title: Real-life assessment of the multidimensional nature of dyspnoea in COPD outpatients.
abstract: Dyspnoea is a prominent symptom of chronic obstructive pulmonary disease (COPD). Recent multidimensional dyspnoea questionnaires like the Multidimensional Dyspnea Profile (MDP) individualise the sensory and affective dimensions of dyspnoea. We tested the MDP in COPD outpatients based on the hypothesis that the importance of the affective dimension of dyspnoea would vary according to clinical characteristics.A multicentre, prospective, observational, real-life study was conducted in 276 patients. MDP data were compared across various categories of patients (modified Medical Research Council (mMRC) dyspnoea score, COPD Assessment Test (CAT) score, Global Initiative for Chronic Obstructive Lung Disease (GOLD) airflow obstruction categories, GOLD "ABCD" categories, and Hospital Anxiety and Depression Scale (HADS)). Univariate and multivariate regressions were conducted to explore factors influencing the affective dimension of dyspnoea. Cluster analysis was conducted to create homogeneous patient profiles.The MDP identified a more marked affective dimension of dyspnoea with more severe mMRC, CAT, 12-item Short-Form Health Survey mental component, airflow obstruction and HADS. Multivariate analysis identified airflow obstruction, depressive symptoms and physical activity as determinants of the affective dimension of dyspnoea. Patients clustered into an "elderly, ex-smoker, severe disease, no rehabilitation" group exhibited the most marked affective dimension of dyspnoea.An affective/emotional dimension of dyspnoea can be identified in routine clinical practice. It can contribute to the phenotypic description of patients. Studies are needed to determine whether targeted therapeutic interventions can be designed and whether they are useful.
authors.affiliation: Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS1158 "Neurophysiologie respiratoire expérimentale et clinique", Paris, France AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale (Département "R3S"), Paris, France capucine.morelot@psl.aphp.fr.
authors.forename: Capucine
authors.initials: C
authors.lastname: Morélot-Panzini
authors.affiliation: Patient-Centered Outcomes, Mapi, Lyon, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Gilet
authors.affiliation: Université Joseph Fourier, Grenoble, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Aguilaniu
authors.affiliation: UPRES EA220, Hôpital Foch, Suresnes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Devillier
authors.affiliation: Service de Pneumologie, Hôpital Larrey, Centre Hospitalier Régional et Universitaire de Toulouse, Toulouse, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Didier
authors.affiliation: Clinique des Maladies Respiratoires, Centre Hospitalier Régional et Universitaire de Lille, Lille, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Perez
authors.affiliation: Pierre Fabre Médicament, Castres, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Pignier
authors.affiliation: Patient-Centered Outcomes, Mapi, Lyon, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Arnould
authors.affiliation: Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS1158 "Neurophysiologie respiratoire expérimentale et clinique", Paris, France AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale (Département "R3S"), Paris, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Similowski
mesh_terms: D000368:Aged; D016000:Cluster Analysis; D003863:Depression / Q000150:complications; D004417:Dyspnea / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume; D005602:France; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008173:Lung Diseases, Obstructive / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010045:Outpatients; D010641:Phenotype; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology*; D011788:Quality of Life; D012720:Severity of Illness Index; D012907:Smoking; D011795:Surveys and Questionnaires; D013997:Time Factors