Consequences of Chronic Obstructive Pulmonary Disease in Community-based Patients

Abstract

Summary The impact of chronic obstructive pulmonary disease (COPD) on patients who were community based was investigated in 31 people (17 men and 14 women aged 45 to 78 years (mean age 64) recruited from six general practitioners in a small town. Basic demographic data were collected by semi-structured verbal questioning. Dyspnoea was measured using the Medical Research Council (MRC) dyspnoea scale and the Functional Limitation Profile (FLP) was used to measure functional status. Subjects were stratified according to the MRC dyspnoea scale. In each case, a higher score indicates higher disability. Analysis of data showed a direct relationship between FLP and MRC dyspnoea grades, ie the global physical score, global psychosocial score and the overall FLP scores increased as the MRC grades increased. Highly significant differences were found between subjects with lower MRC grades 2 and 3 and subjects with higher MRC grades 4 and 5 (p < 0.0001). A significant difference was found between physical and psychosocial scores of those subjects with low MRC grades (p < 0.009), while no significant difference was found between those two scores in subjects with high MRC grades (p = 0.44). Marked differences were observed in the effects of physical and psychosocial disabilities between low and high severity groups. As expected, subjects who scored high on the MRC scale were much more restricted in their daily activities. Those scoring low on the MRC scale also had considerable psychosocial disabilities which often go undetected in a community setting. The impact of chronic obstructive pulmonary disease (COPD) on patients who were community based was investigated in 31 people (17 men and 14 women aged 45 to 78 years (mean age 64) recruited from six general practitioners in a small town. Basic demographic data were collected by semi-structured verbal questioning. Dyspnoea was measured using the Medical Research Council (MRC) dyspnoea scale and the Functional Limitation Profile (FLP) was used to measure functional status. Subjects were stratified according to the MRC dyspnoea scale. In each case, a higher score indicates higher disability. Analysis of data showed a direct relationship between FLP and MRC dyspnoea grades, ie the global physical score, global psychosocial score and the overall FLP scores increased as the MRC grades increased. Highly significant differences were found between subjects with lower MRC grades 2 and 3 and subjects with higher MRC grades 4 and 5 (p < 0.0001). A significant difference was found between physical and psychosocial scores of those subjects with low MRC grades (p < 0.009), while no significant difference was found between those two scores in subjects with high MRC grades (p = 0.44). Marked differences were observed in the effects of physical and psychosocial disabilities between low and high severity groups. As expected, subjects who scored high on the MRC scale were much more restricted in their daily activities. Those scoring low on the MRC scale also had considerable psychosocial disabilities which often go undetected in a community setting.