Improving the process of care in chronic obstructive pulmonary disease: The COPD Assessment Test (CAT) in the armature of the tools assessing COPD
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Specialty Trainee in Pneumonology, 1st University Clinic of Pneumonology, “Sotiria” Hospital for Diseases of the Chest, Athens
Registrar, 1st University Clinic of Pneumonology, “Sotiria” Hospital for Diseases of the Chest, Athens
Nikoletta Rovina   

1st Department of Pneumonology, University of Athens, Medical School, “Sotiria” Hospital for Diseases of the Chest, 152, Mesogion Ave, Athens GR-11527, Greece
Pneumon 2011;24(3):286–291
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. A major goal of treatment is to ensure optimization of the level of health of the patient, i.e., health status as good as possible for the individual level of disease severity. For a number of reasons, patients with COPD tend to understate the overall severity of their condition, and the ways in which it impacts on their life. This underestimation and/or understatement of the impact of COPD can contribute to sub-optimal management of COPD, by making it difficult for healthcare professionals to assess the full impact of the condition on their patients’ lives accurately and to assign treatment appropriately. There is a need for a tool that is short and simple, self-administered by the patients, suitable for routine use in clinical practice and a reliable and valid measure of the impact of COPD on the life and health status of the patient. It should ensure that patients and healthcare professionals have a common understanding of the impact of the illness, and that their priorities with regard to management are in agreement. When used in conjunction with measurements of lung function, the tool should enable healthcare professionals to optimize the management of each individual patient. The COPD Assessment Test (CAT) was developed to facilitate a meaningful discussion between healthcare professionals and patients and provide a reliable measure of the impact of COPD on the patient’s life. Αs a result of this enhanced communication, the CAT is expected to contribute to improvements in the management of COPD and in the quality of life of the patients. The development and assessment of CAT was supported by the pharmaceutical company GlaxoSmithΚline.
WHO COPD: Burden. World Health Organization [Online]
Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet 1997;349:1498–504.
Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2007:1–30.
Siafakas NM, Vermeire P, Price NB, et al. Optimal assessment and management of chronic obstructive pulmonary disease (COPD): The European Respiratory Society Task Force. Eur Respir J 1995;8:1398–420.
Rennard S, Decramer M, Calverley PMS, et al. Impact of COPD in North America and Europe in 2000: subjects’ perspective of Confronting COPD International Survey. Eur Respir J 2002;20:799–805.
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;23:932–46.
Jansson SA, Andersson F, Borg S, et al. Costs of COPD in Sweden according to disease severity. Chest 2002;122:1994–2002.
Jones PW. Health status measurement in chronic obstructive pulmonary disease. Thorax 2001;56:880-7.
Loukides S, Bakakos P, Kostikas K. Revisiting the COPD megatrials in the new decade: The end of the road or just a new beginning? Pneumon 2011;24:27-29.
Tsiligianni I, Kocks J, Tzanakis N, et al. Factors that influence disease-specific quality of life or health status in patients with COPD: a review and meta-analysis of Pearson correlations. Primary Care Respiratory Journal 2011; in print.
van der Molen T, Willemse WMB, Schokker S, ten Hacken HTN, Postma SD, Juniper FE. Development, validity and responsiveness of the Clinical COPD Questionnaire. Health and Quality of Life Outcomes 2003;1:13-27.
Bestall J, Paul E, Garrod R, Garnham R, Jones P, Wedzicha J. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 1999;54:581-586.
Jones PW, Harding G, Berry P, et al. Development and first validation of the COPD Assessment Test. Eur Respir J 2009;34:648-54.
Jones PW, Harding G, Wiklund I, et al. Improving the process and outcome of care in COPD: development of a standardised assessment tool. Prim Care Respir J 2009;18:208-15.
Jones PW, Brusselle G, Dal Negro RW, et al. Properties of the COPD Assessment Test (CAT) in a cross-sectional European study. ERJ 2011;doi: 10.1183/09031936.00177210.
Kessler R, Partridge MR, Miravitlles M, et al. Symptom variability in patients with severe COPD: a pan-European cross-sectional study. Eur Respir J 2011;37:264–272.
Jones P, Harding G, Wiklund I, et al. The COPD Assessment Test™ (CAT) is responsive to pulmonary rehabilitation. ATS 2010.
Dodd JW, Hogg L, Nolan J, et al. The COPD assessment test (CAT): response to pulmonary rehabilitation. A multicentre, prospective study. Thorax 2011;66:425-9.