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Observational Study
. 2018 Dec 17:14:1-11.
doi: 10.2147/COPD.S179784. eCollection 2019.

Disease awareness in patients with COPD: measurement and extent

Ilaria Baiardini  1 , Paola Rogliani  2 , Pierachille Santus  3 , Angelo G Corsico  4 , Marco Contoli  5 , Nicola Scichilone  6 , Fabiano Di Marco  7 , Patrizia Lessi  8 , Carla Scognamillo  8 , Giorgia Molinengo  9 , Fabio Ferri  10 , Vincenzo Patella  11 , Giuseppe Fiorentino  12 , Mauro Carone  13 , Fulvio Braido  14
Affiliations
Observational Study

Disease awareness in patients with COPD: measurement and extent

Ilaria Baiardini et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Background: Patient awareness of COPD refers to knowledge and acceptance of the disease and its treatment. Although it is relevant to management and outcomes, the disease awareness of patients is poorly investigated, and no validated questionnaires are currently available. We aimed to develop the novel Disease Awareness in COPD Questionnaire (DACQ), which was validated in relation to demographic and clinical features, in patients participating in the SATisfaction and Adherence to COPD Treatment (SAT) study.

Methods: DACQ was developed according to a list of items regarding the patient's knowledge, acceptance, and perception of COPD as well as of treatment needs. The questionnaire was validated by assessing internal structure and consistency, correlations with other patient-reported outcomes, and stability over time. Furthermore, the extent of disease awareness of patients enrolled in the SAT study was assessed by using DACQ, and correlations with demographic and clinical features were evaluated.

Results: DACQ was composed of four domains. Overall reliability and stability over time were adequate; correlations between DACQ and other tools measuring different constructs (ie, treatment satisfaction, illness perception, impact of COPD symptoms on daily life, and dyspnea severity) were, as expected, more limited. In the enrolled patient sample, a suboptimal level of disease awareness (<70%) was detected, especially in terms of disease acceptance and perception. Disease knowledge was positively associated with COPD severity, while the impact of symptoms on daily life was negatively associated with disease acceptance, awareness of treatment needs, and overall awareness.

Conclusion: DACQ proved to be a reliable tool to assess awareness in COPD patients. Awareness of COPD patients need to be improved.

Clinical trial registration: ClinicalTrials.gov ID# NCT02689492.

Keywords: COPD; awareness; patient satisfaction; questionnaire.

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Conflict of interest statement

Disclosure The following authors report personal fees for scientific consultation from Boehringer Ingelheim related to the study: FB, IB, AGC, MC, FDM, GM, PR, NS, and PS. FB has received honoraria for lectures at national and international meetings from Almirall, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, Dompè, Guidotti/Malesci, GlaxoSmithKline, Menarini, Novartis, Lallemand Pharma, Biofutura, Levante Pharma, Merck Sharp and Dohme, and Zambon. He has served as consultant for AstraZeneca, Chiesi Farmaceutici, Novartis, Glaxo Smith Kline, Boehringer Ingelheim, Guidotti/MalesciZambon, and CSL Behring. MC reports grants for research from AstraZeneca and Chiesi and reports personal fees for scientific consultations and/or lectures at national and international meetings from Chiesi, Novartis, AstraZeneca, Glaxo Smith Kline, Boehringer Ingelheim, Menarini, and Zambon, which are not related to the submitted manuscript. FDM has received honoraria for lectures at national and international meetings from Almirall, AstraZeneca, Boehringer Ingelheim, Chiesi Farmaceutici, Dompe, Guidotti/Malesci, GlaxoSmithKline, Menarini, Novartis, and Zambon. He has served as consultant for AstraZeneca, Chiesi Farmaceutici, Novartis, and Zambon, and he has received financial support for research from Novartis and Boehringer Ingelheim. PR has participated as a lecturer, speaker, and advisor in scientific meetings and courses under the sponsorship of Almirall, AstraZeneca, Biofutura, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Menarini Group, Mundipharma, and Novartis. Her department has received funding from Almirall, Boehringer Ingelheim, Chiesi, Novartis, and Zambon. She has 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. PL and CS are employees of Boehringer Ingelheim Italy. FF is an employee of MediNeos Observational Research, Modena, Italy. He received payment from Boehringer Ingelheim Italy for the following activities related to the submitted work: scientific support, clinical operations, data management, statistical analysis, and manuscript preparation. MC, GF, and VP do not report any competing interests. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Patients’ COPD awareness at enrollment. Notes: Normalized DACQ scores (range 0–100) of COPD patients at enrollment visit; higher scores represent higher levels of awareness; mean values (bars), 1 SD (whiskers). Abbreviation: DACQ, Disease Awareness in COPD Questionnaire.
Figure 2
Figure 2
Patients’ COPD awareness according to GOLD 2017 disease severity grades. Notes: Normalized DACQ scores (range 0–100) for: (A) disease acceptance, (B) awareness of treatment needs, (C) disease knowledge, and (D) disease perception; median values (numbers), bottom and top of each box are the 25th and the 75th percentiles, respectively; bottom end and top end of the whiskers are minimum and maximum of all data, respectively. (E) Normalized DACQ total score; mean values (bars), 1 SD (whiskers). Higher scores represent higher levels of awareness. Asterisk (*) indicates a statistically significant difference (P<0.05); the number of patients (N) in each GOLD 2017 grade group is indicated. Only two patients were classified as GOLD 2017 C grade; therefore, they were excluded from the analysis because of the insufficient sample size. Abbreviation: DACQ, Disease Awareness in COPD Questionnaire.
Figure 3
Figure 3
Patients’ COPD awareness according to baseline CAT score. Notes: Normalized DACQ scores (range 0–100) for: (A) disease acceptance, (B) awareness of treatment needs, (C) disease knowledge, and (D) disease perception; median values (numbers), bottom and top of each box are the 25th and the 75th percentiles, respectively; bottom end and top end of the whiskers are minimum and maximum of all data, respectively. (E) Normalized DACQ total score; mean values (bars), 1 SD (whiskers). Higher scores represent higher levels of awareness. Statistically significant differences: *P<0.05; **P<0.01; the number of patients (N) in each CAT group is indicated. Abbreviations: CAT, COPD Assessment Test; DACQ, Disease Awareness in COPD Questionnaire.
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