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P116 Observational study to characterise 24-hour COPD symptoms: cross-sectional results from the ASSESS study
  1. M Miravitlles 1,
  2. H Worth2,
  3. J Soler-Cataluña3,
  4. D Price4,
  5. F De Benedetto5,
  6. F Roche6,
  7. N Skavalan Godtfredsen7,
  8. T van der Molen8,
  9. C Löfdahl9,
  10. L Padullés10,
  11. A Ribera10
  1. 1Hospital Universitari Vall d’Hebron, Barcelona, Spain
  2. 2Klinikum Fürth, University Erlangen-Nürnberg, Fürth, Germany
  3. 3Hospital General de Requena, Valencia, Spain
  4. 4University of Aberdeen, Aberdeen, UK
  5. 5Ospedale Clinicizzato SS. Annunziata, Chieti, Italy
  6. 6Cochin Hospital, University Paris Descartes, Paris, France
  7. 7Bispebjerg University Hospital, Copenhagen, Denmark
  8. 8University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  9. 9Lund University Hospital, Lund, Sweden
  10. 10Almirall R&D Centre, Barcelona, Spain


Introduction and Objectives Little is known about the 24-hour profile of COPD symptoms. This study assessed the frequency/severity of 24-hour symptoms and their impact on patients’ well-being.

Methods This cross-sectional, observational study was conducted in patients with stable COPD. Baseline night-time, early-morning and day-time symptoms (symptom questionnaire), dyspnoea (modified Medical Research Council dyspnoea scale [mMRC]), health status (COPD Assessment Test [CAT]), anxiety/depression levels (Hospital Anxiety and Depression Scale [HADS]) and sleep quality (COPD and Asthma Sleep Impact Scale [CASIS]) were assessed. Primary endpoint: baseline frequency, severity and inter-relationship of night-time, early-morning and day-time symptoms; secondary endpoints: relationship between 24-hour symptoms and dyspnoea, health status, anxiety/depression and sleep quality.

Results 727 patients were recruited from eight countries: 65.8% male, mean ± SD age 67.2 ± 8.8 years, mean ± SD% predicted FEV1 52.7 ± 20.6%. Early-morning/day-time symptoms were most frequent; however night-time symptoms were common (Table). Symptom severity was comparable during the night-time, early-morning and day-time. In the week prior to baseline, 56.7% patients had symptoms throughout the 24-hours (79.9% in 2 or 3 parts of the day). Breathlessness was most common (71.4% patients); its prevalence increased throughout the 24-hours (32.1% night-time, 51.6% early-morning, 65.2% day-time).

Dyspnoea, health status, anxiety/depression and sleep quality were worse in patients with night-time, early-morning or day-time symptoms versus patients without symptoms in each period (all p < 0.001). Most patients with more severe dyspnoea (mMRC scale ≥2) had 24-hour symptoms (range 61.5–68.2%); patients with 24-hour symptoms had the worst health status (mean CAT score 20.0 vs range 8.1–14.9 in all other patients). Patients with any combination of night-time/early-morning symptoms had the highest anxiety (mean HADS scores 6.7–7.5 vs 3.6–5.8 in patients without this combination); depression levels were lowest in patients with no symptoms/only early-morning symptoms (mean HADS scores 4.2–5.4 vs 6.5–7.8 in all other patients). Patients with any night-time symptom had worse sleep quality than patients without night-time symptoms (mean CASIS scores 41.6–51.1 vs 31.6–35.5).

Conclusions Most patients had COPD symptoms throughout the 24-hours. Dyspnoea, health status, anxiety/depression levels and sleep quality were significantly worse in patients who had symptoms in any part of the day.

Abstract P116 Table 1.

Prevalence and severity of COPD symptoms throughout the 24-hour day

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