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• W3205940375 abstract "TOPIC: Obstructive Lung Diseases TYPE: Original Investigations PURPOSE: Rescue inhaler use is routine in chronic obstructive pulmonary disease (COPD) management. Yet, data on real-time use by patients has remained difficult to obtain, being largely reliant on surveys. Activity level is presumed to decrease with worsening disease, but hard data has been elusive. This has made understanding the interplay between organized vs disorganized rescue inhaler use and activity level difficult to ascertain. We hypothesize that organized inhaler use allows for greater activity levels (steps) than disorganized inhaler use within GOLD groups. METHODS: 184 individuals from a single center of the COPDGene cohort agreed to participate in this 21-day observational study. Each participant used a smartphone to complete a daily symptom diary (EXAcerbations of Chronic pulmonary disease Tool, EXACT), wore a wrist-worn accelerometer to record continuously physical activity and completed the Clinical Visit PROactive Physical Activity in COPD questionnaire. 58 users of metered dose inhalers for rescue (albuterol) were provided with an inhaler sensor, which time stamped each inhaler actuation. These users were divided into GOLD (Global Initiative for Chronic Obstructive Lung Disease) II, III, and IV. The organized group was defined as having one more more rescue inhaler usages within the same 2-hour time window for 6 consecutive days or more. The disorganized group was defined as any inhaler use that did not fit the aforementioned criteria. A coefficient of variance (CoV) was calculated for daily step average and standard deviation. RESULTS: The organized GOLD III demonstrated a higher average daily step count compared to the disorganized (3,135 vs 2,030). The organized GOLD IV demonstrated a lower step count, daily average, and SD when compared to the disorganized. The disorganized GOLD IV group showed a lower CoV (22% vs ~31%) when compared to all other groups. The average standard deviation was greater for the organized groups, except for GOLD IV. CONCLUSIONS: This small analysis suggests that regular use of a rescue inhaler may support increased activity levels, evidenced by the higher average daily step count in the organized GOLD III group. This type of real-world data may prove helpful in clinical decision making, particularly when considering initiating a long-acting agent. The lower CoV and increased activity levels for the GOLD IV disorganized group may suggest a more stable disease state and optimized management when compared to the organized GOLD IV group. Though the average standard deviations are greater for the organized group, the CoV supports relatively comparable variability in the standard deviation of daily steps within and across groups. CLINICAL IMPLICATIONS: Though further investigation is necessary, real-world data on rescue inhaler usage will likely be useful in determining appropriate pharmacological interventions in COPD patients in order to maximize their corresponding activity levels. DISCLOSURES: No relevant relationships by Russell Bowler, source=Web Response No relevant relationships by Andrew Hill, source=Web Response No relevant relationships by Ayal Levi, source=Web Response" @default.
• W3205940375 created "2021-10-25" @default.
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• W3205940375 date "2021-10-01" @default.
• W3205940375 modified "2023-09-25" @default.
• W3205940375 title "COPD: ORGANIZED VS DISORGANIZED RESCUE INHALER USE" @default.
• W3205940375 doi "https://doi.org/10.1016/j.chest.2021.07.1642" @default.
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