P210 Are sputum and blood biomarkers of inflammation repeatable in stable COPD?

Abstract

Poster sessions Thorax 2012;67(Suppl 2):A1-A204 A155 to analyze the relationship between inhaler attributes and overall satisfaction. Least-squares regression and additive models were used to analyze the relationships between inhaler satisfaction, compliance and health outcomes. Results Data were included for 1443 patients for whom self-completed and matched physician-completed record forms were available. The majority of patients (71.8%) were male; mean age was 65.2 years. Very few patients (0.7%) were 'not at all compliant' with their physician's prescribing instructions, whilst 33.3% were 'fully compliant'. Most patients (75.1%) were more satisfied with their inhaler than not; 6.6% were 'very satisfied'. Key attributes influencing satisfaction related to durability, ergonomics and ease of use. There was a significant association between inhaler satisfaction and compliance (χ 2 − df=89.7; p<0.001). Other factors related to greater compliance, though to a lesser degree, were fewer maintenance drugs (χ 2 − df=17.7; p<0.001) and male gender (χ 2 − df=2.9; p<0.05). Severity of breathlessness, age and ethnicity were not significantly associated with compliance (p>0.05). Higher compliance scores were significantly associated with better health outcomes (Table). There was also a direct association between inhaler satisfaction and better health outcomes (exacerbations and EQ-5D, p<0.001). Conclusions Inhaler satisfaction appears to be significantly associated with COPD treatment compliance, and patients with greater compliance experience better health outcomes, including less frequent exacerbations. Abstract P209 Table 1 Association with health outcomes N R 2 p-value Relationship between health outcomes and increasing compliance score Fewer exacerbations in past 12 months a 1403 0.037 <0.001 Fewer exacerbations managed through hospitalisation in past 12 months a 1084 0.025 <0.001 Lower mMRC dyspnoea scale score a 1419 0.031 <0.0001 Higher EQ-5D score b 1422 0.035 <0.0001 Lower Jenkins Sleep Index b 1402 0.064 <0.0001 Relationship between health outcomes and increasing inhaler satisfaction Fewer exacerbations in past 12 months a 944 0.032 <0.001 Higher EQ-5D score b 959 0.030 <0.001 a Physician-reported; b patient-reported Coefficient of determination (R 2) derived from generalised additive models EQ-5D, EuroQoL-5 dimensions; mMRC, modified Medical Research Council Background Spirometry is a commonly used end-point in COPD clinical trials and there is evidence that spirometric values are reproducible in COPD patients. COPD is heterogeneous and differences in biomarkers of pulmonary and systemic inflammation between patients can be identified. Currently limited short-term reproduc-ibility is available in stable COPD. Aims Assess repeatability of commonly used clinical measures in subjects with stable COPD over 3 and 6 months. Methods Subjects with COPD were enrolled into an observational study and were reviewed at stable visits after 3 and 6 months. Spirometry, blood [peripheral blood total white cell and differential cell counts] and sputum [sputum differential cell counts (%)] markers of inflammation were repeated at each visit. Repeatability of