OBJECTIVES: To explore experiences of participants in SLS COPD (an open-label study comparing fluticasone furoate/vilanterol versus usual care in COPD).1
METHODS: Subsamples of patients completing SLS COPD were interviewed. Standard interviews (telephone/face-to-face) included closed-ended study-specific questions on: background/lifestyle, COPD symptoms/daily-life impact, environmental/temporal trigger factors, self-management/disease awareness, control, exacerbation experience/management, quality of life (QoL; specific dimensions/overall). Extended interviews (face-to-face) included the closed-ended plus additional open-ended questions. Quantitative data were analysed descriptively; qualitative data were analysed by qualitative description approach.
RESULTS: 400 patients were interviewed (standard, n=360/extended, n=40). Mean age (SLS COPD entry/follow-up interview=65.2/66.2 years) and gender (53.3% male) were reasonably representative of patients completing SLS COPD; 37% were current smokers. Breathlessness was the most frequently reported COPD symptom (88.5%) and the most improved/worsened (26.8%/20.9%) during SLS COPD; qualitative analysis revealed breathlessness most impacted: walking, climbing stairs, housework, self-care. Quantitative analysis revealed COPD most impacted functioning, physical activities, relationships/psychological state; qualitative analysis reinforced the broader impact of these on QoL. Strategies to prevent COPD worsening included: exercise, medication adherence, smoking reduction/cessation. 59.5% (n=238/400) described having ‘quite a lot’/’very much’ control over COPD; a high-risk group reported having no control (n=36[9.0%]). 66.5% (n=266/400) reported experiencing an exacerbation; severity of last exacerbation was considered (n=264/266): mild (n=21[7.9%]), moderate (n=74[27.8%]), severe (n=127[47.7%]), very severe (n=42[15.8%]); 60.5% managed this at home (resting/antibiotics and/or oral corticosteroids). Mean/total overall QoL score: 6.5/10; reported QoL changes during SLS COPD were: improvement (35.3%), no change (43.3%), deterioration (21.3%). No specific/serious adverse events were reported in interviews.
CONCLUSIONS: Quantitative and qualitative data confirm breathlessness as the key COPD symptom, impacting most on mobility, daily activities and self-care; however, patients focused more on life-impacts of COPD than symptoms alone. This first, detailed evidence of COPD experiences over an extended period adds valuable information to the SLS COPD findings.
FUNDING: GSK (117375). 1NEJM(2016)375:1253.
