Clinical diaries in COPD: compliance and utility in predicting acute exacerbations
Open Access
- 1 July 2012
- journal article
- Published by Taylor & Francis Ltd in International Journal of Chronic Obstructive Pulmonary Disease
- Vol. 7, 427-435
- https://doi.org/10.2147/copd.s32222
Abstract
Background: Daily diaries are often used to collect data on disease activity, but are burdensome and compliance may be poor. Their use in chronic obstructive pulmonary disease (COPD) and impact on the prevention and treatment of exacerbations is poorly researched. Methods: We investigated diary-keeping in COPD and ascertained items that best predicted emergency attendances for exacerbations. Participants in the active limb of a clinical trial in COPD kept daily diaries rating breathlessness, cough, sputum, physical activity, and use of reliever medication. Results: Data on 55 participants, 67% of whom were female, showed that overall compliance with diary-keeping was 62%. Participants educated to primary school level only had lower compliance (P = 0.05). Twenty patients had at least one emergency attendance, in whom the relative risk of an acute exacerbation for an increase in item score rose from six days prior to hospitalization, most sharply in the last two days. Even for optimal combinations of items, the positive predictive value was poor, the best combination being cough, activity level, and inhaler use. Conclusion: Good compliance can be achieved using daily diaries in COPD, although this is worse in those with a poor educational level. Diary-keeping is not accurate in predicting acute exacerbations, but could be substantially simplified without loss of efficiency.Keywords
This publication has 37 references indexed in Scilit:
- Standardizing Measurement of Chronic Obstructive Pulmonary Disease ExacerbationsAmerican Journal of Respiratory and Critical Care Medicine, 2011
- Development of the EXAcerbations of Chronic Obstructive Pulmonary Disease Tool (EXACT): A Patient-Reported Outcome (PRO) MeasureValue in Health, 2010
- Action plans with limited patient education only for exacerbations of chronic obstructive pulmonary diseasePublished by Wiley ,2010
- Patient Compliance with Assessing and Monitoring of AsthmaJournal of Asthma, 2009
- Experiences of Self-Monitoring: Successes and Struggles During Treatment for Weight LossQualitative Health Research, 2009
- Using instrumented paper diaries to document self-monitoring patterns in weight lossContemporary Clinical Trials, 2008
- Impact on patients' health status following early identification of a COPD exacerbationEuropean Respiratory Journal, 2007
- Defining COPD exacerbations: impact on estimation of incidence and burden in primary carePrimary Care Respiratory Journal, 2006
- Reasons for missing interviews in the daily electronic assessment of pain, mood, and stressPain, 2004
- COPD exacerbations: definitions and classificationsEuropean Respiratory Journal, 2003