Walters, EH and Walters, J and Wills, KE and Robinson, A and Wood-Baker, R, Clinical diaries in COPD: compliance and utility in predicting acute exacerbations, The International Journal of Chronic Obstructive Pulmonary Disease (Online), 7 pp. 427-435. ISSN 1178-2005 (2012) [Refereed Article]
Copyright 2012 Walters et al.
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.
|Item Type:||Refereed Article|
|Keywords:||chronic obstructive pulmonary disease, daily diary, secondary prevention|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Respiratory diseases|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Walters, EH (Professor Haydn Walters)|
|UTAS Author:||Walters, J (Dr Julia Walters)|
|UTAS Author:||Wills, KE (Dr Karen Wills)|
|UTAS Author:||Robinson, A (Professor Andrew Robinson)|
|UTAS Author:||Wood-Baker, R (Professor Richard Wood-Baker)|
|Web of Science® Times Cited:||13|
|Deposited By:||Menzies Institute for Medical Research|
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