Patient reported outcome measures in chronic obstructive pulmonary disease: Which to use?

ABSTRACT

Patient-reported outcomes (PROs), such as symptoms and perceived health status, are essential in chronic obstructive pulmonary disease (COPD) for determining disease severity, impact on daily life, effect of treatment and recovery from exacerbations. This field has evolved rapidly and there are a plethora of instruments assessing different PROs.

The aim of this review is to provide an understanding of the concept of PROs in COPD. The PROs reflect important aspects of COPD which have a direct impact on daily life. Common symptoms such as dyspnea, cough, phlegm, anxiety, fatigue, and pain and as well as physical function and the risk for and occurrence of acute exacerbations should be assessed both in the clinic and in research. Besides impact on daily life, some of the PROs are related to disease progress and mortality. Construction of composite variables including different disease specific and generic PROs provide a general estimation of health status.

KEYWORDS:

• COPD
• PROM
• Measurement
• Dyspnea
• Health status
• Quality of Life
• Exacerbation

Financial & competing interests disclosure

M Ekstrom and J Sundh are involved in a Swedish translation of MDP. None of the authors have financial or other ties that may influence the content of the manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• Patient reported outcome measures (PROMs) should be routinely assessed in clinical practice and trials in COPD.

• PROMs mirror outcomes that are relevant to the individual patient such as symptoms and perceived health status or quality of life.

• PROMs correlate poorly with lung function parameters such as FEV₁.

• Dyspnea is a sensation that consists of different dimension that should be assessed by validated instruments in both research and practice.

• Health status should optimally be assessed by the use of generic and disease-specific instrument enabling both inter-individual and intra-individual comparisons.

• A range of validated PROMs are available, and suggestions are given on which to use in research and patient care.