title: Community-acquired pneumonia: symptoms and burden of illness at diagnosis among US adults aged 50 years and older.
abstract: OBJECTIVE
  Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality in older adults, yet few studies have comprehensively measured the burden of CAP symptoms and their impact from the patient perspective. Our Web-survey used the newly developed CAP burden of illness questionnaire (CAP-BIQ) designed to assess the presence of key symptoms, comorbid conditions affected by CAP, psychosocial impacts, productivity, and CAP-associated physician visits in US adults aged 50 years and older.
  
  
  METHODS
  The CAP-BIQ was developed from semi-structured one-on-one interviews and finalized after cognitive debriefings with recently diagnosed CAP patients. The CAP-BIQ was then administered to 500 survey participants with a CAP diagnosis within the past 120 days confirmed by chest imaging recruited from a Web-based panel. Analyses of survey results were weighted for national representativeness, and were compared between relevant age, hospitalization status, and pneumonia-risk subgroups.
  
  
  RESULTS
  The survey participants' mean age was 62.4 years; 45 % were men; and 39.6 % were hospitalized due to CAP. On average, the surveys were completed 56.9 days after pneumonia diagnosis. Nearly all participants reported tiredness, cough, body aches, weakness, shortness of breath, wheezing, and a weak appetite at the time of diagnosis (99.0, 96.8, 96.9, 94.1, 89.1, 85.8, and 78.5 %, respectively). There was generally greater symptom prevalence at diagnosis in younger, nonhospitalized, or high-risk subgroups when compared to their respective older, hospitalized, or low-risk counterparts. Most participants reported at least one cough-related and weakness-related impact on their daily life and activities from CAP. Over three quarters of the respondents (77.4 %) needed assistance from a friend or family member during their bout with pneumonia and a majority of respondents (83.6 %) were satisfied with the care they received from their doctors across the course of their illness.
  
  
  CONCLUSIONS
  This study systematically assessed CAP symptoms and their impacts using the CAP-BIQ, a questionnaire with established content validity. At CAP diagnosis, the range of patient-reported symptoms was broader than previous studies have reported. Additionally, the overwhelming need for caregiver assistance demonstrates the burden this illness places on older adults.
authors.affiliation: United BioSource Corporation, Bethesda, MD 20814, USA. kathy.wyrwich@unitedbiosource.com
authors.forename: Kathleen W
authors.initials: KW
authors.lastname: Wyrwich
authors.forename: Holly
authors.initials: H
authors.lastname: Yu
authors.forename: Reiko
authors.initials: R
authors.lastname: Sato
authors.forename: David
authors.initials: D
authors.lastname: Strutton
authors.forename: John H
authors.initials: JH
authors.lastname: Powers
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D017028:Caregivers / Q000706:statistics & numerical data; D017714:Community-Acquired Infections / Q000191:economics / Q000453:epidemiology; D015897:Comorbidity; D017281:Cost of Illness; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011014:Pneumonia / Q000191:economics / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
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