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Impact of preventing exacerbations on deterioration of health status in COPD

Spencer, Sally and Calverley, Peter MA and Burge, P Sherwood and Jones, Paul W (2004) Impact of preventing exacerbations on deterioration of health status in COPD. European Respiratory Journal, 23 (5). pp. 698-702.

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Abstract

Exacerbations of chronic obstuctive pulmonary disease (COPD) are associated with worse health status. The Inhaled Steroids in Obstructive Lung Disease in Europe (ISOLDE) study showed that treatment with fluticasone propionate (FP) reduced exacerbation frequency and the rate of deterioration in health status as compared with placebo. The present study analysed these data to test whether the effect of FP on health status was attributable to its effect on exacerbations. Rates of deterioration in St George's Respiratory Questionnaire (SGRQ) total score were obtained for 613 patients with moderate to severe COPD followed for a maximum of 3 yrs. Exacerbation rates were skewed and could not be normalised, therefore, patients were stratified into three exacerbation groups: none, infrequent (<1.65 exacerbations x yr(-1)) and frequent (>1.65 exacerbations x yr(-1)). There were 91 patients with no exacerbations, 285 with infrequent exacerbations and 235 with frequent exacerbations. Frequent exacerbations were independently associated with a worse baseline SGRQ score (p<0.0001) and a more rapid rate of deterioration in health status (p=0.0003). Exacerbation frequency and rate of decline in forced expiratory volume in one second were independently related to the rate of deterioration in SGRQ score. Statistical modelling showed the beneficial effect of fluticasone propionate on deterioration in health status to be largely due to its effect on exacerbation frequency.

Item Type: Article
Journal or Publication Title: European Respiratory Journal
Uncontrolled Keywords: Chronic obstructive pulmonary disease ; exacerbation ; health status ; quality of life
Subjects: R Medicine > R Medicine (General)
Departments: Faculty of Health and Medicine
ID Code: 53971
Deposited By: ep_importer_pure
Deposited On: 04 May 2012 13:09
Refereed?: Yes
Published?: Published
Last Modified: 26 Jul 2012 20:20
Identification Number:
URI: http://eprints.lancs.ac.uk/id/eprint/53971

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