Symptom assessment is a central component of understanding disease burden in COPD. In addition to ensuring a patient-centered approach to disease assessment, understanding the burden of symptoms directly informs initial and subsequent inhaled therapy selections. The classic symptoms of COPD include presence of cough, phlegm, chest tightness, wheezing, and shortness of breath. However, patients will often characterize their symptom burden based on impact to daily activities such as dressing, household chores, and exertional activities (mowing the lawn, taking a flight of stairs). When assessing symptoms in COPD, it is necessary to consider classic and patient-centered symptom descriptions.
Several validated symptom assessment tools are available for clinical assessments. The two tools recommended by the GOLD treatment recommendations are the modified Medical Research Council Score (mMRC) and COPD Assessment Test (CAT). The mMRC is a single item question that assesses shortness of breath on a scale from zero to four. The CAT assesses 8 domains on a scale from zero to five, leading to score ranging from zero to 40. A mMRC ≥2 or CAT ≥10 suggests suboptimal symptom control, and can indicate a need for initiation or up-titration of inhaled therapies.
What Does It Mean When Symptoms are Controlled?
This two-part series from the COPD Foundation provides a patient-level overview of COPD symptoms, COPD symptom control, and provides useful patient resources to monitor and understand symptom burden.
Symptom Assessment Tools
- What does it mean when COPD symptoms are controlled? Part 1 (online article)
- What does it mean when COPD symptoms are controlled? Part 2 (online article)
A COPD Symptom Infographic
The COPD Foundation provides an infographic to understand COPD symptoms and potential triggers. This graphic is useful to display in clinical areas that provide COPD care.
- COPD Symptoms and Triggers to Avoid and Prevent Worsening (PDF infographic)