Understanding the impact of chronic obstructive pulmonary disease exacerbations on patient health and quality of life.

Exacerbations of chronic obstructive pulmonary disease (COPD) represent a significant clinical problem, and are associated with decreased lung function, worsening quality of life and decreased physical activity levels, with even a single exacerbation having detrimental effects. The occurrence of COPD exacerbations can also have a considerable impact on healthcare costs and mortality rates, with over one-fifth of patients hospitalized for a COPD exacerbation for the first time dying within one year of discharge. This highlights the need for COPD exacerbations to be a major focus in clinical practice. Furthermore, the substantial effect that COPD exacerbations can have on patient mental health should not be underestimated. Despite their clinical importance, COPD exacerbations are poorly recognized and reported by patients, and improving patient understanding and reporting of exacerbations to ensure prompt treatment may minimize their deleterious effects. Renewed focus on improving current clinical practice with support from evidence-based guidelines is required. This also raises a challenge to payors, healthcare systems and government policies to do more to tackle the considerable outstanding burden of COPD exacerbations.

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Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest J.R. Hurst reports grants, personal fees and non-financial support from pharmaceutical companies that make medicines to treat COPD. N. Skolnik reports nonfinancial support from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline and Sanofi; personal fees from AstraZeneca, Boehringer Ingelheim and Eli Lilly; and has served on advisory boards for AstraZeneca, Boehringer Ingelheim, Eli Lilly, GlaxoSmithKline, Intarcia, Janssen Pharmaceuticals, Merck, Mylan, Sanofi and Teva Pharmaceutical. G.J. Hansen reports no conflicts of interest. A. Anzueto reports grants or fees from AstraZeneca, Boehringer Ingelheim, Forest Laboratories, GlaxoSmithKline and Novartis. G.C. Donaldson reports personal fees from the American Thoracic Society, AstraZeneca, Micom Ltd and the Research Foundation Flanders (FWO) outside the submitted work. M.T. Dransfield reports grants from the American Lung Association, the Department of Defense, the Department of Veterans Affairs and the National Heart, Lung, and Blood Institute; personal fees from Mereo and Quark; personal fees and other from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline and PneumRx; and other from Boston Scientific, Pulmonx, Novartis and Yungjin. P. Varghese is an employee of AstraZeneca.