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PLoS One. 2014 Jan 10;9(1):e85540. doi: 10.1371/journal.pone.0085540. eCollection 2014.

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

Author information

1
Respiratory Epidemiology, GlaxoSmithKline R&D, Uxbridge, United Kingdom.
2
Observational Data Analytics, GlaxoSmithKline R&D, Research Triangle Park, North Carolina, United States of America.
3
Global Health Outcomes, GlaxoSmithKline R&D, Uxbridge, United Kingdom.

Abstract

BACKGROUND & AIMS:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

PMID:
24427316
PMCID:
PMC3888425
DOI:
10.1371/journal.pone.0085540
[Indexed for MEDLINE]
Free PMC Article

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