Observational study to characterise 24-hour COPD symptoms: Interim analysis of ASSESS
Background:Â Little is known about the 24-hour profile of COPD symptoms.
Aim:Â To assess the prevalence/severity of 24-hour COPD symptoms and their impact on patientsâ€™ well-being.
Methods:Â This ongoing, 6-month prospective observational study will recruit 720 patients with COPD. Baseline night-time, early-morning and day-time symptoms, HRQoL, anxiety/depression and sleep quality were assessed.Â A prioriÂ interim analysis: 11 Oct 2012.
Results:Â 314 patients recruited to date: 69% male, meanÂ±SD age 67Â±9 yrs, meanÂ±SD % pred FEV1Â 49.7Â±17.8%. Baseline COPD symptom frequency/severity are reported in Table; in the week prior to baseline, 56% patients had symptoms throughout the day. Breathlessness was most common (67% patients); its prevalence increased during the day (28% night, 43% morning, 62% day). Patients with symptoms in 3 parts of the day had the worst HRQoL (CAT score 19.3 vs 6.7â€“16.8 in patients with symptoms in â‰¤2 parts of the day). Patients with any symptoms at night had higher anxiety/depression levels vs those with only morning and/or day symptoms or no symptoms (Hospital Anxiety and Depression Scale score 13.8â€“16.0 vs 8.3â€“12.4) and worse sleep quality (COPD and Asthma Sleep Impact Scale scores 33.7â€“48.7 vs 27.7â€“32.2).
Conclusions:Â Over half of patients had symptoms during the whole 24 hours; these patients had the worst HRQoL. Patients with night symptoms had poorest sleep quality and increased anxiety/depression.