title: Disease severity and symptoms among patients receiving monotherapy for COPD.
abstract: OBJECTIVE
  To examine the burden of respiratory symptoms, quality of life and co-morbid illness in COPD patients receiving maintenance treatment in a real world setting.
  
  
  METHODS
  In a single visit, patients with a physician's diagnosis of COPD who were receiving monotherapy with a long-acting bronchodilator (LABD) performed spirometry, completed symptom questionnaires, and reported their treatments, history of exacerbations and co-morbidities.
  
  
  RESULTS
  We enrolled 1084 patients of whom 1072 had acceptable spirometry. 689 (64%) had airflow obstruction (FEV1/FVC≤0.70) while 383 (36%) failed to meet spirometric criteria for COPD despite receiving maintenance therapy and having comparable symptoms and comorbid illness. Among those with confirmed COPD, dyspnoea was worse in those with more severe airflow limitation though exacerbation frequency was comparable across COPD stages.
  
  
  CONCLUSIONS
  COPD is commonly diagnosed and treated in patients without airflow obstruction. Many COPD patients receiving LABD monotherapy continue to suffer significant symptoms, exacerbations and poor quality of life.
authors.affiliation: UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA. mdransfield99@msn.com
authors.forename: Mark T
authors.initials: MT
authors.lastname: Dransfield
authors.forename: William
authors.initials: W
authors.lastname: Bailey
authors.forename: Glenn
authors.initials: G
authors.lastname: Crater
authors.forename: Amanda
authors.initials: A
authors.lastname: Emmett
authors.forename: Dianne M
authors.initials: DM
authors.lastname: O'Dell
authors.forename: Barbara
authors.initials: B
authors.lastname: Yawn
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000367:Age Factors; D000368:Aged; D000420:Albuterol / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015897:Comorbidity; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004417:Dyspnea / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000188:drug therapy*; D011788:Quality of Life; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D013147:Spirometry / Q000379:methods; D016896:Treatment Outcome; D014797:Vital Capacity
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol