title: Physical activity in COPD patients decreases short-acting bronchodilator use and the number of exacerbations.
abstract: BACKGROUND
  Physically inactive patients with chronic obstructive pulmonary disease (COPD) exhibit higher rates of exacerbations and symptoms of dyspnoea than active patients. Whether the use of COPD medication explains these differences is not known.
  
  
  OBJECTIVE
  This study evaluated differences in the use of COPD medication and the number of exacerbations due to physical activity.
  
  
  METHODS
  A COPD cohort (N = 719) was followed through medical records to identify hospital admissions, and exercise activity was evaluated using mailed questionnaires. The national drug reimbursement registry identified drug purchases for one year.
  
  
  RESULTS
  The use of maintenance therapies, such as long-acting muscarinic antagonists (LAMAs), long-acting beta agonists (LABAs), inhaled corticosteroids (ICS), and theophylline, did not differ significantly between physically active (N = 346) and inactive (N = 355) COPD patients. The cumulative dose of salbutamol (85 vs. 218 mg, adjusted P = 0.01) and oral corticosteroids (OCS) (621 vs. 1068 mg, adjusted P = 0.02) were significantly higher in inactive patients, regardless of disease severity. LABAs, LAMAs, and ICS were used in reduced doses in both patient groups compared to daily defined doses (DDD). Physical activity was independently associated with the number of hospital admissions and the use of OCS and short-acting bronchodilators.
  
  
  CONCLUSIONS
  Physical inactivity in COPD was not associated with poorer use of maintenance therapies. In contrast, inactivity was independently associated with the number of exacerbations measured by hospital admissions and the use of OCS and short-acting symptom-relieving medications.
authors: Clinical Research Unit of Pulmonary Diseases and Division of Pulmonology HUCH Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Finland. Electronic address: milla.katajisto@fimnet.fi.
authors: Milla
authors: M
authors: Katajisto
authors: Clinical Research Unit of Pulmonary Diseases and Division of Pulmonology HUCH Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Finland.
authors: Jukka
authors: J
authors: Koskela
authors: Clinical Research Unit of Pulmonary Diseases and Division of Pulmonology HUCH Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Finland.
authors: Ari
authors: A
authors: Lindqvist
authors: Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, Finland.
authors: Maritta
authors: M
authors: Kilpeläinen
authors: Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, Finland.
authors: Tarja
authors: T
authors: Laitinen
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use; D000368:Aged; D000420:Albuterol / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects / Q000502:physiology*; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology*; D011788:Quality of Life; D013147:Spirometry / Q000379:methods
chemical_list: D000305:Adrenal Cortex Hormones; D058666:Adrenergic beta-2 Receptor Agonists; D001993:Bronchodilator Agents; D018727:Muscarinic Antagonists; D000420:Albuterol
keywords: COPD; Maintenance medication; Physical activity; Rescue medication exacerbation