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. 2020 Jan;7(1):26-37.
doi: 10.15326/jcopdf.7.1.2019.0135.

Assessment of the COPD Assessment Test Within U.S. Primary Care

Richard H Stanford  1 , Maggie Tabberer  2 , Mark Kosinski  3 , Phaedra T Johnson  3 , John White  3 , Maureen Carlyle  3 , Nicole A Tillery  1
Affiliations

Assessment of the COPD Assessment Test Within U.S. Primary Care

Richard H Stanford et al. Chronic Obstr Pulm Dis. 2020 Jan.

Abstract

Rationale: Uptake of the COPD Assessment Test (CATTM) is not yet widespread in patients with chronic obstructive pulmonary disease (COPD) within U.S. primary care and its alignment with other assessments has not been evaluated in U.S. clinical practice.

Objectives: To assess the alignment of the CAT with other standard measures of COPD severity and its usability in a U.S. primary care population.

Methods: This was a multicenter, prospective, observational, longitudinal study of patients with COPD and their primary care physicians. Patients with spirometry-confirmed airflow restriction completed a daily electronic diary (eDiary) over 12 weeks; surveys were also administered at baseline and at 6- and 12-week follow-up.

Measurements and main results: In the study population (n=178), statistically significant differences (P<0.05) were found across 4 CAT impact score groups where at all time points patients in the Low Impact CAT score group had superior lung function and physical/mental health status than patients in the Medium, High, and Very High Impact groups. Numerical, though lesser, differences were also found across these latter 3 groups. Furthermore, the average total EXAcerbations of COPD Tool (EXACT®) score was significantly worse in patients in the highest CAT score group over the first 7 days.

Conclusions: COPD severity; respiratory symptoms; frequency, severity, and duration of pulmonary exacerbations; and overall physical and mental health status are linked concurrently and prospectively to CAT impact score categories. The stratification of patients according to CAT impact scores, and application of clinical and functional health status information to these categories, enhances the usability of the CAT in practice settings for COPD management.

Keywords: COPD Assessment Test; EXACT; EXacerbations of COPD Tool; chronic obstructive pulmonary disease; communication; primary health care.

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Conflict of interest statement

The authors declare the following conflicts of interest during the last 3 years in relation to this article: RHS was formerly, and MT and NAT are employees of and own shares in GlaxoSmithKline plc. MK, PTJ, JW, and MC are employees of and own shares in Optum plc. Optum plc received funding from GlaxoSmithKline plc to conduct this study, but were not paid for manuscript development. This study was funded by GlaxoSmithKline plc (GSK study HO-14-14653/204942). GlaxoSmithKline plc was involved in the design of this study, the collection, analysis, and interpretation of data, the writing of this manuscript and the decision to submit for publication.

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