Patient-perceived treatment burden of chronic obstructive pulmonary disease

Nathan Harb, Juliet M. Foster, Claudia C. Dobler

Research output: Contribution to journalArticleResearchpeer-review

14 Citations (Scopus)

Abstract

Background: While chronic morbidity and mortality from COPD is well documented, little is known about the treatment burden faced by patients with COPD. Subjects and methods: Patients with severe airflow obstruction (forced expiratory volume in 1 second [FEV1] <50% predicted) representing different age-groups, sex, and number of comorbidities participated in a semistructured interview. Interviews were conducted until thematic saturation was reached. Interviews were recorded, transcribed, and analyzed thematically using an established treatment-burden framework. Results: A total of 26 patients (42% male, mean age 66.7±9.8 years) with severe (n=15) or very severe (n=11) airflow limitation (mean FEV1 32.1%±9.65% predicted) were interviewed. Participants struggled with various treatment-burden domains, predominantly with changing health behaviors, such as smoking cessation and exercise. Interviewees often only ceased smoking after a major health event, despite being advised to do so earlier by a doctor. Recommended exercise regimens, such as pulmonary rehabilitation classes, were curtailed, although some patients replaced them with light home-based exercise. Interviewees had difficulty attending medical appointments, often relying on others to transport them. Overall, COPD patients indicated they were not willing to accept the burden of treatments where they perceived minimal benefit. Conclusion: This study describes the substantial treatment burden experienced by patients with COPD. Medical advice may be rejected by patients if the benefit of following the advice is perceived as insufficient. Health professionals need to recognize treatment burden as a source of nonadherence, and should tailor treatment discussions to fit patients’ values and capacity to achieve optimal patient outcomes.

Original languageEnglish
Pages (from-to)1641-1652
Number of pages12
JournalInternational Journal of COPD
Volume12
DOIs
Publication statusPublished - 1 Jun 2017
Externally publishedYes

Fingerprint

Chronic Obstructive Pulmonary Disease
Therapeutics
Forced Expiratory Volume
Interviews
Exercise
Health Behavior
Health
Smoking Cessation
Comorbidity
Appointments and Schedules
Rehabilitation
Age Groups
Smoking
Morbidity
Light
Lung
Mortality

Cite this

@article{b4cfe0b2e13b42539eac3aba1e1ad35d,
title = "Patient-perceived treatment burden of chronic obstructive pulmonary disease",
abstract = "Background: While chronic morbidity and mortality from COPD is well documented, little is known about the treatment burden faced by patients with COPD. Subjects and methods: Patients with severe airflow obstruction (forced expiratory volume in 1 second [FEV1] <50{\%} predicted) representing different age-groups, sex, and number of comorbidities participated in a semistructured interview. Interviews were conducted until thematic saturation was reached. Interviews were recorded, transcribed, and analyzed thematically using an established treatment-burden framework. Results: A total of 26 patients (42{\%} male, mean age 66.7±9.8 years) with severe (n=15) or very severe (n=11) airflow limitation (mean FEV1 32.1{\%}±9.65{\%} predicted) were interviewed. Participants struggled with various treatment-burden domains, predominantly with changing health behaviors, such as smoking cessation and exercise. Interviewees often only ceased smoking after a major health event, despite being advised to do so earlier by a doctor. Recommended exercise regimens, such as pulmonary rehabilitation classes, were curtailed, although some patients replaced them with light home-based exercise. Interviewees had difficulty attending medical appointments, often relying on others to transport them. Overall, COPD patients indicated they were not willing to accept the burden of treatments where they perceived minimal benefit. Conclusion: This study describes the substantial treatment burden experienced by patients with COPD. Medical advice may be rejected by patients if the benefit of following the advice is perceived as insufficient. Health professionals need to recognize treatment burden as a source of nonadherence, and should tailor treatment discussions to fit patients’ values and capacity to achieve optimal patient outcomes.",
author = "Nathan Harb and Foster, {Juliet M.} and Dobler, {Claudia C.}",
year = "2017",
month = "6",
day = "1",
doi = "10.2147/COPD.S130353",
language = "English",
volume = "12",
pages = "1641--1652",
journal = "International Journal of COPD",
issn = "1176-9106",
publisher = "Dove Medical Press Ltd.",

}

Patient-perceived treatment burden of chronic obstructive pulmonary disease. / Harb, Nathan; Foster, Juliet M.; Dobler, Claudia C.

In: International Journal of COPD, Vol. 12, 01.06.2017, p. 1641-1652.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Patient-perceived treatment burden of chronic obstructive pulmonary disease

AU - Harb, Nathan

AU - Foster, Juliet M.

AU - Dobler, Claudia C.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Background: While chronic morbidity and mortality from COPD is well documented, little is known about the treatment burden faced by patients with COPD. Subjects and methods: Patients with severe airflow obstruction (forced expiratory volume in 1 second [FEV1] <50% predicted) representing different age-groups, sex, and number of comorbidities participated in a semistructured interview. Interviews were conducted until thematic saturation was reached. Interviews were recorded, transcribed, and analyzed thematically using an established treatment-burden framework. Results: A total of 26 patients (42% male, mean age 66.7±9.8 years) with severe (n=15) or very severe (n=11) airflow limitation (mean FEV1 32.1%±9.65% predicted) were interviewed. Participants struggled with various treatment-burden domains, predominantly with changing health behaviors, such as smoking cessation and exercise. Interviewees often only ceased smoking after a major health event, despite being advised to do so earlier by a doctor. Recommended exercise regimens, such as pulmonary rehabilitation classes, were curtailed, although some patients replaced them with light home-based exercise. Interviewees had difficulty attending medical appointments, often relying on others to transport them. Overall, COPD patients indicated they were not willing to accept the burden of treatments where they perceived minimal benefit. Conclusion: This study describes the substantial treatment burden experienced by patients with COPD. Medical advice may be rejected by patients if the benefit of following the advice is perceived as insufficient. Health professionals need to recognize treatment burden as a source of nonadherence, and should tailor treatment discussions to fit patients’ values and capacity to achieve optimal patient outcomes.

AB - Background: While chronic morbidity and mortality from COPD is well documented, little is known about the treatment burden faced by patients with COPD. Subjects and methods: Patients with severe airflow obstruction (forced expiratory volume in 1 second [FEV1] <50% predicted) representing different age-groups, sex, and number of comorbidities participated in a semistructured interview. Interviews were conducted until thematic saturation was reached. Interviews were recorded, transcribed, and analyzed thematically using an established treatment-burden framework. Results: A total of 26 patients (42% male, mean age 66.7±9.8 years) with severe (n=15) or very severe (n=11) airflow limitation (mean FEV1 32.1%±9.65% predicted) were interviewed. Participants struggled with various treatment-burden domains, predominantly with changing health behaviors, such as smoking cessation and exercise. Interviewees often only ceased smoking after a major health event, despite being advised to do so earlier by a doctor. Recommended exercise regimens, such as pulmonary rehabilitation classes, were curtailed, although some patients replaced them with light home-based exercise. Interviewees had difficulty attending medical appointments, often relying on others to transport them. Overall, COPD patients indicated they were not willing to accept the burden of treatments where they perceived minimal benefit. Conclusion: This study describes the substantial treatment burden experienced by patients with COPD. Medical advice may be rejected by patients if the benefit of following the advice is perceived as insufficient. Health professionals need to recognize treatment burden as a source of nonadherence, and should tailor treatment discussions to fit patients’ values and capacity to achieve optimal patient outcomes.

UR - http://www.scopus.com/inward/record.url?scp=85020457703&partnerID=8YFLogxK

U2 - 10.2147/COPD.S130353

DO - 10.2147/COPD.S130353

M3 - Article

VL - 12

SP - 1641

EP - 1652

JO - International Journal of COPD

JF - International Journal of COPD

SN - 1176-9106

ER -