Non-interventional study on patient perception of COPD symptoms

Chronic obstructive pulmonary disease (COPD) is the third leading cause of deaths worldwide, according to World Health Organisation (WHO) reports. It's also the sixth leading cause of disability-adjusted life years (DALYs) in middle-income countries - a figure that is expected to increase to fifth position by 2030.

Impact on daily lives

As a result, a cross-sectional study of patients with severe COPD to assess patient perception of symptom variability in Middle East and Africa (MEA) countries has been launched by biopharmaceutical company, AstraZeneca.

COPD is characterised by persistent airflow limitation associated with a chronic inflammation of the small airways according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2015/16 guidelines. This is manifested in multiple respiratory symptoms, including dyspnea, cough, sputum production, wheezing and chest tightness. Anorexia, fatigue, and weight loss may also be expressed in more severe disease. The study of GOLD risk category C and D patients with severe COPD is primarily intended to assess patient perception of daily and weekly symptoms and the impact on daily life activities.

According to Dr Jasvanti Bhana, AstraZeneca South Africa VP for medical and regulatory affairs, it is believed that the spike in COPD mortality rates is directly linked to the expanding smoking epidemic, exposure to biomass fuel - particularly in the developing world, reduced mortality from other common causes of death (ischaemic heart disease, infectious diseases), and the aging of the world population.

“Although COPD symptoms have been extensively reviewed in the literature, daily and weekly variation of symptoms and their impact on daily life activities have received less attention, especially in the MEA region,” says Bhana. “No published study in MEA has investigated the fluctuation of COPD symptoms, treatment patterns and their consistency with the GOLD guidelines.”

Identifying behaviours

It also aims to explore the current practice in management of stable GOLD C and D COPD patients. “On conclusion of this study we must be able to describe the current treatment practice for the management of GOLD C and D COPD in MEA countries and their adherence to the GOLD 2016 guidelines,” says Bhana. “We also want to draw comparisons between these categories to uncover patient perceptions of symptom variability and their impacts. Identifying demographic, behavioural and clinical factors associated with symptom variability is another important study outcome sought by our NIS researchers.”

With South Africa now included in the study – there are nine participating countries. Other countries taking part include Algeria, Egypt, Jordan, Kuwait, Lebanon, Qatar, Turkey and the United Arab Emirates. It is expected that approximately 3,085 stable GOLD C & D COPD patients will be recruited during the 12-month multi-centre study, of which 350 will be South African patients.

“Data collation – directly gathered from patients via self-administered questionnaires – will take place during a one-visit assessment; no follow ups will be performed. By design, there also are no specific tests or examinations carried out for the purpose of the study,” she says.