULTS: Of 752 respondents completing the survey, 42.3% reported having both NT/EM symptoms, 32.7% reported either NT or EM symptoms, and 25.0% reported neither. Mean (±SD) age was 60.2 (±8.0) years and the majority of respondents were female (60.5%), white (91.6%), and former/current smokers (87.1%). Respondents with EM symptoms experienced EM symptoms for an average of 5.2 (±5.0) years. Respondents with NT symptoms experienced NT symptoms for an average of 5.4 (±5.8) years. Compared to respondents without symptoms, those with both or either NT/EM symptoms reported lower mean SF-12v2 Physical Component Summary scores (PCS: both, 34.0 vs either, 38.6 vs neither, 43.8; p<0.01) and Mental Component Summary scores (MCS: both, 47.0 vs either, 52.8 vs neither, 54.3; p<0.01), as well as higher mean CAT scores (both, 21.6 vs either, 13.8 vs neither, 9.1; p<0.01) and mMRC grade (both, 1.8 vs either, 1.1 vs neither, 0.8; p<0.01), indicating a greater impact of COPD symptoms and dyspnea for respondents with both or either symptoms.

CONCLUSIONS: COPD patients with NT/EM symptoms reported lower physical QoL scores and a greater impact of COPD symptoms and dyspnea compared with patients without symptoms.

CLINICAL IMPLICATIONS: Improved management of NT/EM symptoms may decrease the burden associated with these symptoms.

DISCLOSURE: Sean Sullivan: Consultant fee, speaker bureau, advisory committee, etc.: consultant fees from Forest Research Institute Michelle Mocarski: Employee: Forest Research Institute Qian Cai: Employee: of HealthCore, Inc., which received funding from Forest Research Institute, Inc., for study design, data collection, data analysis and interpretation Judith Stephenson: Employee: of HealthCore, Inc., which received funding from Forest Research Institute, Inc., for study design, data collection, data analysis and interpretation Hiangkiat Tan: Employee: of HealthCore, Inc., which received funding from Forest Research Institute, Inc., for study design, data collection, data analysis and interpretation Jalpa Doshi: Consultant fee, speaker bureau, advisory committee, etc.: Forest

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