The impact of morning symptoms on daily activities in chronic obstructive pulmonary disease

Abstract

Background:

This survey assessed the impact of symptoms of COPD on patients’ ability to perform activities throughout the day and the extent to which physicians provided advice including how medications may help maintain quality of life.

Methods:

The survey had three inclusion criteria – physician’s diagnosis of COPD, age 30–70 years and presence of at least one of four listed symptoms to a greater extent in the morning. Participants were randomly selected from a panel who had previously agreed to participate in surveys. The survey was conducted in eight countries and contained 31 questions in the main section on the effects of symptoms of COPD throughout the day on patients’ ability to perform tasks, how patients adjusted their lives and the extent to which physicians offered advice and support.

Results:

Routine activities took 10–15 minutes longer and more strenuous activities around 30 minutes longer than before symptoms had become worse in the morning. Half had made changes to their morning routines and just over half confirmed that morning symptoms affected the rest of their day. The majority believed their medications provided sufficient relief of morning symptoms but less than a quarter believed they helped improve their ability to perform tasks. Physicians were unlikely to discuss this aspect of patient care routinely even though there was evidence to suggest that the challenge of performing tasks had a greater impact on patients than the symptoms themselves.

Conclusions:

Morning symptoms of COPD can severely compromise patients’ ability to perform tasks throughout the day. Despite this, physicians are unlikely to discuss with patients how their ability to perform tasks might be improved.

Keywords::

• Activities
• COPD
• Education
• Guidelines
• Morning
• Patient
• Physician
• Symptoms

Transparency

Declaration of funding

The survey was carried out by Kantar Health and sponsored by Novartis. Novartis had no input in the preparation of this manuscript.

Author contributions: P.O’H. interpreted the data provided by Kantar Health and prepared drafts of the manuscript and was responsible for the final version and its submission. N.H.C. reviewed the data provided by Kantar Health and the drafts of the manuscript, revised all sections where appropriate, and approved of the final version of the manuscript.

Declaration of financial/other relationships

N.H.C. has disclosed that he has served on advisory boards of Novartis, Boehringer Ingelheim, Pfizer, AstraZeneca, Chiesi and GlaxoSmithKline but has received no financial remuneration regarding this paper, nor has he other financial or other interests to declare in relation to this manuscript. P.O’H. is an independent consultant. He was contracted by Kantar Health UK to co-author this manuscript and remunerated by the company for his input.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgements

The authors thank Mr Tim Stedman at Kantar Health UK for his work in the design of the survey, the preparation of the questionnaire and the provision of data for the analyses we carried out. The authors also thank Dr Roberto Forlan MSc PhD, Chief Statistician at Kantar Health, for the statistical analyses carried out on the data.