Prevalence and burden of breathlessness in patients with chronic obstructive pulmonary disease managed in primary care.

<h4>Background & aims</h4>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 Datalin...

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Autores principales:	Hana Müllerová, Chao Lu, Hao Li, Maggie Tabberer
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fda6d5cd704e467fba8809744eac09a2
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spelling	oai:doaj.org-article:fda6d5cd704e467fba8809744eac09a22021-11-18T08:38:00ZPrevalence and burden of breathlessness in patients with chronic obstructive pulmonary disease managed in primary care.1932-620310.1371/journal.pone.0085540https://doaj.org/article/fda6d5cd704e467fba8809744eac09a22014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24427316/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background & aims</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.Hana MüllerováChao LuHao LiMaggie TabbererPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 1, p e85540 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hana Müllerová Chao Lu Hao Li Maggie Tabberer Prevalence and burden of breathlessness in patients with chronic obstructive pulmonary disease managed in primary care.
description	<h4>Background & aims</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.
format	article
author	Hana Müllerová Chao Lu Hao Li Maggie Tabberer
author_facet	Hana Müllerová Chao Lu Hao Li Maggie Tabberer
author_sort	Hana Müllerová
title	Prevalence and burden of breathlessness in patients with chronic obstructive pulmonary disease managed in primary care.
title_short	Prevalence and burden of breathlessness in patients with chronic obstructive pulmonary disease managed in primary care.
title_full	Prevalence and burden of breathlessness in patients with chronic obstructive pulmonary disease managed in primary care.
title_fullStr	Prevalence and burden of breathlessness in patients with chronic obstructive pulmonary disease managed in primary care.
title_full_unstemmed	Prevalence and burden of breathlessness in patients with chronic obstructive pulmonary disease managed in primary care.
title_sort	prevalence and burden of breathlessness in patients with chronic obstructive pulmonary disease managed in primary care.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/fda6d5cd704e467fba8809744eac09a2
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Prevalence and burden of breathlessness in patients with chronic obstructive pulmonary disease managed in primary care.

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