A recent literature review found that up to 90% of COPD patients experience ADL-limiting morning symptoms.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommends increased physical activity as a non-pharmacologic intervention for COPD, but morning symptoms can decrease physical activity.
Morning sypmptoms are seen across all stages of COPD, the most common being cough, sputum production, and shortness of breath.
Up to 90% of COPD patients may experience physical limitations related to morning symptoms, including getting out of bed, showering, dressing.
In patients with COPD, guideline-oriented medical treatment significantly improves activity limitations caused by morning symptoms.
Authors' comments: “[P]hysicians should include the evaluation of morning symptoms in their clinical assessment and they should include the control of morning symptoms as a goal of treatment..."
A systematic literature review, highlighted in the slides above, found that COPD patients at all disease stages experience symptoms first thing in the morning that limit the ability to perform important activities of daily living. The authors also found that guideline-recommended treatment reduced these limitations and yet improving morning symptoms is not a focus in current guidelines or considered a clinical treatment goal.Do you discuss morning symptoms with your COPD patients?Â Â
1. van Buul AR, Kasteleyn MJ, Chavannes NH, Taube C. Association between morning symptoms and physical activity in COPD: a systematic review. European Respiratory Review 2017 26: 160033; DOI: 10.1183/16000617.0033-2016
2. Global Strategy for the Diagnosis MaPoC. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2016. www.goldcopd.org. Date last updated: Dec 2015. Date last accessed: March 14, 2016.
3. Bateman ED, Chapman KR, Singh D, et al. Aclidinium bromide and formoterol fumarate as a fixed-dose combination in COPD: pooled analysis of symptoms and exacerbations from two six-month, multicentre, randomised studies (ACLIFORM and AUGMENT). Respir Res. 2015; 16: 92.