Clarke Stephanie Y, Williams Marie T, Johnston Kylie N, Lee Annemarie L
Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3199, Australia.
Physiotherapy Department, Eastern Health, Melbourne, VIC 3128, Australia.
J Clin Med. 2025 Jan 3;14(1):252. doi: 10.3390/jcm14010252.
Patient-reported outcome measures (PROMs) assess the severity and impact of both pain and dyspnea in those with acute exacerbations of chronic obstructive pulmonary disease (COPD), but their frequency of use in clinical practice is unknown. This study aimed to determine the point prevalence of pain and dyspnea assessment in patients hospitalized with an acute exacerbation of COPD and the measurement tools applied for this purpose in clinical practice. Clinical notes and observation charts of patients admitted with acute exacerbations of COPD to a metropolitan hospital in 2019 and 2020 were retrospectively audited to identify the point prevalence of pain and dyspnea assessment, the PROMs applied, and their associated focal periods. Pain and dyspnea were assessed using a PROM in 99% and 8% of cases of acute exacerbation of COPD, respectively. All PROMs used measured symptom intensity. Focal periods were rarely reported in the assessment of pain; in the dyspnea assessment, timeframes predominantly reflected the impact of exertion. At this single health service site, in people hospitalized with an acute exacerbation of COPD, pain was more frequently assessed using a PROM than dyspnea. Understanding factors influencing clinicians' choice of assessment tools may inform future recommendations for the assessment of these symptoms in people hospitalized with exacerbations of COPD.
患者报告结局测量指标（PROMs）可评估慢性阻塞性肺疾病（COPD）急性加重患者的疼痛和呼吸困难的严重程度及影响，但在临床实践中的使用频率尚不清楚。本研究旨在确定因COPD急性加重住院患者中疼痛和呼吸困难评估的时点患病率，以及临床实践中用于此目的的测量工具。对2019年和2020年因COPD急性加重入住一家大都市医院的患者的临床记录和观察图表进行回顾性审核，以确定疼痛和呼吸困难评估的时点患病率、所应用的PROMs及其相关的重点时间段。在COPD急性加重病例中，分别有99%和8%的病例使用PROMs评估疼痛和呼吸困难。所有使用的PROMs均测量症状强度。在疼痛评估中很少报告重点时间段；在呼吸困难评估中，时间框架主要反映运动的影响。在这个单一的医疗服务机构，在因COPD急性加重住院的患者中，使用PROMs评估疼痛比评估呼吸困难更频繁。了解影响临床医生选择评估工具的因素可能为未来对COPD急性加重住院患者这些症状评估的建议提供依据。
