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. 2024 Mar 26;11(2):144-154.
doi: 10.15326/jcopdf.2023.0415.

Health Status Progression Measured Using Weekly Telemonitoring of COPD Assessment Test Scores Over 1 Year and Its Association With COPD Exacerbations

Paul Jones  1 , Toru Soutome  2 , Taizo Matsuki  2 , Masahiro Shinoda  3 , Osamu Hataji  4 , Motohiko Miura  5 , Masaharu Kinoshita  6 , Akira Mizoo  7 , Kazunori Tobino  8 , Takanobu Nishi  2 , Takeo Ishii  2 , Yoko Shibata  9
Affiliations

Health Status Progression Measured Using Weekly Telemonitoring of COPD Assessment Test Scores Over 1 Year and Its Association With COPD Exacerbations

Paul Jones et al. Chronic Obstr Pulm Dis. .

Abstract

Background: A previous longitudinal study of chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) score changes suggested patients fall into 3 patterns: stable, improving, and worsening. This study assessed the evolution of CAT scores over time and its relationship to exacerbations.

Methods: In total, 84 participants used a telemedicine platform to complete CAT weekly for 52 weeks. Completion rates, annualized change in CAT scores, and learning effects were measured, as well as CAT changes of >4 units during look-back periods of 4 and 8 weeks. In a subgroup of participants with at least a 25% completion rate (adherent group, n=68 [81%]), the relationship between change in CAT score and exacerbations at any time during the study was examined post hoc.

Results: Linear regression showed that 50%, 22%, and 28% of the adherent subgroup had CAT scores indicating worsening, stable, and improving health status, respectively. In the adherent subgroup, 70% (n=7/10) of participants who had an exacerbation during the study had worsening CAT scores, versus 47% (n=27/58) without an exacerbation. The hazard ratio association between CAT score increase and moderate exacerbation was 1.13 (95% confidence interval: 1.03-1.24). Most participants experienced at least one CAT score change of >4 units, and 7% showed an initial learning effect with a median of 2 weeks.

Conclusion: Measuring trends in CAT scores may allow future studies to group patients into 3 defined categories of change over time and quantify CAT change trajectories to assess treatment response and potentially predict medium-term outcomes within individual patients.

Keywords: CAT score; COPD; exacerbations; patient-reported outcome; telemonitoring.

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Conflict of interest statement

MS, OH, MM, MK, AM, and KT report having received grants from the GSK group of companies for the conduct of this study. YS reports having received personal fees from the GSK group of companies during the conduct of the study, and lecture fees from AstraZeneca, Novartis, and Boehringer Ingelheim. TN is an employee of GSK. TM is an employee of GSK and holds stocks/shares. TI and TS are former employees of GSK. PJ is an Emeritus Professor of Respiratory Medicine at St George’s, University of London, and a former full-time employee of GSK at the time of protocol development and contributed to study design and protocol on behalf of GSK. He is a part-time consultant at GSK and holds stocks/shares.

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