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Sarah Houben-Wilke, PhD1 Filip J. J. Triest, MD1,2 Frits M.E. Franssen, MD, PhD1,2 Daisy J.A. Janssen, MD, PhD1,3 Emiel F.M. Wouters, MD, PhD1,2 Lowie E.G.W. Vanfleteren, MD, PhD1,2
Author Affiliations
- CIRO, Center of Expertise for Chronic Organ Failure, Horn, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- Centre of Expertise for Palliative Care, Maastricht University Medical Center, Maastricht, The Netherlands
- COPD Center, Sahlgrenska University Hospital and Institute of Medicine, Gothenburg University, Gothenburg, Sweden
Address correspondence to:
Dr. Sarah Houben-Wilke
Hornerheide 1
6085 NM Horn
The Netherlands
Email: sarahwilke@ciro-horn.nl
Phone: +31 (0)475 587 602
Abstract
Beyond respiratory impairment, patients with chronic obstructive pulmonary disease (COPD) often suffer from comorbidities which are associated with worse health status, higher health care costs and worse prognosis. Reported prevalences of comorbidities largely differ between studies which might be explained by different assessment methods (objective assessment, self-reported assessment, or assessment by medical records), heterogeneous study populations, inappropriate control groups, incomparable methodologies, etc. This narrative review demonstrates and further evaluates the variability in prevalence of several comorbidities in patients with COPD and control individuals and discusses several shortcomings and pitfalls which need to be considered when interpreting comorbidity data. Like in other chronic organ diseases, the accurate diagnosis and integrated management of comorbidities is a key for outcome in COPD. This review highlights that there is a need to move from the starting point of an established index disease towards the concept of the development of multimorbidity in the elderly including COPD as an important and highly prevalent pulmonary component.
Citation
Citation: Houben-Wilke S, Triest FJJ, Franssen FME, Janssen DJA, Wouters EFM, Vanfleteren LEGW.Revealing methodological challenges in chronic obstructive pulmonary disease studies assessing comorbidities: a narrative review. Chronic Obstr Pulm Dis. 2019; 6(2):In press. doi: http://dx.doi.org/10.15326/jcopdf.6.2.2018.0145
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Cara B. Pasquale, MPH1 Jeffrey Vietri, PhD2 Radmila Choate, MPH3 Angee McDaniel, PharmD4 Reiko Sato, PhD2 Kimbal D. Ford, PharmD5 Elisha Malanga, BS1 Barbara P. Yawn, MD, MSc1
Author Affiliations
- Research Department, COPD Foundation, Inc., Washington, D.C.
- Patient & Health Impact, Pfizer, Inc., Collegeville, Pennsylvania
- College of Public Health, University of Kentucky Lexington, and Consultant, COPD Foundation, Inc.
- Medical Affairs, Pfizer, Inc., Columbia, Missouri
- Medical Affairs, Pfizer, Inc., Lexington, Kentucky
Abstract
Community acquired pneumonia (CAP) carries high morbidity, mortality, and economic burden, which is even higher in adults diagnosed with chronic obstructive pulmonary disease (COPD). While several studies have assessed the clinical burden and mortality risk of CAP and COPD, very few studies focus on CAP burden from a COPD patient perspective. Individuals recently diagnosed with CAP and with pre-existing COPD were recruited through the COPD Foundation. The CAP Burden of Illness Questionnaire (CAP-BIQ), a content validated questionnaire assessing CAP symptomatology, duration of symptoms and CAP impact on work, activities and family, was administered at baseline and at 30-days follow-up.
Of the 490 participants recruited, 481 had data sufficient for analysis. The prevalence of respiratory-related symptoms was very high (>90%) at the time of diagnosis with other generalized symptoms such as fatigue, trouble sleeping, headaches and confusion present in more than 60% of participants. Mean duration of symptoms varied from approximately 2 weeks for headaches and fever to more than a month for fatigue, wheezing, dyspnea, and cough. Employed participants missed an average of 21 days of work and those not employed missed 36 days of usual activities. Over 84% required help from family, friends or care givers.
CAP is a serious and burdensome condition for people with COPD, a condition that can impair activities for weeks, frequently requires care from family or friends, and includes lingering symptoms. The patient-reported impact of CAP reported in this study underscores the need for prevention strategies in this population.
Citation
Citation: Pasquale CB, Vietri J, Choate R, et al.Patient-reported consequences of community-acquired pneumonia in patients with chronic obstructive pulmonary disease. Chronic Obstr Pulm Dis. 2019; 6(2):In press. doi: http://dx.doi.org/10.15326/jcopdf.6.2.2018.0144
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