The Relationship Between 24-Hour Symptoms and COPD Exacerbations and Healthcare Resource Use: Results from an Observational Study (ASSESS)

Marc Miravitlles*, Heinrich Worth, Juan José Soler-Cataluña, David Price, Fernando De Benedetto, Nicolas Roche, Nina S. Godtfredsen, Thys van der Molen, Claes Göran Löfdahl, Laura Padullés, Anna Ribera

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

This observational study assessed the relationship between nighttime, early-morning and daytime chronic obstructive pulmonary disease (COPD) symptoms and exacerbations and healthcare resource use. COPD symptoms were assessed at baseline in patients with stable COPD using a standardised questionnaire during routine clinical visits. Information was recorded on exacerbations and healthcare resource use during the year before baseline and during a 6-month follow-up period. The main objective of the analysis was to determine the predictive nature of current symptoms for future exacerbations and healthcare resource use. 727 patients were eligible (65.8% male, mean age: 67.2 years, % predicted forced expiratory volume in 1 second: 52.8%); 698 patients (96.0%) provided information after 6 months. Symptoms in any part of the day were associated with a prior history of exacerbations (all p <0.05) and nighttime and early-morning symptoms were associated with the frequency of primary care visits in the year before baseline (both p <0.01). During follow-up, patients with baseline symptoms during any part of the 24-hour day had more exacerbations than patients with no symptoms in each period (all p <0.05); there was also an association between 24-hour symptoms and the frequency of primary care visits (all p ≤ 0.01). Although there was a significant association between early-morning and daytime symptoms and exacerbations during follow-up (both p <0.01), significance was not maintained when adjusted for potential confounders. Prior exacerbations were most strongly associated with future risk of exacerbation. The results suggest 24-hour COPD symptoms do not independently predict future exacerbation risk.

Original languageEnglish
Pages (from-to)561-568
Number of pages8
JournalCOPD: Journal of Chronic Obstructive Pulmonary Disease
Volume13
Issue number5
Early online date16 Mar 2016
DOIs
Publication statusPublished - 2016

Keywords

  • cohort
  • exacerbation risk
  • morning symptoms
  • nighttime symptoms
  • prospective
  • retrospective

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    Miravitlles, M., Worth, H., Soler-Cataluña, J. J., Price, D., De Benedetto, F., Roche, N., Godtfredsen, N. S., van der Molen, T., Löfdahl, C. G., Padullés, L., & Ribera, A. (2016). The Relationship Between 24-Hour Symptoms and COPD Exacerbations and Healthcare Resource Use: Results from an Observational Study (ASSESS). COPD: Journal of Chronic Obstructive Pulmonary Disease, 13(5), 561-568. https://doi.org/10.3109/15412555.2016.1150447