Younger Patients Feel Heavier Burden, Greater Impact of COPD, Global Survey Reveals

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by Forest Ray PhD |

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Younger patients report feeling a heavier burden and greater daily impact from the symptoms of chronic obstructive pulmonary disease (COPD) than older patients, a global survey has revealed.

Physicians should thus optimize treatment for these younger patients, say researchers leading the survey.

The findings were published in an article, “Daily Impact of COPD in Younger and Older Adults: Global Online Survey Results from over 1,300 Patients,” in the journal COPD: Journal of Chronic Obstructive Pulmonary Disease.

Although COPD is generally considered to be a disease affecting older people, some estimates suggest that more than 50% of COPD cases occur among patients younger than 70.

An estimated 5.9% of adults, 18 and older, reported being diagnosed with COPD in the United States. Estimates rise to 6.5% among those 45–55, 9.6% among those 55–64, and 12.5% among adults 65 or older.

“Despite this, the younger COPD population has not been well described, and little is known about the relative impact of COPD symptoms on patients of different ages and their daily activities,” the researchers wrote.

Thus, scientists from Radboud University Medical Center, in the Netherlands, together with Boehringer Ingelheim and the European Federation of Allergy and Airways Diseases Patients’ Associations (EFA), developed a survey to assess the impact of COPD on patients’ lives, the differences in disease burden between younger and older patients, and patients’ attitudes about their ability to manage their symptoms.

The online survey was conducted by Instar Research. A total of 1,375 adults, 45 and older, from Europe, China, Japan, and the U.S. responded to the survey. All patients were receiving COPD maintenance therapy, and were stratified into three groups according to their age: 45–54 (365 patients), 55–64 (440 patients), 65 and older (570 patients).

Overall, younger patients, between the ages of 45 and 54, reported feeling a greater sense of disease burden, and claimed that symptoms impacted their daily activities to a greater extent than did patients 65 and older.

More younger patients reported that their disease “extremely” or “very much” affected their ability to perform tasks outside their homes — 37% vs. 22% in the older group — and to travel long distances — 38% vs. 18% in the older group.

The younger respondents were also more than twice as likely to find themselves planning their day around periods of breathlessness and/or coughing — 41% vs. 19% in the older group.

Among patients in the younger group, 35% reported their well-being as “poor” or “very poor,” compared to 28% in the older group. Younger patients were also significantly more likely than older patients to report feeling “stressed,” “overwhelmed,” “anxious,” and “sad.”

“One possible explanation as to why the perceived burden differs strongly is that younger patients are usually more active in terms of their work and social life, and so have differing expectations about what life with COPD will be,” Nicole Hass, representative of the EFA and one of the study’s authors, said in a press release.

Younger patients were found to speak more frequently with their healthcare team than older patients, indicating a greater reliance upon healthcare providers. Those in the younger group were also more than three times as likely as older respondents to want information to better manage their inhaler device — 18% of younger respondents did not want such information, compared to 58% in the older cohort.

“Although more research is needed to better understand why these age differences exist, these findings show we need to make patients more aware of how they can positively impact their disease progression through things like speaking to clinicians about optimal treatment aimed at keeping them active in their daily lives,” Hass said.

Overall, the survey results highlight the substantial physical and psychosocial impact that COPD has on patients, particularly those 45–54.

“Younger patients with COPD reported a higher impact on their daily activities, wellbeing and requirement for adjusting their activities due to their symptoms than older patients,” the researchers wrote. “Our findings highlight the importance of optimizing treatment for younger patients with COPD and suggest that clinicians should not overlook the burden of disease in these patients.”

Richard Dekhuijzen, PhD, pulmonologist and the study’s lead author, said: “This is one of the few surveys that looks at the impact of COPD in different age groups. As healthcare professionals, we have to realize that the same disease has a different impact in younger and older patients, and that the perceived impact has to be addressed to tailor and optimize treatment to suit each patient.”