Patient-centred outcomes in primary care management of COPD — what do recent clinical trial data tell us?

Abstract

Summary Traditionally, the severity of chronic obstructive pulmonary disease (COPD) and effectiveness of interventions have been determined using measures of lung function. However, a relatively small reduction or change in lung function — such as those observed in mild to moderate COPD — may not always reflect the impact of the disease or intervention on patients' physical and psychological well-being. This paper examines the utility of various outcome measures that can be used in primary care to monitor and manage COPD. In particular, it demonstrates the importance of measuring patient-centred outcomes, such as health-related quality of life and exacerbations, which may reflect more accurately the effects of the disease and treatment on patients' everyday lives. Recent large-scale clinical trials of budesonide/formoterol and fluticasone/salmeterol combination therapies and tiotropium have utilised these outcome measures to show the significant benefits these treatments bestow to patients in the presence of relatively modest gains in lung function.