Impact of Chronic Obstructive Pulmonary Disease on Quality of Life: The Role of Dyspnea
Section snippets
Assessment of dyspnea in chronic obstructive pulmonary disease
A discrepancy often exists between the patient’s perception and the physician’s clinical evaluation of the impact of symptoms that frequently accompany COPD, particularly as it relates to dyspnea. The patient’s individual perception of symptom burden frequently does not correspond precisely with the clinician’s assessment of traditional signs during physical examination, such as labored breathing, breath sounds and wheezing, accessory muscle use, or changes in respiratory rate. The American
Instruments for dyspnea assessment
Because assessment and evaluation of dyspnea depend on subjective experience, the measurement of dyspnea can be difficult and must rely on patients’ self-reports for quantification of its intensity and impact. Instruments can be discriminative, measuring differences in the intensity of dyspnea between groups of individuals, or evaluative, measuring changes in dyspnea as an outcome of intervention or treatment. Ideally, instruments to evaluate dyspnea should be of clinical value as well as
Chronic Obstructive Pulmonary Disease Interventions That Improve Dyspnea
Clinical trials of pulmonary rehabilitation and pharmacologic interventions, or a combination of both, have often included assessments of functional capacity, HRQOL, and dyspnea as important health outcomes in patients with COPD.
Summary
Increasingly recognized as an important contributor to the disability associated with COPD, dyspnea provides information about the impact of respiratory impairment on the patient’s HRQOL, likely the most important aspect of COPD from the patient’s perspective. No longer solely an outcome measure in clinical research of chronic lung disease, dyspnea is increasingly—and appropriately—considered a fundamental, and potentially modifiable, symptom of COPD in the clinical setting. Indeed, in patients
References (45)
Outcome measures in COPD
Prim Care Respir J
(2004)- et al.
Spirometry and dyspnea in patients with COPD: when small differences mean little
Chest
(1996) What outcomes should be measured in patients with COPD?
Chest
(2001)Issues concerning health-related quality of life in COPD
Chest
(1995)- et al.
Measuring functional status in chronic lung disease: conclusions from a randomized control trial
Respir Med
(1991) - et al.
Dyspnea is a better predictor of 5-year survival than airway obstruction in patients with COPD
Chest
(2002) - et al.
The measurement of dyspnea: contents, interobserver agreement, and physiologic correlates of two new clinical indexes
Chest
(1984) - et al.
Measurement of health-related quality of life in the National Emphysema Treatment Trial
Chest
(2004) - et al.
In-hospital short-term training program for patients with chronic airway obstruction
Chest
(2001) - et al.
Exercise training improves exertional dyspnea in patients with COPD: evidence of the role of mechanical factors
Chest
(2003)
Power of outcome measurements to detect clinically significant changes in pulmonary rehabilitation of patients with COPD
Chest
Improvement in exercise tolerance with the combination of tiotropium and pulmonary rehabilitation in patients with COPD
Chest
A 6-month, placebo-controlled study comparing lung function and health status changes in COPD patients treated with tiotropium or salmeterol
Chest
Multicentre randomised placebo-controlled trial of inhaled fluticasone propionate in patients with chronic obstructive pulmonary disease
Lancet
Long-term effect of inhaled budesonide in mild and moderate chronic obstructive pulmonary disease: a randomised controlled trial
Lancet
Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: a randomised controlled trial
Lancet
The efficacy and safety of fluticasone propionate (250 μg)/salmeterol (50 μg) combined in the Diskus inhaler for the treatment of COPD
Chest
Quality of life changes in COPD patients treated with salmeterol
Am J Respir Crit Care Med
Mechanisms of dyspnea in COPD
Chronic obstructive pulmonary disease surveillance—United States, 1971–2000
MMWR Surveill Summ
Dyspnea: mechanisms, assessment, and management: a consensus statement
Am J Respir Crit Care Med
Measurement of dyspnea in chronic obstructive pulmonary disease: what is the tool telling you?
Chron Respir Dis
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