Perception of symptoms and quality of life – comparison of patients’ and physicians’ views in the COPD MIRROR study

Abstract

Bartolome Celli,1,2 Francesco Blasi,3,4 Mina Gaga,5 Dave Singh,6 Claus Vogelmeier,7,8 Valeria Pegoraro,9 Nicoletta Caputo,10 Alvar Agusti11 1Pulmonary and Critical Care Medicine Division, Brigham and Women’s Hospital, 2Harvard Medical School, Boston, MA, USA; 3Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy; 4Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; 57th Respiratory Medicine Department and Asthma Centre, Athens Chest Hospital, Athens, Greece; 6Medicines Evaluation Unit, University of Manchester, University Hospital of South Manchester, Manchester, UK; 7Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-Universität Marburg, Marburg, Germany, 8German Center for Lung Research (DZL), Giessen, Germany; 9Real World Insight, QuintilesIMS, Milan, Italy; 10Primary Market Research, QuintilesIMS, Milan, Italy; 11Respiratory Institute, Hospital Clinic, IDIBAPS, CibeRes, University of Barcelona, Barcelona, Spain Objectives: The aim of this study was to compare potential differences between the perception that COPD patients have of their disease and the perception that physicians have of how the disease affects their patients.Methods: Surveys in COPD patients and physicians caring for COPD patients were conducted in Spain, Italy, and Germany. Online questionnaires mirrored to explore the same domains, were administered to patients and physicians. Physicians were asked to respond to the questionnaire taking a recently seen patient who represents the majority of COPD patients usually managed, as a reference. Patients with COPD completed a survey containing the same questions offered to the physicians (Medical Investigation of Respiratory COPD Perception [MIRROR] survey). Comparisons between the responses of patients and general practitioners (GPs) and between patients and pulmonologists (PULs) were run separately using the chi-square, Fisher’s exact, or Student’s t-tests.Results: A total of 334 COPD patients, 333 GPs, and 333 PULs participated in the surveys. The typical perception that PULs have of the COPD patient was that of an older man with more severe disease and less likely to be a smoker, than the included COPD patients. COPD was regarded as a major health problem by patients and physicians, but its impact on overall quality of life among more severe patients was less strongly perceived by physicians than by patients. Instead, physicians paid more attention to domains related to clinical features (cough, phlegm, and dyspnea), while underestimating COPD impact on leisure and social activities. The majority of patients stated not being completely frank with their doctors during visits. Both GPs and PULs seemed to recognize this issue but underestimated its extent.Conclusion: To improve the doctor–patient communication, a more frank reporting by the patients of their symptoms and feelings and an increased awareness of physicians about the impact on nonconventional domains that patients perceive as importantly affected by COPD should be encouraged. Keywords: COPD, perception, QoL

Keywords

• COPD
• perception
• QoL