Associations between comorbid load and baseline characteristics in COPD patients with comorbidities: preliminary results

Chronic Obstructive Pulmonary Disease (COPD) action plans are widely implemented in usual care, but evidence of their use in the presence of comorbidities is limited. Comorbid symptoms may lead to incorrect or delayed treatment actions, and comorbidities often cause hospitalisation and mortality.

In an ongoing controlled trial in the Netherlands and Australia we aim to include 233 COPD patients with ≥ 1 comorbidity. Patients are randomly assigned to an intervention group, with training in the use of a daily symptom diary for their COPD and comorbidities linked to pre-specified individualised actions, or a control group. Follow-up is one year. Associations between the comorbid load and baseline characteristics (e.g. COPD severity, exercise capacity, literacy) will be assessed using multivariate logistic regression analyses.

Baseline characteristics of the first 100 patients (mean age 69.0 ± 9.6; 64.0% male) showed that 43% of the COPD patients had ≥ 2 major comorbidities. Multivariate logistic regression analyses showed that lower cognitive function (Mini Mental State Examination; OR 1.45 (95% CI 1.08-2.00)) and worse emotional function (Chronic Respiratory Questionnaire; OR 1.72 (95% CI 1.02-2.94)) were associated with having ≥ 2 comorbidities. Lower self-reported exercise hours a week (OR 1.09; 95% CI 0.99-1.18) and higher BODE composite score of Body Mass Index, Obstruction, Dyspnoea, and Exercise capacity (OR 1.24; 95% CI 0.91-1.68) were borderline significant.

Diminished cognitive function and worse emotional function are associated with comorbid load in patients with COPD, highlighting the need to account for comorbidities in everyday management of COPD.