Course of COPD assessment test (CAT) and clinical COPD questionnaire (CCQ) scores during recovery from exacerbations of chronic obstructive pulmonary disease

Jesús Molina,Alonso Fernández-Nistal,Marc Miravitlles,María Buendía,María Espinosa De Los Monteros,Patricia García-Sidro

doi:10.1186/1477-7525-11-147

Abstract

IntroductionCOPD exacerbations have a negative impact on lung function, decrease quality of life (QoL) and increase the risk of death. The objective of this study was to assess the course of health status after an outpatient or inpatient exacerbation in patients with COPD.MethodsThis is an epidemiological, prospective, multicentre study that was conducted in 79 hospitals and primary care centres in Spain. Four hundred seventy-six COPD patients completed COPD assessment test (CAT) and Clinical COPD Questionnaire (CCQ) questionnaires during the 24 hours after presenting at hospital or primary care centres with symptoms of an exacerbation, and also at weeks 4–6. The scores from the CAT and CCQ were evaluated and compared at baseline and after recovery from the exacerbation.ResultsA total of 164 outpatients (33.7%) and 322 inpatients (66.3%) were included in the study. The majority were men (88.2%), the mean age was 69.4 years (SD = 9.5) and the mean FEV1 (%) was 47.7% (17.4%). During the exacerbation, patients presented high scores in the CAT: [mean: 22.0 (SD = 7.0)] and the CCQ: [mean: 4.4 (SD = 1.2)]. After recovery there was a significant reduction in the scores of both questionnaires [CAT: mean: -9.9 (SD = 5.1) and CCQ: mean: -3.1 (SD = 1.1)]. Both questionnaires showed a strong correlation during and after the exacerbation and the best predictor of the magnitude of improvement in the scores was the severity of each score at onset.ConclusionsDue to their good correlation, CAT and CCQ can be useful tools to measure health status during an exacerbation and to evaluate recovery. However, new studies are necessary in order to identify which factors are influencing the course of the recovery of health status after a COPD exacerbation.

Highlights

Chronic Obstructive Pulmonary Disease (COPD) exacerbations have a negative impact on lung function, decrease quality of life (QoL) and increase the risk of death
COPD is often aggravated by acute periods of increased symptoms called exacerbations
They cause 10-12% of primary care visits, 1-2% of emergency room visits and 10% of hospitalizations in Spain [4]. This is why, from an economic standpoint, these data are of particular relevance since 44% of the annual cost per patient involving COPD is due to hospital admissions, exacerbations being the most frequent cause [5]

Summary

Introduction

COPD exacerbations have a negative impact on lung function, decrease quality of life (QoL) and increase the risk of death. Numerous studies have shown that exacerbations generate a large impact on health systems [3,4]. They cause 10-12% of primary care visits, 1-2% of emergency room visits and 10% of hospitalizations in Spain [4]. This is why, from an economic standpoint, these data are of particular relevance since 44% of the annual cost per patient involving COPD is due to hospital admissions, exacerbations being the most frequent cause [5]

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Conclusion