Treatable traits qualifying for nonpharmacological interventions in COPD patients upon first referral to a pulmonologist: the COPD sTRAITosphere.

Autor:	van 't Hul AJ; Radboud University Medical Center, Radboud Institute for Health Sciences, Dept of Respiratory Diseases, Nijmegen, The Netherlands., Koolen EH; Radboud University Medical Center, Radboud Institute for Health Sciences, Dept of Respiratory Diseases, Nijmegen, The Netherlands., Antons JC; Radboud University Medical Center, Radboud Institute for Health Sciences, Dept of Respiratory Diseases, Nijmegen, The Netherlands., de Man M; Bernhoven, Dept of Respiratory Diseases, Uden, The Netherlands., Djamin RS; Dept of Respiratory Diseases, Amphia Hospital, Breda, The Netherlands., In 't Veen JCCM; Dept of Respiratory Diseases, STZ Centre of Excellence for Asthma & COPD, Franciscus Gasthuis & Vlietland Hospital, Rotterdam, The Netherlands., Simons SO; Dept of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands., van den Heuvel M; Radboud University Medical Center, Radboud Institute for Health Sciences, Dept of Respiratory Diseases, Nijmegen, The Netherlands., van den Borst B; Radboud University Medical Center, Radboud Institute for Health Sciences, Dept of Respiratory Diseases, Nijmegen, The Netherlands., Spruit MA; Dept of Respiratory Medicine, Maastricht University Medical Centre, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands.; Dept of Research and Development, CIRO+, Horn, The Netherlands.; REVAL-Rehabilitation Research Center, BIOMED-Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.
Jazyk:	angličtina
Zdroj:	ERJ open research [ERJ Open Res] 2020 Nov 02; Vol. 6 (4). Date of Electronic Publication: 2020 Nov 02 (Print Publication: 2020).
DOI:	10.1183/23120541.00438-2020
Abstrakt:	Introduction: The present study assessed the prevalence of nine treatable traits (TTs) pinpointing nonpharmacological interventions in patients with COPD upon first referral to a pulmonologist, how these TTs co-occurred and whether and to what extent the TTs increased the odds having a severely impaired health status. Methods: Data were collected from a sample of 402 COPD patients. A second sample of 381 patients with COPD was used for validation. Nine TTs were assessed: current smoking status, activity-related dyspnoea, frequent exacerbations <12 months, severe fatigue, depressed mood, poor physical capacity, low physical activity, poor nutritional status and a low level of self-management activation. For each TT the odds ratio (OR) of having a severe health status impairment was calculated. Furthermore, a graphic representation was created, the COPD sTRAITosphere, to visualise TTs prevalence and OR. Results: On average 3.9±2.0 TTs per patient were observed. These TTs occurred relatively independently of each other and coexisted in 151 unique combinations. A significant positive correlation was found between the number of TTs and Clinical COPD Questionnaire total score (r=0.58; p<0.001). Patients with severe fatigue (OR: 8.8), severe activity-related dyspnoea (OR: 5.8) or depressed mood (OR: 4.2) had the highest likelihood of having a severely impaired health status. The validation sample corroborated these findings. Conclusions: Upon first referral to a pulmonologist, COPD patients show multiple TTs indicating them to several nonpharmacological interventions. These TTs coexist in many different combinations, are relatively independent and increase the likelihood of having a severely impaired health status. Competing Interests: Conflict of interest: A.J. van 't Hul has nothing to disclose. Conflict of interest: E.H. Koolen has nothing to disclose. Conflict of interest: J.C. Antons has nothing to disclose. Conflict of interest: M. de Man has nothing to disclose. Conflict of interest: R.S. Djamin has nothing to disclose. Conflict of interest: J.C.C.M. in 't Veen reports grants from Boehringer Ingelheim, Teva, Chiesi and Sanofi outside the submitted work. Conflict of interest: S.O. Simons has nothing to disclose. Conflict of interest: M. van den Heuvel has nothing to disclose. Conflict of interest: B. van den Borst has nothing to disclose. Conflict of interest: M.A. Spruit reports grants from the Netherlands Lung Foundation and Stichting Astma Bestrijding, and grants and personal fees from AstraZeneca and Boehringer Ingelheim, outside the submitted work. (Copyright ©ERS 2020.)
Databáze:	MEDLINE
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