Prevalence and Burden of Breathlessness in Patients with Chronic Obstructive Pulmonary Disease Managed in Primary CareReportar como inadecuado




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Background and Aims

Breathlessness is a primary clinical feature of chronic obstructive pulmonary disease COPD. We aimed to describe the frequency of and factors associated with breathlessness in a cohort of COPD patients identified from the Clinical Practice Research Datalink CPRD, a general practice electronic medical records database.

Methods

Patients with a record of COPD diagnosis after January 1 2008 were identified in the CPRD. Breathlessness was assessed using the Medical Research Council MRC dyspnoea scale, with scoring ranging from 1–5, which has been routinely administered as a part of the regular assessment of patients with COPD in the general practice since April 2009. Stepwise multivariate logistic regression estimated independent associations with dyspnoea. Negative binomial regression evaluated a relationship between breathlessness and exacerbation rate during follow-up.

Results

The total cohort comprised 49,438 patients diagnosed with COPD; 40,425 82% had any MRC dyspnoea grade recorded. Of those, 22,770 46% had moderate-to-severe dyspnoea MRC≥3. Breathlessness increased with increasing airflow limitation; however, moderate-to-severe dyspnoea was also observed in 32% of patients with mild airflow obstruction. Other factors associated with increased dyspnoea grade included female gender, older age ≥70 years, obesity BMI ≥30, history of moderate-to-severe COPD exacerbations, and frequent visits to the general practitioner. Patients with worse breathlessness were at higher risk of COPD exacerbations during follow-up.

Conclusions

Moderate-to-severe dyspnoea was reported by >40% of patients diagnosed with COPD in primary care. Presence of dyspnoea, including even a perception of mild dyspnoea MRC = 2, was associated with increased disease severity and a higher risk of COPD exacerbations during follow-up.



Autor: Hana Müllerová , Chao Lu, Hao Li, Maggie Tabberer

Fuente: http://plos.srce.hr/



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