Doctors Tend to Underestimate the Emotional Impact of COPD Exacerbations - Patients Fear Being Hospitalised or Dying

Lund, Sweden (ots/PRNewswire) -

- New Patient Data in COPD Brings Valuable Insight to the
Consequences of Exacerbations on Patients' Lives, Demonstrating a
Strong Psychological Impairment

New data from a multinational, interview-based patient study,
published today in the medical journal CHEST, shed light on COPD
patients' comprehension, recognition, and experience of exacerbations
and the burden associated with these events(1).

Exacerbations are known to impair health-related quality of life
(HRQL) in patients with COPD and increase the risk of mortality(2).
Today's paper also brings valuable insight into the burden of
exacerbations as experienced by patients. The study shows that
physicians often underestimate the psychological impairment
experienced by patients during an exacerbation. Exacerbations cause
substantial anxiety, patients reported; 12% stated they worry about
dying, 10% that they worry about suffocating, 10% that they will
experience a permanent worsening of their condition and 8% that they
will be hospitalised. A majority of patients reported that besides
influencing their activities in daily life, a worsening of symptoms
significantly affects their mood causing a variety of negative
feelings, such as depression, irritability/bad temper, anxiety,
isolation, anger, and guilt. Moreover 42% stated that exacerbations
affected their personal relationships.

"The observation that physicians fail to appreciate the
considerable changes to the patient's emotional wellbeing
demonstrates a communications gap between patients and their doctors
and represents a dilemma in the management of COPD. Such
underestimation of the burden of exacerbations may contribute to
under treatment of COPD by healthcare professionals. This is worrying
since the existing evidence shows that early medical intervention
improves recovery time, minimises the risk of hospitalisation and
improves health-related quality of life(3). A clear link between
increased exacerbation frequency and risk of mortality has also been
demonstrated(4)" explained study lead-investigator, Professor Romain
Kessler, Department of Pulmonology, Hôpitaux Universitaires de
Strasbourg in France.

The study was conducted among 125 patients diagnosed with COPD
from France, Germany, Spain, Sweden and the UK. The patients were
aged greater than or equal to 50 and had experienced a minimum of 2
exacerbations during the previous year. 65% were male COPD patients.
During the previous 12 months, patients had experienced a mean of 4.6
exacerbations with an average duration of 2 weeks and a mean recovery
time of 10 days. Notably, 20% felt that they had not returned to
their previous state of health after an exacerbation, demonstrating
the importance of reducing these events.

The importance of improving patients' health-related quality of
life (HRQL) was further supported by data from a pooled analysis of
two multinational randomised controlled clinical trials recently
presented at the COPD5 congress in Birmingham, UK(5,6). The analysis
showed that HRQL was the strongest predictor of mortality in COPD(5)
and that the addition of budesonide to formoterol (Symbicort(R))
and/or a short-acting bronchodilator reduced the risk of mortality
compared to bronchodilators alone(6).

Another interesting finding supporting the observed communications
gap between healthcare professionals and patients is that, although a
term commonly used by physicians, only 1.6% of patients understood
what was meant by the widely used clinical term 'exacerbations' (in
the study defined as a worsening of respiratory symptoms such that
bronchodilators, and/or oral corticosteroids, and/or antibiotics,
and/or oxygen therapy, and/or hospitalisation were required).
Instead, patients used simpler, easier to understand terms to
describe a worsening of their condition. The single term used most
often by patients to describe an exacerbation is 'crisis',
underscoring the seriousness with which patients view the worsening
of their condition.

Two-thirds of patients stated they are aware of the symptoms
associated with their condition getting worse, recognising them as
warning signs. Most patients (85%) experience the same symptoms from
one exacerbation to another - 'breathlessness' being the most
commonly recollected warning sign. At the onset of an exacerbation,
33% of patients reported that they react by self-administering their
medication while only a minority contacts their physician.

"The observation that two-thirds of patients are easily able to
identify consistent warning signs is new and important. The finding
suggests a window of opportunity for intervening and preventing a
full-blown deterioration. The fact that patients show a willingness
to undertake self-medication moreover suggests a potential role for
self-management based on individual action plans," concluded
Professor Kessler.

References:

1 Kessler R, Ståhl E, Vogelmeier C, Haughney J, Trudeau E,
Löfdahl C-G, and Partridge M R. Patient Understanding, Detection, and
Experience of COPD Exacerbations: An Observational, Interview-Based
Study. Chest 2006;130 133-142.
http://www.chestjournal.org/cgi/content/abstract/130/1/133

2 Calverley PM, Boonsawat Z, Zhong N, Peterson S and Olsson H.
Maintenance therapy with budesonide and formoterol in chronic
obstructive pulmonary disease. Eur Resp J 2003; 22; 912-919.

3. Wilkinson TM, Donaldson GC, Hurst JR, et al. Early therapy
improves outcomes of exacerbations of chronic obstructive pulmonary
disease. Am J Respir Crit Care Med 2004; 169:1298-1303.

4. Soler-Cataluña JJ, Martínez-Garcia MÁ, Román Sánchez P, Salcedo
E, Navarro M, Ochando R. Severe acute exacerbations and mortality in
patients with chronic obstructive pulmonary disease. Thorax
2005;60:925-31.

5. Jones P, Calverley P, Larsson T, Peterson S. St George's
Respiratory Questionnaire (SGRQ) scores may help identify COPD
patients at increased risk of death over 1 year. Presentation at
COPD5, Birmingham, UK, 28 June 2006, Abstract 34.

6 Calverley P, Jones P, Larsson T, Peterson S. Preventing
mortality in COPD: The value of inhaled budesonide added to
bronchodilators. Presentation at COPD5, Birmingham, UK, 28 June 2006,
Abstract 35.

The study was conducted with the support of AstraZeneca R&D, Lund,
Sweden.

AstraZeneca is the manufacturer of Symbicort(R), a combination of
the inhaled corticosteroid budesonide and rapid- and long-acting
beta-agonist formoterol, which is indicated for the treatment of
asthma and COPD.

ots Originaltext: AstraZeneca
Im Internet recherchierbar: http://www.presseportal.de

Contact:
For further information, please do not hesitate to contact: Anette
Orheim, AstraZeneca, Office: +46-46-33-80-87, Mobile:
+46-709-13-19-52 Or Mette Thorn Sørensen, Cohn & Wolfe, Office:
+45-33-13-13-20, Mobile: +45-41-38-43-00