Abstract
Although patients with Chronic Obstructive Pulmonary Disease (COPD), especially those with frequent exacerbations, show a compromised quality of life in cross-sectional studies, it remains unclear if patient-reported outcomes (PROs) can be used to predict COPD exacerbations. The aim of this study was to identify PROs that are predictors of COPD exacerbations during 2 years of follow-up.
We based the analysis on the prospective ICE COLD ERIC cohort study from Switzerland and the Netherlands (N = 409) that includes COPD patients (aged ≥ 40) with GOLD stages II to IV from general practitioners. PROs included the Chronic Respiratory Questionnaire (CRQ), the Hospital Anxiety and Depression Scale, the Feeling Thermometer, the Physical Activity Questionnaire (LAPAQ) and self-efficacy questions. COPD exacerbations during 2 years after baseline assessment were ascertained through patient self-reports and patient charts and centrally adjudicated by an expert committee (Puhan, M. et al. Eur Respir J 2013;42:956-963). We used negative binomial regression to assess the association of PROs and exacerbations.
After adjusting for age, sex, FEV1, previous exacerbations and smoking status only the CRQ total score (incidence rate ratio per one unit increase in CRQ score [1-7 scale] 0.89, 95% CI 0.79-1.00 p=0.049) and the CRQ dyspnea score (incidence rate ratio 0.90, 95% CI 0.82-0.98, p=0.014) predicted exacerbations statistically significantly. The CRQ fatigue, CRQ mastery and LAPAQ scores showed statistically significant associations in unadjusted analyses only.
The CRQ total and dyspnea scores were significant predictors of exacerbations and may be used in multivariate prediction models to predict COPD exacerbations.
- © 2014 ERS