Abstract
The Salford Lung Study in chronic obstructive pulmonary disease (SLS COPD) was a 12-month, Phase III, open-label, randomised study comparing the effectiveness and safety of initiating once-daily fluticasone furoate 100 µg/vilanterol 25 µg (FF/VI) with continuing usual care (UC). Follow-up interviews were conducted among a subset of 400 patients who completed SLS COPD to further understand patients’ experiences with treatment outcomes and the impact of COPD, and potential risk factors associated with higher rates of exacerbations during SLS COPD. Another objective was to explore how such patient-centred outcomes differed by randomised treatment. Patients’ perceived control over COPD and effects on quality of life (QoL) were similar between treatment groups at the time of the follow-up interview, but more patients in the FF/VI group compared with UC reported perceived improvements in COPD control and QoL during the study. Of patients who experienced ≥2 exacerbations during SLS COPD, a greater percentage were women, were unemployed or homemakers, or were on long-term sick leave. Having ≥2 exacerbations also appeared to be associated with smoking, seeing a hospital specialist, a feeling of having no/little control over COPD, perceived worsening of feelings of control and reduced overall QoL since the start of the study, being aware of impending exacerbation occurrence and a more severe last exacerbation. Initiation of FF/VI was associated with a greater perceived improvement in patients’ control of their COPD and QoL throughout SLS COPD than continuation of UC. Suggestions that smoking status and feelings of control are potentially related to exacerbation require further investigation.
Highlights
Chronic obstructive pulmonary disease (COPD) is one of the most common respiratory conditions in the UK, characterised by chronic airflow limitation and persistent respiratory symptoms including breathlessness, cough and sputum production.[1]
The impact of COPD on the quality of life (QoL) domains of functioning, activities, relationships, psychological well-being and independence assessed on a scale of 1–4, with higher scores indicating greater impact were similar in both treatment groups, with mean scores of 2.0–2.5 across all domains in the furoate μg/vilanterol μg (FF/VI) group and 2.1–2.5 in the usual care group
A greater percentage of patients initiated on fluticasone furoate (FF)/VI perceived an improvement in control over COPD, and reported improvement in QoL issues experienced in different domains of life and in overall QoL
Summary
Chronic obstructive pulmonary disease (COPD) is one of the most common respiratory conditions in the UK, characterised by chronic airflow limitation and persistent respiratory symptoms including breathlessness (dyspnoea), cough and sputum production.[1]. The experiences of all SLS COPD follow-up interview participants together have been reported previously.[19] These showed that breathlessness was the dominant symptom for patients in SLS COPD, and that this symptom had the greatest impact on participants’ daily functioning, inhibiting their ability to perform physical activities.[19]. During SLS COPD, 31.3, 23.3 and 45.5% of participants experienced none, one, or at least two exacerbations, respectively Of those subjects who participated in the exit interviews, approximately half had been randomised to initiate treatment with FF/VI 100/25 μg (48.3%) while the other half continued usual care (51.8%).
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