COPD
-
Clinical Trial
The COPD Assessment Test (CAT): short- and medium-term response to pulmonary rehabilitation.
The COPD Assessment Test (CAT) is a recently introduced instrument to assess health-related quality of life in COPD. We aimed to evaluate the longitudinal change in CAT following Pulmonary Rehabilitation (PR), and test the relationship between CAT and CRQ-Self Report (SR) over time. We hypothesised that the CAT would show similar responsiveness to PR as the CRQ-SR both in the short and medium-term. ⋯ In COPD, the CAT score is immediately responsive to PR and remains improved at 6 months. There is no significant difference in the short and medium term changes in the CAT and CRQ-SR following PR. We propose that for most clinical indications for assessing health-related quality of life in COPD, the CAT is a robust and practical alternative to longer-established instruments such as the CRQ-SR.
-
Comparative Study Clinical Trial
Streptococcus pneumoniae urinary antigen test and acute exacerbations of chronic obstructive pulmonary disease.
Streptococcus pneumoniae is one of the most common bacteria identified in sputum obtained from subjects with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). ⋯ The results of the pneumococcal urinary antigen test were similar for AECOPD subjects with and without pneumonia. This test may be a useful method for preventing the under-diagnosis of S. pneumoniae-related exacerbations of COPD. The detection of pneumococcal antigen in the urine is not related to the persistent colonization of the respiratory mucosa by S. pneumoniae.
-
Multicenter Study
Is the CAT questionnaire sensitive to changes in health status in patients with severe COPD exacerbations?
The COPD Assessment Test (CAT) was validated in English showing good psychometric properties. The objective of this study is to assess the capacity of the CAT to detect changes in health status in patients experiencing COPD exacerbations (ECOPD) and to further explore the validity of the Spanish version. An observational study was conducted in 49 Spanish centres. ⋯ Change in CAT correlated well with Δ SGRQ (r = 0.63; p < 0.01). The CAT showed to be sensitive to the change in health status associated with ECOPD. We also provide evidence of the validity of the Spanish version.
-
Pharmacological lung volume reduction in COPD is an important goal in treatment with long-acting bronchodilators because in addition to airflow limitation, lung hyperinflation considerably affects COPD symptoms. Quantitative computed tomography (CT) simultaneously provides structural information about airway dimensions, emphysematous changes, and lung volumes, some of which are difficult to be evaluated by pulmonary function. Here, we evaluated changes in CT parameters and pulmonary function in 30 patients with COPD who underwent CT scans before and one year after starting tiotropium treatment and in 12 patients with COPD who were not treated with long-acting bronchodilators. ⋯ Changes in LAV, CT-TLV, RV, and RV/TLC were significantly greater in the tiotropium, than the non-bronchodilator group. The tiotropium-induced reduction in LAV correlated with the decrease in RV (ρ = 0.45, p = 0.01). Our findings not only indicate the value of the comprehensive CT measurements in assessing the effects of bronchodilators, including pharmacological lung volume reduction, but also further understanding of the structural changes underlying physiological improvements induced by bronchodilators.