Rp.35 Evolution Of Health Status Of Patients With Copd Followed For Two Years In Primary Care

Author(s): 
J.M. Cots1, C. Llor2, J. Molina3, K. Naberan4, M. Miravitlles5
1 Family Physician, Barcelona, Spain
2 Family Physician, Tarragona, Spain
3 Family Physician, Madrid, Spain
4 Family Physician, Zaragoza, Spain
5 Pneumologist, Barcelona, Spain
Text: 
Patients with COPD experience a progressive impairment in health status over time. This impairment is accelerated by the presence of exacerbations. We aimed to evaluate the impairment in health status measured with the St. George’s Respiratory Questionnaire (SGRQ) of a cohort of ambulatory COPD patients followed for two years in primary care. The impact of treatment of exacerbations with either moxifloxacin (MOX) or amoxicillin/clavulanic acid (AMC) was also investigated. A total of 229 patients were included. 14 died, 44 were lost to follow-up and 35 did not complete the SGRQ at all visits, leaving 136 (59.3%) patients for the analysis. 96% were men, with a mean age of 70 years (SD: 9.7), mean FEV1(%) = 48.7% (SD: 14.5%). Baseline SGRQ 41.95 units (SD: 19.2). During 2 years, 90 patients (66.2%) suffered at least one exacerbation, with a mean of 1.89 exacerbations/patient (SD: 2.4). Patients without exacerbations presented a mean improvement of –5.32 units, but those with exacerbations experienced a mean impairment of 0.2 units. Patients treated with MOX experienced an improvement of –2.6 units (SD: 13.08) in the total SGRQ score compared with patients treated with AMC who suffered an impairment of 4.2 units (SD: 16.2) (p = 0.050). The symptoms score improved by –5.71 (SD: 16.6) units with MOX and was impaired by 7.46 (SD: 21.0) with AMC (p = 0.022). Exacerbations significantly impair health status, but treatment with a fluoroquinolone (MOX) preserves health status, probably due to a higher rate of clinical success and faster recovery or exacerbations.
Literature: 
RP.35 EVOLUTION OF HEALTH STATUS OF PATIENTS WITH COPD FOLLOWED FOR TWO YEARS IN PRIMARY CARE