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一项观察性纵向研究,该研究通过社区获得性肺炎疾病负担问卷对全国范围内接受调查的老年人报告的症状负担和社区获得性肺炎恢复时间进行了研究。

Observational longitudinal study of symptom burden and time for recovery from community-acquired pneumonia reported by older adults surveyed nationwide using the CAP Burden of Illness Questionnaire.

作者信息

Wyrwich Kathleen W, Yu Holly, Sato Reiko, Powers John H

机构信息

Evidera, Inc., Bethesda, MD, USA.

Pfizer Inc., Collegeville, PA, USA.

出版信息

Patient Relat Outcome Meas. 2015 Jul 30;6:215-23. doi: 10.2147/PROM.S85779. eCollection 2015.

Abstract

BACKGROUND

Millions of older adults who develop community-acquired pneumonia (CAP) each year survive, but there is a large knowledge gap on the burden of CAP and the recovery process in survivors from the patient perspective.

METHODS

The newly developed CAP Burden of Illness Questionnaire was administered through a Web survey to a nationwide sample of US adults aged ≥50 years who were recently diagnosed with CAP. Survey respondents with unresolved symptoms or other CAP-related health problems completed a second survey 30 days later; a third survey was completed another 30 days later by respondents with unresolved symptoms or problems. Nationally representative results describing the average time to recovery of symptoms and other CAP-related problems were achieved using post-stratification weights.

RESULTS

Five hundred participants completed the initial survey. The time to resolution for the CAP symptoms of weakness, shortness of breath, and tiredness exceeded 3 weeks on average. There was an average of 13 days of absenteeism, and 3 weeks (mean =21 days) before achieving full work/activity productivity after CAP. For participants with health conditions that worsened from pneumonia, chronic emphysema and chronic obstructive pulmonary disease took the longest to return to baseline (mean =60 and 52.4 days, respectively).

CONCLUSION

The results from this study demonstrate that older adults surviving a CAP episode experience a significant multi-symptom illness with long recovery periods to achieve pre-CAP health and productivity. These findings highlight the need for further research on effective clinician-patient communication, the need for patient-centered outcomes in clinical trials for CAP therapeutics, adequate home care during the recovery process, and the pursuit of CAP prevention strategies.

摘要

背景

每年有数百万患社区获得性肺炎(CAP)的老年人存活下来,但从患者角度来看,关于CAP的负担以及幸存者的康复过程,仍存在巨大的知识空白。

方法

通过网络调查,向全国范围内年龄≥50岁且最近被诊断为CAP的美国成年人样本发放新开发的CAP疾病负担问卷。有未解决症状或其他与CAP相关健康问题的调查受访者在30天后完成第二次调查;有未解决症状或问题的受访者在再过30天后完成第三次调查。使用事后分层权重得出描述症状及其他与CAP相关问题平均恢复时间的全国代表性结果。

结果

500名参与者完成了初始调查。虚弱、呼吸急促和疲劳等CAP症状的缓解时间平均超过3周。平均旷工13天,CAP后平均需要3周(平均=21天)才能恢复到完全的工作/活动能力。对于因肺炎导致健康状况恶化的参与者,慢性肺气肿和慢性阻塞性肺疾病恢复到基线所需时间最长(分别平均为60天和52.4天)。

结论

本研究结果表明,CAP发作后存活的老年人经历了一种多症状的严重疾病,恢复到CAP前的健康和能力水平需要很长时间。这些发现凸显了进一步研究有效医患沟通的必要性、CAP治疗临床试验中以患者为中心结局的必要性、康复过程中充足家庭护理的必要性以及CAP预防策略的必要性。

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