Disease cognitions, adherence and quality of life in patients suffering from chronic obstructive pulmonary disease

Objectives: The Chronic Obstructive Pulmonary Disease (COPD) self-management at home requires the patients to adhere to prescriptions, which may be too complex or articulated. Aim of our work was to evaluate cognitions, adherence and Quality of Life in COPD patients. Methods: 45 COPD inpatients, consecutively enrolled in our Clinic, were administered the Adhrence Schedule in Chronic Obstructive Lung Disease (ASiCOLD) and the St. George Respiratory Questionnaire. The ASiCOLD, build in our Psychology Unit, evaluates the cognitive, behavioural and emotional aspects which may influence the COPD home self-management. The St. George Respiratory Questionnaire assesses patients' Quality of Life. Results: As to the ASiCOLD, out of the 45 interviewed (aged 67.3±7.6 years, 31 males and 14 females), 77.8% considered important to exercise daily, but only 40.0% thought to be able to perform regularly at home physical activities; 73.3% considered important for their health care to take the prescribed medicines and 84.4% thought to be able to adhere to drug treatment; 57.8% considered important to respect the dietary regimen and 57.8% thought to be able to eat properly at home. Concerning the disease knowledge, 25.0% reported to have sufficient knowledge whereas 26.7% did not. Moreover 37.8% declared to find it difficult to accept the disease and 25.0% did not accept the behavioural limitations due to illness. Finally, 60.0% reported that family members did help in disease management. Patients' QoL scores, assessed by means of the St. George, resulted low in all the domains (total score: 52.1±21.1; symptoms: 49.3±27.0, impact: 45.2±24.9, activity: 66.1±23.3; score range 0-100). Conclusions: These data provide useful information for the multidisciplinary management of COPD patients since they enlight the necessity of psychoeducational programmes in order to enhance patients abilities and behavioural resources, which are the fundamental basement for treatment adherence.