COPD: the patient perspective

Abstract

Chronic obstructive pulmonary disease (COPD) is a highly prevalent disease characterized by nonreversible airway obstruction. Well-characterized symptoms such as exertional dyspnea and fatigue have a negative impact on patients' quality of life (QoL) and restrict physical activity in daily life. The impact of COPD symptoms on QoL is often underestimated; for example, 36% of patients who describe their symptoms as being mild-to-moderate also admit to being too breathless to leave the house. Additionally, early morning and nighttime symptoms are a particular problem. Methods are available to allow clinicians to accurately assess COPD symptoms, including patient questionnaires. Integrated approaches to COPD management, particularly pulmonary rehabilitation, are effective strategies for addressing symptoms, improving exercise capacity and, potentially, also increasing physical activity. Inhaled bronchodilators continue to be the mainstay of drug therapy in COPD, where options can be tailored to meet patients' needs with careful selection of the inhaled medication and the device used for its delivery. Overall, an integrated approach to disease management should be considered for improving QoL and subsequent patient outcomes in COPD.

Keywords: COPD; patients; physical activity levels; pulmonary rehabilitation.

Figure 1

Pedometer indices for public health. Note: Data from Tudor-Locke et al.

Figure 2

Mapping COPD characteristics. Abbreviation: COPD, chronic obstructive pulmonary disease.

Figure 3

Synergistic bronchodilator effect from the simultaneous blockade of M₂/M₃ receptors and the activation of β₂-adrenoceptors. Notes: Gray columns indicate the effect of saline or tiotropium on ACh-induced bronchoconstriction in the absence of carmoterol (control) in anesthetized guinea pigs. **P,0.01 and ***P,0.001 versus corresponding control. Values are mean ± standard error of the mean of six to eight different animals. Adapted from Pulmonary Pharmacology & Therapeutics, Vol 20, Issue 3, Rossoni G, Manfredi B, Razzetti R, Civelli M, Berti F, Positive interac tion of the novel β₂-agonist carmoterol and tiotropium bromide in the control of airway changes induced by different challenges in guinea-pigs. Pages 250–257, Copyright 2007, with permission from Elsevier. Abbreviations: ACh, acetylcholine; ITP, intratracheal pressure; iv, intravenous.