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Obstructive Lung Diseases |

Symptom Severity and Morning Activity Limitation Associated With Patterns of Increased Inhaler Use in Patients With Chronic Obstructive Pulmonary Disease (COPD) FREE TO VIEW

Deborah Casey, MD; Kenneth Chapman, MD; Kim Lavoie, PhD; Renata Rea, RRT; Katherine Arias, PhD; Paul Jones, MD
Author and Funding Information

Asthma and Airway Centre, University Health Network, Toronto, ON, Canada


Chest. 2015;148(4_MeetingAbstracts):708A. doi:10.1378/chest.2267276
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Abstract

SESSION TITLE: COPD Posters III

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Patients with COPD experience significant symptom burden. Greater understanding of the impact this has on behaviour, including patterns of inhaler use, could be useful in optimizing patient care. In a cross-Canada survey of respiratory specialists and COPD patients, we included questions aimed at better understanding patient behaviour.

METHODS: 23 respiratory specialists from across Canada completed a questionnaire related to management of COPD and questionnaires about the care and perceived behaviours of 210 individual patients. 187 patients from the same practices completed questionnaires exploring their experience of COPD treatment. Data on inhaler use and morning activity were collected as part of the larger survey assessing gaps in COPD care.

RESULTS: Mean patient age was 70.8 yrs., 52% were male and 90% reported having ≥ 1 comorbid condition. Severe dyspnea (MRC dyspnea score ≥ 4) was associated with shorter time between waking and self-reported first inhaler use. 33% of patients reported first inhaler use within 5 min., a further 27% of patients reported first inhaler use within 15 min. and only 10% used their first inhaler ≥1 hr. after waking. 25% reported using a short-acting bronchodilator first after waking, another 25% reported using a long-acting muscarinic antagonist first. Self-reported morning function was affected; 71% of patients needed ≥1 hr before being able to leave the house in the morning, and 27% needed ≥2 hrs. Those taking more bedtime salbutamol needed longer before being able to leave the house after waking, and severe dyspnea scores were associated with higher physician-reported use of salbutamol before bedtime.

CONCLUSIONS: Patients with severe dyspnea are more likely to use their inhalers sooner after waking, and to use more frequent evening salbutamol, than patients with less severe dyspnea. Morning activity limitation was greater in patients reporting more short-acting bronchodilator use.

CLINICAL IMPLICATIONS: Patterns of inhaler use and functional limitation, particularly before bed and after waking, could provide physicians with insight into disease severity and degree of disability for patients with COPD. This should be part of assessing patients with this disease.

DISCLOSURE: Deborah Casey: Consultant fee, speaker bureau, advisory committee, etc.: Almirall, Consultant fee, speaker bureau, advisory committee, etc.: AstraZeneca, Grant monies (from industry related sources): GSK, Grant monies (from industry related sources): Boehringer Ingelheim, Grant monies (from industry related sources): VitalAire, University grant monies: AFP Innovation Fund, Consultant fee, speaker bureau, advisory committee, etc.: Takeda, Consultant fee, speaker bureau, advisory committee, etc.: Novartis, Consultant fee, speaker bureau, advisory committee, etc.: Grifols, Consultant fee, speaker bureau, advisory committee, etc.: Janssen, Consultant fee, speaker bureau, advisory committee, etc.: Roche Kenneth Chapman: University grant monies: CIHR, Grant monies (from industry related sources): Almirall, Grant monies (from industry related sources): AstraZeneca, Grant monies (from industry related sources): Novartis, Grant monies (from industry related sources): GSK, Grant monies (from industry related sources): Boehringer Ingelheim, Grant monies (from industry related sources): Roche, Grant monies (from industry related sources): Grifols, Grant monies (from industry related sources): CSL Behring, Grant monies (from sources other than industry): Takeda, Consultant fee, speaker bureau, advisory committee, etc.: GSK, Consultant fee, speaker bureau, advisory committee, etc.: AstraZeneca, Grant monies (from industry related sources): Novartis, Consultant fee, speaker bureau, advisory committee, etc.: Grifols, Consultant fee, speaker bureau, advisory committee, etc.: CSL Behring Kim Lavoie: Grant monies (from industry related sources): Abbvie, Consultant fee, speaker bureau, advisory committee, etc.: Abbvie, Consultant fee, speaker bureau, advisory committee, etc.: Almirall, Consultant fee, speaker bureau, advisory committee, etc.: Boehringer Ingelheim, Consultant fee, speaker bureau, advisory committee, etc.: Novartis, Consultant fee, speaker bureau, advisory committee, etc.: Janssen, Consultant fee, speaker bureau, advisory committee, etc.: Takeda Renata Rea: Employee: Almirall, Employee: AstraZeneca Katherine Arias: Employee: Almirall, Employee: AstraZeneca Paul Jones: Grant monies (from industry related sources): Almirall, Grant monies (from industry related sources): AstraZeneca, Consultant fee, speaker bureau, advisory committee, etc.: Almirall, Consultant fee, speaker bureau, advisory committee, etc.: AstraZeneca, Consultant fee, speaker bureau, advisory committee, etc.: GSK, Consultant fee, speaker bureau, advisory committee, etc.: Menarini, Consultant fee, speaker bureau, advisory committee, etc.: Roche, Consultant fee, speaker bureau, advisory committee, etc.: Mundipharma, Consultant fee, speaker bureau, advisory committee, etc.: Janssen

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