Primary Care Centre Jaume I, Tarragona, Spain.
Int J Clin Pract. 2012 Jul;66(7):711-7. doi: 10.1111/j.1742-1241.2012.02930.x.
To assess the usefulness of a patient diary card of symptoms for monitoring the evolution of an exacerbation of chronic bronchitis (CB) and chronic obstructive pulmonary disease (COPD) in primary care.
Multicentre, observational study. Patients with an exacerbation filled out a diary every day before bedtime during 10 days. The diary score ranged from 0 (best) to 28 (worst). A visit was performed at day 15 to collect the patient diaries.
Of the 1101 patients studied 921 returned the diaries (83.7%). Clinical failure was found in 236 patients (25.6%). The mean global score on day 1 was 21.5 ± 3.8. Patients considered as cured at day 10 presented a lower score at day 1 (21.1 ± 3.9) vs. those who failed (22.6 ± 4.2; p < 0.001). When no reduction was observed in the score from days 1 to 3, the percentage of failures was 36.1%, being only 11.6% with a reduction of 5 points or more (p < 0.001). The strongest correlation with failure was observed with general status, breathing, symptom scale and the need for extra inhaler doses.
A symptom diary card seems to be a valuable tool to monitor the evolution of an acute exacerbation of CB/COPD in primary care.
评估症状患者日记卡在监测慢性支气管炎（CB）和慢性阻塞性肺疾病（COPD）急性加重在初级保健中的作用。
多中心、观察性研究。患有加重的患者在睡前每天填写日记，持续 10 天。日记评分范围为 0（最佳）至 28（最差）。在第 15 天进行就诊以收集患者日记。
在研究的 1101 名患者中，有 921 名（83.7%）返回了日记。发现 236 名患者（25.6%）临床失败。第 1 天的平均全球评分为 21.5 ± 3.8。在第 10 天被认为治愈的患者在第 1 天的评分较低（21.1 ± 3.9）与失败的患者相比（22.6 ± 4.2；p < 0.001）。如果第 1 天至第 3 天的评分没有降低，则失败的百分比为 36.1%，只有 11.6%的评分降低了 5 分或更多（p < 0.001）。与失败最密切相关的是一般状况、呼吸、症状量表和额外吸入器剂量的需求。
症状日记卡似乎是监测 CB/COPD 急性加重在初级保健中演变的一种有价值的工具。
