The Relationship Between 24-Hour Symptoms and COPD Exacerbations and Healthcare Resource Use: Results from an Observational Study (ASSESS)

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@article{a77f2eb43f154eeca75f3c0ee3c7b88a,
title = "The Relationship Between 24-Hour Symptoms and COPD Exacerbations and Healthcare Resource Use: Results from an Observational Study (ASSESS)",
abstract = "This observational study assessed the relationship between nighttime, early-morning and daytime chronic obstructive pulmonary disease (COPD) symptoms and exacerbations and healthcare resource use. COPD symptoms were assessed at baseline in patients with stable COPD using a standardised questionnaire during routine clinical visits. Information was recorded on exacerbations and healthcare resource use during the year before baseline and during a 6-month follow-up period. The main objective of the analysis was to determine the predictive nature of current symptoms for future exacerbations and healthcare resource use. 727 patients were eligible (65.8{\%} male, mean age: 67.2 years, {\%} predicted forced expiratory volume in 1 second: 52.8{\%}); 698 patients (96.0{\%}) provided information after 6 months. Symptoms in any part of the day were associated with a prior history of exacerbations (all p <0.05) and nighttime and early-morning symptoms were associated with the frequency of primary care visits in the year before baseline (both p <0.01). During follow-up, patients with baseline symptoms during any part of the 24-hour day had more exacerbations than patients with no symptoms in each period (all p <0.05); there was also an association between 24-hour symptoms and the frequency of primary care visits (all p ≤ 0.01). Although there was a significant association between early-morning and daytime symptoms and exacerbations during follow-up (both p <0.01), significance was not maintained when adjusted for potential confounders. Prior exacerbations were most strongly associated with future risk of exacerbation. The results suggest 24-hour COPD symptoms do not independently predict future exacerbation risk.",
keywords = "Cohort, exacerbation risk, morning symptoms, nighttime symptoms, prospective, retrospective, COPD",
author = "Marc Miravitlles and Heinrich Worth and Soler-Catalu{\~n}a, {Juan Jos{\'e}} and David Price and {De Benedetto}, Fernando and Nicolas Roche and Godtfredsen, {Nina S.} and {van der Molen}, Thys and L{\"o}fdahl, {Claes G{\"o}ran} and Laura Padull{\'e}s and Anna Ribera",
year = "2016",
month = "9",
doi = "10.3109/15412555.2016.1150447",
language = "English",
volume = "13",
pages = "561--568",
journal = "COPD: Journal of Chronic Obstructive Pulmonary Disease",
issn = "1541-2563",
publisher = "Taylor & Francis",
number = "5",

}