COPD perceptions in doctors and patients

by Ed Susman

Doctors and patients with chronic obstructive pulmonary disease (COPD) agree that shortness of breath is the condition’s most debilitating symptom, but on other issues patients and clinicians are not on the same page, a survey shows.

For example, “patients and physicians are both aware of the prevalence of morning symptoms, but physicians are less aware of the prevalence and importance of symptoms in the afternoon and evening,” Ronald Balkissoon, MD, of the University of Colorado Health Sciences Center in Denver, wrote in his poster presentation at the 2010 American Thoracic Society annual meeting.

And patients “worry most about symptoms worsening over time, whereas physicians thought their patients worried most about being put on oxygen,” Balkissoon reported.

He and his colleagues interviewed 1,187 patients via telephone in April and May of 2009 to get their opinions on various aspects of COPD and its symptoms. And in May 2009 they surveyed 499 doctors — 200 pulmonary disease specialists and 299 primary care physicians.

The largest group of patients — about 62% — expressed concern about worsening symptoms. About 63% of doctors thought that was a major concern as well, although doctors believed other symptoms were more of a problem.

Among the significant differences between physicians and patients:

* 75% of physicians thought that their patients most feared being put on oxygen, but only about 47% of patients considered that their major concern.
* 73% of the doctors thought that losing independence was a major fear of patients, but just 55% of patients expressed that concern.
* 17% of doctors thought patients were fearful of not seeing friends and family more often, but that concern was mentioned by about 40% of the patients.
* 25% of doctors thought the ability to handle aspects of personal hygiene was feared by patients, an underestimation as 40% of patients said that was a concern.
* 46% of doctors thought that the possibility of having to leave their home would be fearful for patients, but just 36% of the patients agreed.
* 46% of doctors believed that patients would be fearful about their ability to continue working, but just 22% of the patients expressed that same concern.

“Increasing physician awareness of the gaps that exist between patients’ and physicians’ perceptions of the burden of COPD may make counseling efforts more effective,” Balkissoon wrote.

Ed Susman is a MedPage Today contributing writer.

Originally published in MedPage Today. Visit for more pulmonary news.