Longitudinal Assessment of Symptom Distress and Its Association with Disease Severity Among Patients with Chronic Obstructive Pulmonary Disease: A Prospective Observational Study.

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a long-lasting problem with the lungs that leads to many symptoms, poor quality of life, and greater use of the health care system. The aim of this study was to evaluate longitudinal changes in symptom distress among patients with chronic obstructive pulmonary disease (COPD) over a 6- months follow-up period and to examine the association between baseline symptom distress and disease severity. In total, 341 patients with COPD were recruited from the Department of Pulmonology at Maharishi Markandeshwar (Deemed to be University) Hospital in Mullana, Haryana, India. The Symptom Distress Scale (SDS) was used to calculate symptom distress at baseline, 3 months, and 6 months post-enrolment into the study. Demographics (age and sex) and clinical data (exacerbation history, number of medications take, etc.) were collected using a standardized data collection sheet and statistical analyses were done using SPSS version 25.0. Most of the patients were in GOLD Stage II (58.7%) or GOLD Stage III (28.4%). The mean SDS scores decreased substantially from a baseline score of 26.38 ± 8.18 to a score of 24.59 ± 8.18 at 3 months and a score of 21.65 ± 9.39 at 6 months (p < 0.001). There were strong correlations between baseline SDS scores and the SDS scores at 3 months (r = 0.951, p < 0.001) and at 6 months (r = 0.812, p < 0.001). Baseline SDS scores did not differ significantly between the COPD severity stages (p = 0.271). Multiple regression analysis revealed that age, gender, smoking status, COPD duration, and disease severity were not significant predictors of baseline symptom distress. A significant reduction in mean symptom distress scores was observed among patients with COPD over the 6-months follow-up period; however, the observation design does not allow conclusions regarding the factors responsible for these changes.