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The relationship between symptom experience and the level of daily physical activity in patients with COPD. Hans VAN REMOORTEL Turkish Thoracic Society Congress April 3-7, 2013 Belek - Antalya. www.proactivecopd.com.
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The relationshipbetweensymptomexperience and the level of dailyphysicalactivityin patientswith COPD • Hans VAN REMOORTEL • TurkishThoracic Society Congress • April 3-7, 2013 • Belek - Antalya
www.proactivecopd.com The PROactive project is funded by the Innovative Medicines Initiative Joint Undertaking (IMI JU) # 115011; and matching funds at each academic institution Academic partners Patient / Scientific organizations EFPIA members Small Medium Enterprise
Rationale • Functional performance (Kocks PCRJ 2011) • = activitiespeopleactually do • Reduces risk hospitalizationduetoexacerbation(Garcia-AymerichThorax 2003) • Relatedtoquality of life(Arne IJCOPD 2011) • Predictor all-causemortality(Garcia-rioChest 2012) 1.0 Q4 Q3 0.8 Probability of survival 0.6 Q2 0.4 Q1 80 60 0 20 40 Time (months)
Rationale • Measurement(Kocks PCRJ 2011)
Rationale Field assessment: Activity monitors (accelerometry (+ other sensors)) Rabinovich et al.; European Respiratory Journal; 2013 Van Remoortel et al.; Plos One; 2012
Rationale Patient report: Clinical COPD Questionnaire (CCQ) functional status domain Adapted from T. van der Molen, Department of General Practice, University Medical Center, Groningen, The Netherlands
Rationale Objectivemeasurements CCQ functional status domain 6 5 4 25000 20000 3 15000 CCQ functional status domain Steps.day-1 2 10000 5000 1 IV III C I II 0 I III IV II Shrikrishna ERJ 2012 Liu SWJ 2012 GOLD stage GOLD stage
Rationale Objectivemeasurements CCQ functional status domain 1.0 1.0 Q4 <1 Q3 1 & <2 0.8 0.8 2 & <3 Probability of survival Probability of survival Q2 0.6 0.6 3 0.4 0.4 Q1 80 60 0 60 20 40 0 20 40 Time (months) Time (months) Garcia-rio, Chest, 2012 Sundh, IJCOPD, 2012
Methods • Aim= Identifythe relationbetweenfunctional performance measuredby PRO and physicalactivity monitoring at the individualpatientlevel • Inclusion • + 40y • FEV1/FVC < 70% • +10 pack years • Exclusion • Impairment of normalmovementpatternunrelatedtorespiratorydisease • Otherrespiratorydisease
Methods • Design Spirometry 6MWD mMRC CAT CCQ CRQ-SAS mMRC CAT CCQ CRQ-SAS mMRC CAT CCQ CRQ-SAS mMRC CAT CCQ CRQ-SAS V4 V1 V2 V3 14 days 14 days 14 days PA monitoring PA monitoring
Results • Baseline characteristics
Results • Physicalactivity monitoring • PatientReportedOutcome
Results • Univariatecorrelations STEPS (amount) r= -0.51 r= -0.33 r= -0.50 r= -0.45
Results • Univariatecorrelations INTENSITY DURING WALKING r= -0.49 r= -0.31 r= -0.49 r= -0.45
Conclusion • Functional performance measuredwith a PRO is modestlyrelated to the amount and intensity of PA. • Information obtainedwith a PRO does not provide aninsight in the physicalactivity level of patientswith COPD and canthereforenotbeused as a surrogateforobjective PA measurement. • PROactive tool = capturingphysicalactivitybyanobjectiveassessment (activitymonitoring) ANDsymptomexperience of the patients (PRO).
Prof. Dr. M. Decramer Prof. Dr. W. Janssens Prof. Dr. T. Troosters Prof. Dr. R. Gosselink
Thankyouforyourattention! hans.vanremoortel@faber.kuleuven.be