Pasquale Cara B, Vietri Jeffrey, Choate Radmila, McDaniel Angee, Sato Reiko, Ford Kimbal D, Malanga Elisha, Yawn Barbara P
Research Department, COPD Foundation, Inc., Washington, D.C.
Patient & Health Impact, Pfizer, Inc., Collegeville, Pennsylvania.
Chronic Obstr Pulm Dis. 2019 Apr 9;6(2):132-144. doi: 10.15326/jcopdf.6.2.2018.0144.
Community acquired pneumonia (CAP) carries high morbidity, mortality, and economic burden, which is even higher in adults diagnosed with chronic obstructive pulmonary disease (COPD). While several studies have assessed the clinical burden and mortality risk of CAP and COPD, very few studies focus on CAP burden from a COPD patient perspective. Individuals recently diagnosed with CAP and with pre-existing COPD were recruited through the COPD Foundation. The CAP Burden of Illness Questionnaire (CAP-BIQ), a content validated questionnaire assessing CAP symptomatology, duration of symptoms and CAP impact on work, activities and family, was administered at baseline and at 30-days follow-up. Of the 490 participants recruited, 481 had data sufficient for analysis. The prevalence of respiratory-related symptoms was very high (>90%) at the time of diagnosis with other generalized symptoms such as fatigue, trouble sleeping, headaches and confusion present in more than 60% of participants. Mean duration of symptoms varied from approximately 2 weeks for headaches and fever to more than a month for fatigue, wheezing, dyspnea, and cough. Employed participants missed an average of 21 days of work and those not employed missed 36 days of usual activities. Over 84% required help from family, friends or care givers. CAP is a serious and burdensome condition for people with COPD, a condition that can impair activities for weeks, frequently requires care from family or friends, and includes lingering symptoms. The patient-reported impact of CAP reported in this study underscores the need for prevention strategies in this population.
社区获得性肺炎（CAP）具有高发病率、高死亡率和高经济负担，在被诊断为慢性阻塞性肺疾病（COPD）的成年人中负担甚至更高。虽然有几项研究评估了CAP和COPD的临床负担及死亡风险，但很少有研究从COPD患者的角度关注CAP负担。通过慢性阻塞性肺疾病基金会招募了近期被诊断为CAP且患有COPD的个体。在基线和30天随访时，使用了《CAP疾病负担问卷》（CAP-BIQ），这是一份经过内容验证的问卷，用于评估CAP症状、症状持续时间以及CAP对工作、活动和家庭的影响。在招募的490名参与者中，481名有足够的数据用于分析。诊断时，呼吸道相关症状的患病率非常高（>90%），超过60%的参与者还出现了其他全身性症状，如疲劳、睡眠障碍、头痛和意识模糊。症状的平均持续时间各不相同，头痛和发热约为2周，而疲劳、喘息、呼吸困难和咳嗽则超过1个月。有工作的参与者平均缺勤21天，无工作的参与者平均有36天无法进行日常活动。超过84%的人需要家人、朋友或护理人员的帮助。对于COPD患者来说，CAP是一种严重且负担沉重的疾病，这种疾病会使活动能力受损数周，经常需要家人或朋友的照顾，并且症状会持续存在。本研究中患者报告的CAP影响凸显了在这一人群中制定预防策略的必要性。
