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Review
. 2013:8:461-71.
doi: 10.2147/COPD.S49392. Epub 2013 Oct 14.

COPD management: role of symptom assessment in routine clinical practice

Thys van der Molen  1 , Marc Miravitlles, Janwillem W H Kocks
Affiliations
Review

COPD management: role of symptom assessment in routine clinical practice

Thys van der Molen et al. Int J Chron Obstruct Pulmon Dis. 2013.

Abstract

Patients with chronic obstructive pulmonary disease (COPD) present with a variety of symptoms that significantly impair health-related quality of life. Despite this, COPD treatment and its management are mainly based on lung function assessments. There is increasing evidence that conventional lung function measures alone do not correlate well with COPD symptoms and their associated impact on patients' everyday lives. Instead, symptoms should be assessed routinely, preferably by using patient-centered questionnaires that provide a more accurate guide to the actual burden of COPD. Numerous questionnaires have been developed in an attempt to find a simple and reliable tool to use in everyday clinical practice. In this paper, we review three such patient-reported questionnaires recommended by the latest Global Initiative for Chronic Obstructive Lung Disease guidelines, ie, the modified Medical Research Council questionnaire, the clinical COPD questionnaire, and the COPD Assessment Test, as well as other symptom-specific questionnaires that are currently being developed.

Keywords: chronic obstructive pulmonary disease; questionnaires; symptoms.

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Figures

Figure 1
Figure 1
Symptoms of chronic obstructive pulmonary disease. Notes: Patients were asked if they had experienced any symptoms (breathlessness [n = 1,769], phlegm [n = 1,552], cough [n = 1,433], wheezing [n = 1,018] or chest tightness [n = 690]) in the 7 days prior to the telephone interview. Multiple answers were possible. © 2011 European Respiratory Society. Reproduced with permission of the European Respiratory Society. Eur Respir J. February 2011;37:264–272; published ahead of print November 29, 2010; DOI: 10.1183/09031936.00051110.
Figure 2
Figure 2
Self-reported perceived severity of chronic obstructive pulmonary disease (mild, moderate, or severe) reported by degree of breathlessness, adapted and reproduced. Notes: Breathlessness assessed by the MRC dyspnea scale adapted as per Bestall et al. [1, “Only get breathless after strenuous exercise” (n = 727); 2, “Get breathless when hurrying on level ground or walking on slight incline” (n = 898); 3, “Have to stop even when walking at my own pace or walk slower than most people my age” (n = 517); 4, “Have to stop for breath every few minutes when walking even on level ground” (n = 639); and 5, “Too breathless to leave the house” (n = 210)]. © 2002 European Respiratory Society. Reproduced with permission of the European Respiratory Society. Eur Respir J. October 2002 20:799–805; DOI:10.1183/09031936. 02.03242002. Abbreviation: MRC, Medical Research Council.
Figure 3
Figure 3
Clinical COPD questionnaire. Abbreviation: COPD, chronic obstructive pulmonary disease.
Figure 4
Figure 4
COPD Assessment Test. Abbreviation: COPD, chronic obstructive pulmonary disease.
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References

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    1. global Initiative for Obstructive Lung Disease Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease 2011 Available from: http://www.goldcopd.comAccessed July 25, 2013

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