Stability of distinct symptom experiences in patients with chronic obstructive pulmonary disease (COPD)

Vivi L Christensen; Tone Rustøen; Magne Thoresen; Are M Holm; Signe B Bentsen

doi:10.1016/j.rmed.2022.106944

Stability of distinct symptom experiences in patients with chronic obstructive pulmonary disease (COPD)

Respir Med. 2022 Sep:201:106944. doi: 10.1016/j.rmed.2022.106944. Epub 2022 Aug 9.

Authors

Vivi L Christensen¹, Tone Rustøen², Magne Thoresen³, Are M Holm⁴, Signe B Bentsen⁵

Affiliations

¹ Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway. Electronic address: vivi.l.christensen@usn.no.
² Institute of Health and Society, Department of Nursing Science, University of Oslo, Oslo, Norway; Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
³ Department of Biostatistics, Faculty of Medicine, University of Oslo, Oslo, Norway.
⁴ Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
⁵ Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Haugesund, Norway.

PMID: 35970058
DOI: 10.1016/j.rmed.2022.106944

Abstract

Purpose: This study aimed to examine reclassification rates among classes of chronic obstructive pulmonary disease (COPD) patients based on their distinct symptom experiences and to assess how these subgroups differed in symptom scores and health-related quality of life (HRQoL) outcomes over one year. Moreover, we wished to assess how these subgroups differed in demographic and clinical characteristics at 12 months.

Patients and methods: This is a follow-up study of 267 patients with moderate, severe, and very severe COPD. Based on their distinct symptom experiences using the Memorial Symptom Assessment Scale (MSAS), three subgroups (i.e., "high", "intermediate", and "low") were identified at baseline. In the present study, transitions between the subgroups at three, six, nine, and 12 months were investigated and calculated as reclassification rates. Differences among the subgroups in symptom scores and HRQoL at each time point and demographic and clinical characteristics at 12 months were evaluated using analysis of variance with post hoc comparisons.

Results: Almost 65% were still in the "high" class after 12 months. At 12 months, pairwise comparisons for respiratory function measurements were not significantly different. Compared to the "intermediate" and "low" class, patients in the "high" class were more likely to be women and had significantly more comorbidities, reported a significantly higher number of symptoms at all time points, and worse HRQoL scores.

Conclusion: Our findings suggest that the pattern of a high symptom burden in COPD is consistent over time. The patients' individual symptom experiences should be the primary focus of treatment.

Keywords: Latent class analyses; Longitudinal; Stability; Subgroups; Symptom burden.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Comorbidity
Female
Follow-Up Studies
Humans
Male
Pulmonary Disease, Chronic Obstructive* / drug therapy
Quality of Life*