Symptom burden in patients with COPD continues over time
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High symptom burden patterns in patients with COPD are consistent over time and individual symptom experiences should be the main focus in treatment among these patients, researchers concluded in Respiratory Medicine Journal.
“Subgroups of patients with specific symptom experience patterns have been associated with defined clinical characteristics and lower health-related quality of life,” Vivi L. Christensen, MD, from the department of nursing and health sciences at the University of South-Eastern Norway, Drammen, Norway, and colleagues wrote. “Identifying such subgroups may indicate possible treatment opportunities.”
Researchers reported results of a follow-up study of 267 adults with moderate, severe and very severe COPD in Norway. Using the Memorial Symptom Assessment Scale (MSAS), researchers identified three subgroups based on patients’ symptoms at baseline: low (n = 28), intermediate (n = 112) and high (n = 127). Researchers evaluated transitions between these subgroups at 3, 6, 9 and 12 months and differences in symptom scores and health-related quality of life.
After 12 months, 64.7% of patients with COPD remained in the high symptom burden class and 81.8% had low symptom burden.
At 12 months, pairwise comparisons for respiratory function measurements were not significantly different between the groups, according to the results.
Patients with high symptom burden were more likely to be female (66.2% vs. 43.3% and 46%), have more comorbidities (3.3 vs. 1.3 and 2), reported a higher number of symptoms at all time points as measured by the MSAS (19.15 vs. 4.92 and 10.46) and have worse health-related quality of life scores (1.29 vs. 0.29 and 0.67) compared with patients in the low and intermediate symptom burden groups.
The most commonly reported symptom at 12 months was shortness of breath (probability: 1.000 in high group, 0.964 in intermediate group; 0.742 in low group). The second most commonly reported symptom was lack of energy among patients with intermediate and high symptom burden (probability: 0.929 and 0.984, respectively).
“The reclassification rates along with the MSAS and [St. George’s Respiratory Questionnaire] scores as well as the patient characteristics in the current study, provide meaningful information about the stability in COPD patients’ symptom experience and underlines the importance of a broad and individualized symptom assessment,” the researchers wrote. “Our findings suggest that the symptom burden in COPD patients continues over time.”