A cross sectional observational study on the influence of chronic obstructive pulmonary disease on activities of daily living: the COPD-Life study

Giriş: Çalışma kronik obstrüktif akciğer hastalığı (KOAH)nın hastaların günlük yaşam aktivitelerine etkilerinin ve hastaların günlük yaşamlarını sürdürme biçimleri ve gereksinimlerinin belirlenmesi amacıyla tasarlandı. Hastalar ve Metod: Bu ulusal, çok merkezli, kesitsel gözlem çalışmasına, 41 merkezden, eski ve yeni tanılı toplam 497 stabil KOAH hastası [ortalama yaş (standart sapma; SS): 63.3 (9.3) yıl; %59.0u < 65 yaş, %89.9u erkek] dahil edildi. Sosyodemografi ve KOAH ile ilgili veriler kayıt viziti ve bu viziti takiben bir ay içinde hastalarla gerçekleştirilen telefon görüşmesi yoluyla elde edildi. Bulgular: Ortalama (SS) KOAH süresi tüm hastalar için 7.3 (6.5) yıl, semptomların başlangıcından sonra bir yıl ve daha geç bir zamanda tanı alan hastalar için 5.4 (4.6) yıldı. Dispne (%83.1) en sık görülen semptom, merdiven çıkma (%66.6) en zorlanılan aktiviteydi. Hastaların çoğunluğu KOAHın kronik bir hastalık olduğunun (%63.4), sürekli tedavi gerektirdiğinin (%79.7), temel nedenin sigara içme olduğunun (%63.5) bilincindeydi. Türkiyedeki 45-65 yaş aralığında olan KOAH hastalarının oranı %59 olarak tespit edildi. Hastaların %84ünün en az ilkokul mezunu olduğu gözlemlenmiştir. Çalışma sonuçlarına göre hastaların ortalama iki kişiye bakmakla yükümlü oldukları ve %91inin evden dışarı çıkabilirken, üçte ikisinden fazlasının bakkala ve pazara rahat gidebildikleri tespit edildi. Gerek eğitim durumu, gerekse yaş grupları arasında cihazın düzenli kullanımının dağılımı açısından anlamlı bir farklılık bulunamadı. Hastaların KOAH tedavisinden beklentilerinde nefes alabilmek (%24.1), yürümek (%17.1) ve merdiven çıkmak (%11.7) ilk üç sırada yer alırken, nefes darlığı (%43.3) öncelikli tedavi gereksinimi olarak ifade edildi. Sonuç: Bu çalışmada KOAHın yaşlı hastalarda görüldüğü izlenimine ters olarak, genç hasta oranının düşünülenden daha yüksek olduğu, hastaların önemli bir bölümünün ev dışına çıkma zorunluluğu olduğu ve KOAH hastalarında cihazlarını düzenli olarak kullanma durumunun eğitim ve yaştan bağımsız olduğu görülmüştür. Bulgularımız genel kanının aksine, KOAHın sadece yaşlı hastalara özgü bir hastalık olmayıp KOAH hastalarının hayatın içinde ve aktif olduklarına ve vakitlerinin çoğunu evde ve yatakta geçirmediklerine işaret etmektedir. Dolayısıyla, tedavilerinde her zaman yanlarında taşıyabilecekleri ve kolay kullanılan bir cihazın, hayatın içinde yaşamlarını sürdüren bu hastaların günlük yaşamlarını iyileştirmedeki önemi ortaya çıkmaktadır.

Kronik obstrüktif akciğer hastalığının günlük yaşam aktivitelerine etkilerini araştırmaya yönelik kesitsel gözlem çalışması: KOAH la Yaşam çalışması

Introduction: This study was designed to identify the impact of chronic obstructive pulmonary disease (COPD) on activities of daily living, life styles and needs in patients. Patients and Methods: Participants of this national, multi-centered, cross-sectional observational study included 497 stable COPD patients from 41 centers. The mean age (standard deviation; SD) was 63.3 (9.3) years with 59.0% of the patients under the age of 65, and 89.9% of the participants were male. Sociodemographic and COPD-related data were gathered at enrollment and during the 1-month telephone follow-up. Results: The mean (SD) COPD duration was 7.3 (6.5) years in the overall population while 5.4 (4.6) years for patients who recieved COPD diagnosis at least one year after the onset of symptoms. Dyspnea was the most common (83.1%) symptom and walking up stairs (66.6%) was the most difficult activity to be performed. Majority of the patients were aware of COPD as a chronic disease (63.4%), requiring ongoing treatment (79.7%), mainly caused by smoking (63.5%). 59% of the patients were under the age of 65 years-old. In 84% of patients, graduation from at least a primary school was identified. Results revealed an average number of two dependants that were obliged to look after per patient, ability to go on an outing in 91% of the patients, and going grocery shopping with ease in more than two-thirds of the study population. There was no significant difference in regular use of medication device across different educational or age groups. The top three COPD treatment expectations of the patients were being able to breathe (24.1%), walking (17.1%), and walking up stairs (11.7%), while shortness of breath (43.3%) was the first priority treatment need. Conclusion: In contrast to the common view that COPD prevalance is higher in old age population, this study showed that the rate of the disease is higher among younger patients than expected; indispensability of out of the house activities in majority of patients; and use of regular medication device to be independent of educational level and the age of COPD patients. Our findings indicate that the likelihood of COPD patient population to be composed of younger and active individuals who do not spend majority of their time at home/in bed as opposed to popular belief. Therefore, availability of a portable and easy to use device for medication seems to be important to enhance daily living.

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