Relationship between respiratory symptoms and medical treatment in exacerbations of COPD
| Autor: | Claes-Göran Löfdahl, Peter M.A. Calverley, L-G Carlsson, Erik Ståhl, T Higenbottam, Klas Svensson, R Pauwels Dagger |
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| Rok vydání: | 2005 |
| Předmět: |
Pulmonary and Respiratory Medicine
Budesonide Spirometry medicine.medical_specialty Exacerbation Population Peak Expiratory Flow Rate Pulmonary Disease Chronic Obstructive Formoterol Fumarate Sleep Initiation and Maintenance Disorders Internal medicine Humans Medicine education Intensive care medicine Randomized Controlled Trials as Topic Retrospective Studies COPD education.field_of_study medicine.diagnostic_test business.industry Respiratory disease Retrospective cohort study Middle Aged medicine.disease Bronchodilator Agents Hospitalization Dyspnea Cough Ethanolamines Acute Disease sense organs Formoterol business Algorithms medicine.drug |
| Zdroj: | European Respiratory Journal. 26:406-413 |
| ISSN: | 1399-3003 0903-1936 |
| DOI: | 10.1183/09031936.05.00143404 |
| Popis: | Exacerbations of chronic obstructive pulmonary disease (COPD) can be defined symptomatically or by healthcare contacts, yet the relationship between these events is unknown. Data were collected during a 1-yr study of the budesonide/formoterol combination in COPD patients, where exacerbations, defined by increases in treatment, were compared with daily records of respiratory symptoms, rescue medication use and peak expiratory flow (PEF). The relationship between changes in these variables and the medical event was examined using different modelling approaches. Data from the first exacerbation treated with oral corticosteroids and/or antibiotics and/or hospitalisation (event based) were available in 468 patients. Patients exacerbating were significantly more breathless and more likely to report cough than healthy patients, but did not differ in baseline spirometry. Exacerbations defined by changes in individual symptoms were only weakly related to event-based exacerbations; however, defined with 63% of such events being predicted from symptom changes. Changes in rescue medication use or PEF were poor predictors of event-based exacerbations. The mean peak change in symptoms was closely related to the onset of therapy. In conclusion, event-based exacerbations are a valid way of identifying acute symptom change in a chronic obstructive pulmonary disease population. However, daily symptom monitoring is too variable using the current diary cards to make individual management decisions. |
| Databáze: | OpenAIRE |
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