High Prevalence and Burden of Physical and Psychological Symptoms in a Chronic Obstructive Pulmonary Disease Population in Primary Care Settings in South Africa
Kennedy B Nkhoma,1 Lindsay Farrant,2 Olona Mzimkulu,2 Joy Hunter,2 Irene Higginson,1 Wei Gao,2 Matthew Maddocks,1 Liz Gwyther,2 Richard Harding1 1Cicely Saunders Institute of Palliative Care Policy and Rehabilitation, King’s College London, London, UK; 2Division of Interdisciplinary Palliative Care...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-08-01
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| Series: | International Journal of COPD |
| Subjects: | |
| Online Access: | https://www.dovepress.com/high-prevalence-and-burden-of-physical-and-psychological-symptoms-in-a-peer-reviewed-fulltext-article-COPD |
| _version_ | 1797755198578360320 |
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| author | Nkhoma KB Farrant L Mzimkulu O Hunter J Higginson I Gao W Maddocks M Gwyther L Harding R |
| author_facet | Nkhoma KB Farrant L Mzimkulu O Hunter J Higginson I Gao W Maddocks M Gwyther L Harding R |
| author_sort | Nkhoma KB |
| collection | DOAJ |
| description | Kennedy B Nkhoma,1 Lindsay Farrant,2 Olona Mzimkulu,2 Joy Hunter,2 Irene Higginson,1 Wei Gao,2 Matthew Maddocks,1 Liz Gwyther,2 Richard Harding1 1Cicely Saunders Institute of Palliative Care Policy and Rehabilitation, King’s College London, London, UK; 2Division of Interdisciplinary Palliative Care & Medicine, Department of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South AfricaCorrespondence: Kennedy B Nkhoma, Email kennedy.nkhoma@kcl.ac.ukBackground: Many deaths globally are attributable to non-communicable disease, and four-fifths of these deaths are in low- and middle-income countries. Globally, COPD is currently the third leading cause of mortality.Research Question: 1) To determine the prevalence and burden of symptoms and concerns, and 2) determine predicting factors of symptom burden among patients with COPD.Methods: A cross-sectional survey was conducted at eight primary care sites in Western Cape. We collected socio-demographic data (age, gender, smoking status, number of missed doses of prescribed medication in the last seven days) and clinical data (PEF and KPS). The Memorial Symptom Assessment Scale (MSAS), the Medical Outcomes Study, Social Support Survey (MOS-SSS), the London Chest Activity of Daily Living Scale (LCADLS) and the COPD Assessment Test (CAT) (impairment on person’s life) were administered to patients. We conducted ordered logistic regression analysis to assess factors associated with the burden of symptoms. MSAS subscales: 1) Global symptom distress index, 2) physical symptom distress and 3) psychological symptom distress were dependent outcomes. We constructed three ordinal logistic regression models for each of the three subscales. Covariates were MOS-SSS, LCADLS, CAT, demographic and clinical variables.Results: We recruited n=387 patients, mean age 59.5 years, 53.0% female. In multivariate analysis, each of the three models (ie, global, psychological and physical symptom distress) was positively associated with impairment on person’s life p< 0.001, difficulty to perform activities of daily living p< 0.001, and low social support p< 0.001. Old age was associated with lower global symptom distress (p=0.004), psychological and (0.014) physical distress (0.005). Missing 1 or more doses of medication was associated with higher levels of global (0.004) and physical (0.005) symptom distress.Interpretation: The high prevalence and burden of physical and psychological symptoms provides strong evidence of the need for integrating person-centred assessment and management of symptoms in primary care settings.Keywords: chronic lung disease, chronic obstructive pulmonary disease, symptom burden, symptom distress, symptom prevalence |
| first_indexed | 2024-03-12T17:44:21Z |
| format | Article |
| id | doaj.art-1bf537964bcb4607ac6f54c933aed548 |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-03-12T17:44:21Z |
| publishDate | 2023-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-1bf537964bcb4607ac6f54c933aed5482023-08-03T19:02:11ZengDove Medical PressInternational Journal of COPD1178-20052023-08-01Volume 181665167985633High Prevalence and Burden of Physical and Psychological Symptoms in a Chronic Obstructive Pulmonary Disease Population in Primary Care Settings in South AfricaNkhoma KBFarrant LMzimkulu OHunter JHigginson IGao WMaddocks MGwyther LHarding RKennedy B Nkhoma,1 Lindsay Farrant,2 Olona Mzimkulu,2 Joy Hunter,2 Irene Higginson,1 Wei Gao,2 Matthew Maddocks,1 Liz Gwyther,2 Richard Harding1 1Cicely Saunders Institute of Palliative Care Policy and Rehabilitation, King’s College London, London, UK; 2Division of Interdisciplinary Palliative Care & Medicine, Department of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South AfricaCorrespondence: Kennedy B Nkhoma, Email kennedy.nkhoma@kcl.ac.ukBackground: Many deaths globally are attributable to non-communicable disease, and four-fifths of these deaths are in low- and middle-income countries. Globally, COPD is currently the third leading cause of mortality.Research Question: 1) To determine the prevalence and burden of symptoms and concerns, and 2) determine predicting factors of symptom burden among patients with COPD.Methods: A cross-sectional survey was conducted at eight primary care sites in Western Cape. We collected socio-demographic data (age, gender, smoking status, number of missed doses of prescribed medication in the last seven days) and clinical data (PEF and KPS). The Memorial Symptom Assessment Scale (MSAS), the Medical Outcomes Study, Social Support Survey (MOS-SSS), the London Chest Activity of Daily Living Scale (LCADLS) and the COPD Assessment Test (CAT) (impairment on person’s life) were administered to patients. We conducted ordered logistic regression analysis to assess factors associated with the burden of symptoms. MSAS subscales: 1) Global symptom distress index, 2) physical symptom distress and 3) psychological symptom distress were dependent outcomes. We constructed three ordinal logistic regression models for each of the three subscales. Covariates were MOS-SSS, LCADLS, CAT, demographic and clinical variables.Results: We recruited n=387 patients, mean age 59.5 years, 53.0% female. In multivariate analysis, each of the three models (ie, global, psychological and physical symptom distress) was positively associated with impairment on person’s life p< 0.001, difficulty to perform activities of daily living p< 0.001, and low social support p< 0.001. Old age was associated with lower global symptom distress (p=0.004), psychological and (0.014) physical distress (0.005). Missing 1 or more doses of medication was associated with higher levels of global (0.004) and physical (0.005) symptom distress.Interpretation: The high prevalence and burden of physical and psychological symptoms provides strong evidence of the need for integrating person-centred assessment and management of symptoms in primary care settings.Keywords: chronic lung disease, chronic obstructive pulmonary disease, symptom burden, symptom distress, symptom prevalencehttps://www.dovepress.com/high-prevalence-and-burden-of-physical-and-psychological-symptoms-in-a-peer-reviewed-fulltext-article-COPDchronic lung diseasechronic obstructive pulmonary diseasesymptom burdensymptom distresssymptom prevalence |
| spellingShingle | Nkhoma KB Farrant L Mzimkulu O Hunter J Higginson I Gao W Maddocks M Gwyther L Harding R High Prevalence and Burden of Physical and Psychological Symptoms in a Chronic Obstructive Pulmonary Disease Population in Primary Care Settings in South Africa International Journal of COPD chronic lung disease chronic obstructive pulmonary disease symptom burden symptom distress symptom prevalence |
| title | High Prevalence and Burden of Physical and Psychological Symptoms in a Chronic Obstructive Pulmonary Disease Population in Primary Care Settings in South Africa |
| title_full | High Prevalence and Burden of Physical and Psychological Symptoms in a Chronic Obstructive Pulmonary Disease Population in Primary Care Settings in South Africa |
| title_fullStr | High Prevalence and Burden of Physical and Psychological Symptoms in a Chronic Obstructive Pulmonary Disease Population in Primary Care Settings in South Africa |
| title_full_unstemmed | High Prevalence and Burden of Physical and Psychological Symptoms in a Chronic Obstructive Pulmonary Disease Population in Primary Care Settings in South Africa |
| title_short | High Prevalence and Burden of Physical and Psychological Symptoms in a Chronic Obstructive Pulmonary Disease Population in Primary Care Settings in South Africa |
| title_sort | high prevalence and burden of physical and psychological symptoms in a chronic obstructive pulmonary disease population in primary care settings in south africa |
| topic | chronic lung disease chronic obstructive pulmonary disease symptom burden symptom distress symptom prevalence |
| url | https://www.dovepress.com/high-prevalence-and-burden-of-physical-and-psychological-symptoms-in-a-peer-reviewed-fulltext-article-COPD |
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