Factors That May Affect FEV1 Change Of COPD Patients In One-Year Period

Öz

INTRODUCTION: One of the hallmarks of COPD is the rate of FEV1 decline. There are many factors that may affect pulmonary parameters in a COPD patient. It was aimed to investigate the factors affecting FEV1 changes.

 

MATERIAL-METHODS: COPD outpatients who attended our pulmonology clinic were included. Spirometric values and inhaler device usage performance at that time and 12 months ago were compared.

 

RESULTS: Mean FEV1 values of 204 COPD patients decreased from 1.56±0.51 lt (53.4%) to 1.51±0.50 lt (53.2%). There was a statistically significant relationship between FEV1 change (decline / not) and gender, active smoking, regular inhaler device usage, exacerbation, hospitalization history in last year, presence of comorbidities and inhaler device adherence. FEV1 decline had positive correlation with the number of exacerbations in last year (r=0.432, p<0.001), and negative correlation with inhaler device usage score (r=-0.512, p<0.001). Multivariate regression analysis demonstrated that smoking status, number of exacerbations (per year) and inhaler therapy adherence were the factors that affect FEV1 decline in COPD patients (p=0.007, 0.001 ve 0.003, respectively).

 

CONCLUSION: Smoking is the major parameter that affects FEV1 value in COPD. Inhaler adherence may directly affect FEV1 change. Smoking cessation, preventing COPD exacerbations and increasing inhaler therapy adherence may decrease FEV1 declines of COPD patients in one-year period.

 

 

Anahtar Kelimeler

• FEV1 decline,COPD,smoking

Kaynakça

1. Jemal A, Ward E, Hao Y, Thun M. Trends in the leading causes of death in the United States, 1970–2002. JAMA. 2005;294(10):1255–1259.
2. Broekmans JF, Migliori GB, Rieder HL, Lees J, Ruutu P, Loddenkemper R. et al. European framework for tuberculosis control and elimination in countries with a low incidence. Recommendations of the World Health Organization (WHO), International Union Against Tuberculosis and Lung Disease (IUATLD) and Royal Netherlands Tuberculosis Association (KNCV) Working Group. Eur Respir J 2002;19:765–75.
3. Celli BR, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004;23:932–946.
4. Wise RA. The value of forced expiratory volume in 1 second decline in the assessment of chronic obstructive pulmonary disease progression. Am J Med. 2006 Oct;119: 4-11.
5. Celli BR, Thomas NE, Anderson JA, Ferguson GT, Jenkins CR, Jones PW. et al. Effect of pharmacotherapy on rate of decline of lung function in chronic obstructive pulmonary disease: results from the TORCH study. Am J Respir Crit Care Med. 2008;178(4):332–338
6. Tantucci C, Modina D. Lung function decline in COPD. Int J Chron Obstruct Pulmon Dis 2012; 7: 95–99
7. Campbell AH, Barter CE, O’Connell JM, Huggins R. Factors affecting the decline of ventilatory function in chronic bronchitis. Thorax 1985;40:741–8
8. Vestbo J, Edwards LD, Scanlon PD, Yates JC, Agusti A, Bakke P, et al. Changes in forced expiratory volume in 1 second over time in COPD. N Engl J Med 2011;365:1184–92

9. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management and prevention of chronic pulmonary disease. 2011
10. Turkish Thoracic Society Asthma Working Group. National guide of Turkish Thoracic Society for asthma, Volume 1. Turkish Thoracic Society, 2000: 1–32
11. Turan O, Yemez B, Itil O. The effects of anxiety and depression symptoms on treatment adherence in COPD patients. Prim Health Care Res Dev. 2014;15: 244-251.
12. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24:67–74.
13. Oğuzülgen IK, Köktürk N, Işikdoğan Z. Turkish validation study of Morisky 8-item medication adherence questionnaire (MMAS-8) in patients with asthma and chronic obstructive pulmonary disease. Tuberk Toraks. 2014;62(2):101-7.
14. Gladysheva ES, Malhotra A, Owens RL. Influencing the decline of lung function in COPD: use of pharmacotherapy. Int J Chron Obstruct Pulmon Dis. 2010; 5:153-64.
15. Young RP, Hopkins R, Eaton TE. Forced expiratory volume in one second: not just a lung function test but a marker of premature death from all causes. Eur Respir J 2007; 30: 616–622
16. Donaldson GC, Seemungal TAR, Bhowmik A, Wedzicha JA. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax 2002; 57: 847–852
17. Fletcher C, Peto R. The natural history of chronic airflow obstruction. BMJ 1977;1:1645-1648.
18. Casanova C, de Torres JP, Aguirre-Jaíme A, Pinto-Plata V, Marin JM, Cordoba E. The progression of chronic obstructive pulmonary disease is heterogeneous: the experience of the BODE cohort. Am J Respir Crit Care Med 2011; 184: 1015-21.
19. Dockery DW, Speizer FE, Ferris BG Jr, Ware JH, Louis TA, Spiro A. Cumulative and reversible effects of lifetime smoking on simple tests of lung function in adults. Am Rev Respir Dis 1988; 137: 286–292.
20. Xu X, Weiss ST, Rijcken B, Schouten JP. Smoking, changes in smoking habits, and rate of decline in FEV1: new insight into gender differences. Eur Respir J 1994; 7: 1056–61.
21. Scanlon PD, Connett JE, Waller LA, Altose MD, Bailey WC, Buist AS. Smoking cessation and lung function in mild-to-moderate chronic obstructive pulmonary disease, The Lung Health Study. Am J Respir Crit Care Med. 2001;161:381-90.
22. Lareau SC, Yawn BP. Improving adherence with inhaler therapy in COPD. Int J Chron Obstruct Pulmon Dis. 2010, 5: 401-406.