The COPD assessment test: evaluating responsiveness to pulmonary rehabilitation

¶ … journals attached) describe key findings research studies related COPD management care- 2. You evaluate summarise article a word document. Each summary provide reader a succinct overview findings research.

Words: 171

The chronic obstructive pulmonary disease (COPD) assessment test (CAT) that has been recently introduced in hospitals is a simple way to assess patient-reported quality of life resulting from routine care. The researchers used patient-reported CAT scores in their multicenter prospective study to judge patient's views on improvement in their activity, reduction in their symptoms, and reduced utilization of healthcare when they were allocated to pulmonary rehabilitation programs. The authors' findings support the use of CAT scores in clinical practice since there was an increase in the patient-reported scores with majority feeling 'much better' or 'a little better' after pulmonary rehabilitation. The findings suggest that CAT scores can be used as an outcome measure in COPD patients involved in pulmonary rehabilitation. It is a simple tool to use in routine practice and it allows integration of pulmonary rehabilitation with other forms of care. For patients, CAT scores are also simple since they can fill their scores online thus making the CAT score effective even in home management or home maintenance of rehabilitation.

References:

Dodd, J.W., Hogg, L., Nolan, J., Jefford, H., Grant, A., Lord, V.M., . . . Hopkinson, N.S. (2011). The COPD assessment test (CAT): response to pulmonary rehabilitation. A multicentre, prospective study. Thorax, 66(5), 425-429. doi: 10.1136/thx.2010.156372, 429

Words: 192

The chronic obstructive pulmonary disorder (COPD) assessment test (CAT), which is a simple 8-item questionnaire for patients can be used routinely to assess responsiveness to care. The authors conducted a cohort study where they compared two patient cohorts in separate studies. Recruited patients were required to fill a CAT and provide scores on a six-point scale ranging from 'much worse' to 'completely resolved.' The first cohort aimed at measuring the responsiveness of the CAT to changes in health status during exacerbation while the second assessed the responsiveness of the CAT in patients during pulmonary rehabilitation. The study findings suggest that the CAT is responsive to changes in health status after both exacerbations and pulmonary rehabilitation. The findings support the use of the CAT to monitor COPD health status of patients over time. It also showed the relative ease with which the CAT can be used as a tool to monitor COPD health status gain to patients undergoing exacerbation or pulmonary rehabilitation. The CAT is a robust method and can be used to develop measures of disease severity and recovery. The authors also point at the generalizability of the CAT using local translations.

References:

Jones, P.W., Harding, G., Wiklund, I., Berry, P., Tabberer, M., Yu, R., & Leidy, N.K. (2012). TEsts of the responsiveness of the copd assessment test following acute exacerbation and pulmonary rehabilitation. CHEST Journal, 142(1), 134-140. doi: 10.1378/chest.11-0309, 140

In text (short) APA style citation: (Dodd et al., 2011)

End of text (long) APA style citation: Dodd, J.W., Hogg, L., Nolan, J., Jefford, H., Grant, A., Lord, V.M., . . . Hopkinson, N.S. (2011). The COPD assessment test (CAT): response to pulmonary rehabilitation. A multicentre, prospective study. Thorax, 66(5), 425-429. doi: 10.1136/thx.2010.156372, 429 http://thorax.bmj.com/content/66/5/425.short ADDIN EN.CITE Dodd2011

ecNum>2101

ecord>

ec-number>21012101

ef-type name="Journal Article">17Dodd, James WHogg, LaurenNolan, JaneJefford, HelenGrant, AmyLord, Victoria MFalzon, ChristineGarrod, RachelLee, CassandraPolkey, Michael IJones, Paul WMan, William D-CHopkinson, Nicholas S< itles>< itle>The COPD assessment test (CAT): response to pulmonary rehabilitation. A multicentre, prospective studyThoraxThorax425-42966

umber>52011May 1, 2011

elated-urls>http://thorax.bmj.com/content/66/5/425.abstract10.1136/thx.2010.156372

URL link to full article:

Database used to find the article: EBSCO

Key words used to find the article: COPD, pulmonary rehabilitation, CAT scores

Article Evaluation

Purpose (Aim)

Why?

S

The purpose of the article is clearly described as 'to establish the change in CAT score occurring in response to PR, relating this to an anchor question to explore CAT scores that may be indicative of the minimum clinically important difference (MCID),' (p. 426). The purpose of the study is also further supported by the methods chosen and the slight literature review that is conducted to provide a background to the study.

W

While the study was clear in its primary objective, the authors wanted to relate the CAT score to the minimum clinically important difference (MCID). This does not appear in the literature review. The authors should have discussed the specific importance of relating CAT scores to the MCID.

Audience

Who?

S

The article is primarily aimed at researchers or clinicians in the practice setting. This stems from the fact that the study was aimed at creating justification of the effectiveness of CAT scores and their ease of use in clinical practice. The authors wanted to show clinicians that the tool is effective and can be used as part of routine practice.

W

The study does not fit the wider research arena since it does not show the generalizability of the findings. The authors only focus on the implementation of the CAT score in London and not in other areas. Therefore, researchers or policy makers looking to adopt CAT scores in their settings cannot understand the implications of the study findings to their setting.

Scope

What?

S

The research reported in the article is well conducted and clearly described. The methods used are appropriate and the objective is clearly stated. Therefore, the study fits its scope well and meets its objective.

W

NA

Referencing

S

Of the 19 references in the study, only 4 are from a period earlier than 2004 (roughly 10 years ago). This means the references used are relatively recent and reliable. Though these four references are slightly older, they are also important in describing the background of COPD and pulmonary rehabilitation programs.

W

The article has less than 20 references (n=19) which means that the authors may have limited themselves greatly in referencing.

Presentation

Clear layout

S

The article uses a clear layout of introduction, methods, results, and discussion as the main topics. These topics also have consistent and clear subtopic such as the discussion that has the subtopics of methodological issues, and significance of the findings. The article is easy to understand and follow.

W

None found.

Practical advice

S

The practical advice provided by the authors is in the 'significance of the findings' subsection of the discussion. It is easy to find, read, and understand. The advice is thus, reasonable, relevant, and applicable to the intended audience of the article.

W

The authors could have included a discussion of the wider implication of their findings to other settings in order to capture a larger audience.

S=strengths; W=weaknesses; 3Rs=relevant, reliable, recent (relative but important)

Evaluation Article 2 (not included in word count)

In text (short) APA style citation: (Jones et al., 2012)

End of text (long) APA style citation: Jones, P.W., Harding, G., Wiklund, I., Berry, P., Tabberer, M., Yu, R., & Leidy, N.K. (2012). TEsts of the responsiveness of the copd assessment test following acute exacerbation and pulmonary rehabilitation. CHEST Journal, 142(1), 134-140. doi: 10.1378/chest.11-0309, 140 http://journal.publications.chestnet.org/article.aspx?articleid=1206616&atab=10 ADDIN EN.CITE Jones2012

ecNum>2102

ecord>

Summary of both articles and practical advice

The two articles used in this paper covered similar topics. They were all focused on the use of chronic obstructive pulmonary disorder (COPD) assessment test (CAT) scores as an outcome measure for patient-reported quality of life. The two articles used similar concepts and cover issues related to definition of the disease, management of the disease, and other concepts such as measurement of the disease. The studies touch on issues discussed in the course relating to adult development and ageing since they assess COPD in ageing adults. Findings from the two articles also support the use of CAT scores in routine practice since the test is easy to administer and can also be used for home management and maintenance of patients. The CAT scores also provide actionable information for practitioners to improve the quality of care they provide to their patients. Though the CAT is a patient-completed questionnaire, it is seen to be accurate in detecting minimum clinically important difference (MCID) for clinicians and responsive in detecting changes in patient COPD health status. The practice advice provided by these two articles is for the routine use of CAT scores in assessing the quality of life of COPD patients. The findings also provide advice on the reliability of CAT scores as an outcome measure of patient response to exacerbation and pulmonary rehabilitation.