Symptoms and impact of symptoms on function and health in patients with chronic obstructive pulmonary disease and chronic heart failure in primary health care
Open accessAbstract
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) seem to have several symptoms in common that impact health. However, methodological differences make this difficult to compare. AIM: Comparisons of symptoms, impact of symptoms on function and health between patients with COPD and CHF in primary health care (PHC). METHOD: The study is cross sectional, including patients with COPD (n=437) and CHF (n=388), registered in the patient administrative systems of PHC. The patients received specific questionnaires--the Memorial Symptom Assessment Scale, the Medical Research Council dyspnea scale, and the Fatigue Impact Scale--by mail and additional questions about psychological and physical health. RESULTS: The mean age was 70 ± 10 years and 78 ± 10 years for patients with COPD and CHF respectively (P=0.001). Patients with COPD (n=273) experienced more symptoms (11 ± 7.5) than the CHF patients (n=211) (10 ± 7.6). The most prevalent symptoms for patients with COPD were dyspnea, cough, and lack of energy. For patients with CHF, the most prevalent symptoms were dyspnea, lack of energy, and difficulty sleeping. Experience of dyspnea, cough, dry mouth, feeling irritable, worrying, and problems with sexual interest or activity were more common in patients with COPD while the experience of swelling of arms or legs was more common among patients with CHF. When controlling for background characteristics, there were no differences regarding feeling irritable, worrying, and sexual problems. There were no differences in impact of symptoms or health. CONCLUSION: Patients with COPD and CHF seem to experience similar symptoms. There were no differences in how the patients perceived their functioning according to their cardinal symptoms; dyspnea and fatigue, and health. An intervention for both groups of patients to optimize the management of symptoms and improve function is probably more relevant in PHC than focusing on separate diagnosis groups.
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Refractory breathlessness is highly prevalent and distressing in advanced chronic respiratory disease.
“Refractory breathlessness is a highly prevalent and distressing symptom in advanced chronic respiratory disease.”
From The Breathing, Thinking, Functioning clinical model: a proposal to facilitate evidence-based breathlessness management in chronic respiratory disease (2017) · cites this paper as [1]
The Introduction reports that shortness of breath is common in COPD and that many symptoms can cause significant distress; the Discussion reports functional limitations due to dyspnea. The paper studies patients with COPD and heart failure in primary health care, but does not establish that their breathlessness was refractory or that they had advanced chronic respiratory disease. Page numbers are not available in our copy. (LLM, conf=0.88)
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- Authors
- Theander, K., Unosson, M., Karlsson, I., Eckerblad, J., Luhr, K., & Hasselgren, M.
- Affiliations
- Karlstad University (SE)
- Linköping University (SE)
- Örebro County Council (SE)
- Örebro University (SE)
- Corresponding author
- Theander, Kersti
- Venue
- International Journal of Chronic Obstructive Pulmonary Disease
- Publisher
- Informa UK Limited
- Published
- 2014-07
- Volume
- 9
- Pages
- 785
- ISSN
- 1176-9106 (ISSN-L)
- 1178-2005
- PMC
- PMC4111648
- OpenAlex
- W2097902358
- Cited by
- 68
- References
- 57
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 7 · 2023: 3 · 2022: 6 · 2021: 4 · 2020: 5 · 2019: 9 · 2018: 6 · 2017: 8 · 2016: 5 · 2015: 7 · 2014: 1
- FWCI
- 5.62
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of COPD (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Digitala vetenskapliga arkivet (Diva) (Karlstad University) (submittedVersion, other-oa)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Funders
- Riksförbundet HjärtLung
- Regionala Forskningsrådet Uppsala/Örebro
- Landstinget i Värmland
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- chronic obstructive pulmonary disease, chronic heart failure, symptom burden, dyspnea, fatigue, cough, health-related quality of life, primary care, symptom management, comorbidities
- MeSH terms
- Aged, Aged, 80 and over, Cross-Sectional Studies, Dyspnea, Fatigue, Female, Health Status, Health Status Indicators, Heart Failure, Humans, Male, Middle Aged, Primary Health Care, Surveys and Questionnaires, Sweden, Prevalence, Pulmonary Disease, Chronic Obstructive
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