Characteristics Associated with Accelerated Lung Function Decline in a Primary Care Population with Chronic Obstructive Pulmonary Disease
Hannah R Whittaker,1 Jeanne M Pimenta,2 Deborah Jarvis,1 Steven J Kiddle,3 Jennifer K Quint1 1Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK; 2Epidemiology (Value Evidence and Outcomes), GlaxoSmithKline, R&...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Dove Medical Press
2020-11-01
|
Series: | International Journal of COPD |
Subjects: | |
Online Access: | https://www.dovepress.com/characteristics-associated-with-accelerated-lung-function-decline-in-a-peer-reviewed-article-COPD |
id |
doaj-86ed68bf2386481d8a419c4d9e95a559 |
---|---|
record_format |
Article |
spelling |
doaj-86ed68bf2386481d8a419c4d9e95a5592020-11-26T19:03:22ZengDove Medical PressInternational Journal of COPD1178-20052020-11-01Volume 153079309159679Characteristics Associated with Accelerated Lung Function Decline in a Primary Care Population with Chronic Obstructive Pulmonary DiseaseWhittaker HRPimenta JMJarvis DKiddle SJQuint JKHannah R Whittaker,1 Jeanne M Pimenta,2 Deborah Jarvis,1 Steven J Kiddle,3 Jennifer K Quint1 1Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK; 2Epidemiology (Value Evidence and Outcomes), GlaxoSmithKline, R&D, Uxbridge, UK; 3MRC Biostatistics Unit, University of Cambridge, Cambridge, UKCorrespondence: Hannah R WhittakerImperial College, Emmanuel Kaye Building, National Heart and Lung Institute, London, UKEmail h.whittaker@imperial.ac.ukBackground: Estimates for lung function decline in chronic obstructive pulmonary disease (COPD) have differed by study setting and have not been described in a UK primary care population.Purpose: To describe rates of FEV1 and FVC decline in COPD and investigate characteristics associated with accelerated decline.Patients and Methods: Current/ex-smoking COPD patients (35 years+) who had at least 2 FEV1 or FVC measurements ≥ 6 months apart were included using Clinical Practice Research Datalink. Patients were followed up for a maximum of 13 years. Accelerated rate of lung function decline was defined as the fastest quartile of decline using mixed linear regression, and association with baseline characteristics was investigated using logistic regression.Results: A total of 72,683 and 50,649 COPD patients had at least 2 FEV1 or FVC measurements, respectively. Median rates of FEV1 and FVC changes or decline were − 18.1mL/year (IQR: − 31.6 to − 6.0) and − 22.7mL/year (IQR: − 39.9 to − 6.7), respectively. Older age, high socioeconomic status, being underweight, high mMRC dyspnoea and frequent AECOPD or severe AECOPD were associated with an accelerated rate of FEV1 and FVC decline. Current smoking, mild airflow obstruction and inhaled corticosteroid treatment were additionally associated with accelerated FEV1 decline whilst women, sputum production and severe airflow obstruction were associated with accelerated FVC decline.Conclusion: Rate of FEV1 and FVC decline was similar and showed similar heterogeneity. Whilst FEV1 and FVC shared associations with baseline characteristics, a few differences highlighted the importance of both lung function measures in COPD progression. We identified important characteristics that should be monitored for disease progression.Keywords: pulmonary disease, chronic obstructive, spirometry, lung functionhttps://www.dovepress.com/characteristics-associated-with-accelerated-lung-function-decline-in-a-peer-reviewed-article-COPDpulmonary diseasechronic obstructivespirometrylung function |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Whittaker HR Pimenta JM Jarvis D Kiddle SJ Quint JK |
spellingShingle |
Whittaker HR Pimenta JM Jarvis D Kiddle SJ Quint JK Characteristics Associated with Accelerated Lung Function Decline in a Primary Care Population with Chronic Obstructive Pulmonary Disease International Journal of COPD pulmonary disease chronic obstructive spirometry lung function |
author_facet |
Whittaker HR Pimenta JM Jarvis D Kiddle SJ Quint JK |
author_sort |
Whittaker HR |
title |
Characteristics Associated with Accelerated Lung Function Decline in a Primary Care Population with Chronic Obstructive Pulmonary Disease |
title_short |
Characteristics Associated with Accelerated Lung Function Decline in a Primary Care Population with Chronic Obstructive Pulmonary Disease |
title_full |
Characteristics Associated with Accelerated Lung Function Decline in a Primary Care Population with Chronic Obstructive Pulmonary Disease |
title_fullStr |
Characteristics Associated with Accelerated Lung Function Decline in a Primary Care Population with Chronic Obstructive Pulmonary Disease |
title_full_unstemmed |
Characteristics Associated with Accelerated Lung Function Decline in a Primary Care Population with Chronic Obstructive Pulmonary Disease |
title_sort |
characteristics associated with accelerated lung function decline in a primary care population with chronic obstructive pulmonary disease |
publisher |
Dove Medical Press |
series |
International Journal of COPD |
issn |
1178-2005 |
publishDate |
2020-11-01 |
description |
Hannah R Whittaker,1 Jeanne M Pimenta,2 Deborah Jarvis,1 Steven J Kiddle,3 Jennifer K Quint1 1Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK; 2Epidemiology (Value Evidence and Outcomes), GlaxoSmithKline, R&D, Uxbridge, UK; 3MRC Biostatistics Unit, University of Cambridge, Cambridge, UKCorrespondence: Hannah R WhittakerImperial College, Emmanuel Kaye Building, National Heart and Lung Institute, London, UKEmail h.whittaker@imperial.ac.ukBackground: Estimates for lung function decline in chronic obstructive pulmonary disease (COPD) have differed by study setting and have not been described in a UK primary care population.Purpose: To describe rates of FEV1 and FVC decline in COPD and investigate characteristics associated with accelerated decline.Patients and Methods: Current/ex-smoking COPD patients (35 years+) who had at least 2 FEV1 or FVC measurements ≥ 6 months apart were included using Clinical Practice Research Datalink. Patients were followed up for a maximum of 13 years. Accelerated rate of lung function decline was defined as the fastest quartile of decline using mixed linear regression, and association with baseline characteristics was investigated using logistic regression.Results: A total of 72,683 and 50,649 COPD patients had at least 2 FEV1 or FVC measurements, respectively. Median rates of FEV1 and FVC changes or decline were − 18.1mL/year (IQR: − 31.6 to − 6.0) and − 22.7mL/year (IQR: − 39.9 to − 6.7), respectively. Older age, high socioeconomic status, being underweight, high mMRC dyspnoea and frequent AECOPD or severe AECOPD were associated with an accelerated rate of FEV1 and FVC decline. Current smoking, mild airflow obstruction and inhaled corticosteroid treatment were additionally associated with accelerated FEV1 decline whilst women, sputum production and severe airflow obstruction were associated with accelerated FVC decline.Conclusion: Rate of FEV1 and FVC decline was similar and showed similar heterogeneity. Whilst FEV1 and FVC shared associations with baseline characteristics, a few differences highlighted the importance of both lung function measures in COPD progression. We identified important characteristics that should be monitored for disease progression.Keywords: pulmonary disease, chronic obstructive, spirometry, lung function |
topic |
pulmonary disease chronic obstructive spirometry lung function |
url |
https://www.dovepress.com/characteristics-associated-with-accelerated-lung-function-decline-in-a-peer-reviewed-article-COPD |
work_keys_str_mv |
AT whittakerhr characteristicsassociatedwithacceleratedlungfunctiondeclineinaprimarycarepopulationwithchronicobstructivepulmonarydisease AT pimentajm characteristicsassociatedwithacceleratedlungfunctiondeclineinaprimarycarepopulationwithchronicobstructivepulmonarydisease AT jarvisd characteristicsassociatedwithacceleratedlungfunctiondeclineinaprimarycarepopulationwithchronicobstructivepulmonarydisease AT kiddlesj characteristicsassociatedwithacceleratedlungfunctiondeclineinaprimarycarepopulationwithchronicobstructivepulmonarydisease AT quintjk characteristicsassociatedwithacceleratedlungfunctiondeclineinaprimarycarepopulationwithchronicobstructivepulmonarydisease |
_version_ |
1724414372267163648 |