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[Chronic management of COPD--results of a questionnaire for COPD patients].

AIM: evaluation of real ambulatory treatment followed by COPD patients. Eighty COPD patients were prospectively interviewed: 1 in stage I, 11 in stage II, 36 in stage III and 32 in stage IV. They were asked what medication they use as chronic ambulatory treatment and on what duration through one year, how many periodic check-ups they make. Most used medication is: short acting beta-2-agonists (63 pts), inhaled corticosteroids (40 pts), aminophylline (37 pts), long-acting theophylline (36 pts), and fixed combinations steroid + long-acting beta-2-agonist (35 pts). Eighteen patients had chronic prednisone treatment and 12 antibiotic prophylactic treatment. Only 31 patients had an anti-flu vaccine. There are no significant differences between treatment in rural and urban patients. Most patients follow the treatment for only 6 months a year. CONCLUSIONS: real ambulatory treatment in COPD is generally insufficient as duration and therapeutic principles, associating low frequency of periodic check-ups and a high frequency of exacerbations.

Administration, Inhalation↗

PubMed1997

Are results of the SF-36 health survey and the Nottingham Health Profile similar? A comparison in COPD patients. Quality of Life in COPD Study Group.

A number of questionnaires have been used to assess the health-related quality of life of patients with chronic obstructive pulmonary disease (COPD). The study compares the performance of the SF-36 and the Nottingham Health Profile (NHP) in a sample of 321 male patients with COPD. Score distributions, reliability estimates, and several item scaling tests, including Rasch analysis were compared. Finally, we assessed the relative ability of the two instruments considered in discriminating different levels of disease severity by comparing: (a) their correlations with dyspnea and %FEV1; the receiver operating characteristic (ROC) curves; and the F-statistics. The SF-36 scores were less skewed and more homogeneously distributed than NHP scores. Item scaling tests and reliability estimates showed a better performance of SF-36 items and scales. Nevertheless, results of Rasch analysis evidenced that both instruments have very similar scaling characteristics. Validity results did not show a consistent pattern of superiority for either of the instruments. For the physical domain, correlations of NHP and SF-36 scores with %FEV1 and dyspnea were very similar and substantial (tau > or = 0.30). F-statistics showed that SF-36 physical scale was more precise (86%) than the NHP counterpart in discriminating among levels of dyspnea and %FEV1 impairment. Nevertheless, the ROC curve and its associated area under the curve did not show a significant difference (p > 0.10). Overall results suggest that both instruments are similar in discriminating among different levels of respiratory impairment.

Data Interpretation, Statistical↗

PubMed2006

It takes my breath away: end-stage COPD. Part 1: a case study and an overview of COPD.

End-stage chronic obstructive pulmonary disease (COPD) is a progressive illness without a cure. Because of its unpredictable trajectory, prognosis is difficult as, even in end-stage disease, patients may experience exacerbations and stabilization. There are many symptoms to manage until ultimately, respiratory function is severely compromised. Home care nurses provide much of the care at home and can make a difference in promoting advanced care planning and optimal comfort. This article reviews COPD, the management of subsequent symptoms, and the role of the home care nurse.

Advance Care Planning↗

PubMed2006

Bristol COPD Knowledge Questionnaire (BCKQ): testing what we teach patients about COPD.

Health professionals recommend education of patients about COPD. There is no satisfactory instrument to measure their knowledge and therefore to assess the results of education. A multiple-choice questionnaire (BCKQ) has been designed and tested. Each of 13 topics contains five statements for which there is a right or wrong answer. Its validity and consistency has been assessed, and the test re-test reliability and responsiveness measured after an interval of eight weeks. A copy of the multiple-choice questionnaire is given in the Appendix. The questionnaire was judged by patients and health professionals to have good content and face validity. It has good internal consistency for the 65 items. (Cronbach's alpha 0.73). It can be completed and scored within twenty minutes. The average score in subjects who had not received prior education was 54.7%. In a group not receiving education there was good test-retest reliability (r = 0.71). Following an eight-week education programme there was a significant improvement of 18.3 percentage points, and most of the increase was maintained for six months without any further formal education. BCKQ is suitable for both clinical and research purposes. It will test knowledge that is appropriate for COPD patients and can be used as an assessment tool for individual patients, or as a broad cross-sectional survey instrument. It will enable the effectiveness of education to be assessed and will be of value in developing and comparing different educational interventions.

Aged↗

PubMed2006

[Chronic obstructive pulmonary disease needs adjectives: "guiltless" COPD, "asthma like" and "emphysemal" COPD].

The author proposes an extension of terminology of COPD by introducing to certain situations the adjectives "guiltless" (for patient who never smoked) , "asthma like" (for patients with symptoms with reversible bronchoconstriction and eosinophilia) and emphysemal COPD. The aim of this proposal is better understanding of certain events in the disease and subsequently proper treatment.

Asthma↗

PubMed2003