EARLY THERAPY START IMPROVES EXACERBATION OUTCOME IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE
A six-year study of 128 patients showed that early treatment of exacerbations associated with moderate to severe chronic obstructive pulmonary disease (COPD) hastened and improved recovery, reduced the risk of hospitalization, and led to a better health-related quality of life. British researchers performed the first prospective study to demonstrate the important effect of early treatment on COPD exacerbation outcomes. The study took place between November 1996 and October 2002. (In the disease COPD, patients have persistent obstruction of the airways associated with emphysema or chronic bronchitis.) According to the study authors, the frequency of exacerbations has been shown to be an important determinant of the impaired health-related quality of life seen in COPD, and to affect decline in lung function. An exacerbation was defined as the presence, for at least two consecutive days, of an increase in two "major" symptoms (including severe breathlessness (dyspnea) and the quantity of pus in the sputum), or an increase in one "major" and one "minor" symptom (such as wheeze, sore throat, and cold symptoms). There were 1,099 exacerbations recorded by patients in the daily dairies. Of this number, 625 were reported to a physician. The investigators noted that failure to report exacerbations was associated with an increased risk of emergency hospitalization. A total of 266 exacerbations were treated with oral corticosteroids, which hastened recovery time by 2.63 days. Six hundred of the exacerbations were treated with antibiotics and of these, 241 were given both oral corticosteroids and antibiotics. The paper appears in the second issue for June 2004 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.
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American Journal of Respiratory and Critical Care Medicine