title: The impact of morning symptoms on daily activities in chronic obstructive pulmonary disease.
abstract: BACKGROUND
  This survey assessed the impact of symptoms of COPD on patients' ability to perform activities throughout the day and the extent to which physicians provided advice including how medications may help maintain quality of life.
  
  
  METHODS
  The survey had three inclusion criteria--physician's diagnosis of COPD, age 30-70 years and presence of at least one of four listed symptoms to a greater extent in the morning. Participants were randomly selected from a panel who had previously agreed to participate in surveys. The survey was conducted in eight countries and contained 31 questions in the main section on the effects of symptoms of COPD throughout the day on patients' ability to perform tasks, how patients adjusted their lives and the extent to which physicians offered advice and support.
  
  
  RESULTS
  Routine activities took 10-15 minutes longer and more strenuous activities around 30 minutes longer than before symptoms had become worse in the morning. Half had made changes to their morning routines and just over half confirmed that morning symptoms affected the rest of their day. The majority believed their medications provided sufficient relief of morning symptoms but less than a quarter believed they helped improve their ability to perform tasks. Physicians were unlikely to discuss this aspect of patient care routinely even though there was evidence to suggest that the challenge of performing tasks had a greater impact on patients than the symptoms themselves.
  
  
  CONCLUSIONS
  Morning symptoms of COPD can severely compromise patients' ability to perform tasks throughout the day. Despite this, physicians are unlikely to discuss with patients how their ability to perform tasks might be improved.
authors.affiliation: Healthcare Consultancy , Maidenhead, Berkshire , UK.
authors.forename: Philip
authors.initials: P
authors.lastname: O'Hagan
authors.forename: Niels H
authors.initials: NH
authors.lastname: Chavannes
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010817:Physician-Patient Relations; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology* / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D011897:Random Allocation; D012907:Smoking; D011795:Surveys and Questionnaires