Utilization of Chronic Obstructive Pulmonary Disease Assessment Test (CAT) in Patients with COPD in Low Resource Countries

Background:Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disorder commonly assessed by spirometryand health related quality of life (HRQoL) questionnaires. COPD assessment test (CAT) is a new questionnaire used for HRQoL evaluation especially in a clinic setting. Aims:To assess HRQoL using the CAT, and to determine the relationship of CAT to other measures of COPD such as pulmonary function test (PFT), dyspnea and six minutes walking distance test (6MDWT) among patients with COPD in Nigeria.Settings and Design:Cross-sectional study.Methods:Sixty stable patients with a clinical and spirometric diagnosis of COPD according to the GOLD criteria were recruited into the study. Spirometry was performed according to ATS/ERS guidelines. Health status, dyspnea and functional capacity of the patients were assessed using the CAT questionnaire, modified medical research council (MMRC) dyspnea scaleand six-minute walking distance (6MDWT) respectively.Results:The mean age was 68.8 years ± 10.3. Sixty percent of the study participants were male. The mean BMI was 21.6 ± 4.8 kg/m2, 37(61.7%) of the patients were ex-smokers, 3.3% were current smokers and 35% were never smokers. In terms of frequency of exacerbations 18.3% had ≤ 1 per year and 5.0% had ≥ 2 per year. The CAT was strongly associated with 6MWDT (r = 0.85P < 0.001), FEV1% predicted (r= 0.67, P< 0.001) and with MMRC (r=0.64, p<0.01).Conclusions:CAT scores correlated well with percent FEV1, dyspnea and exercise tolerance which measures various aspect of COPD. It may serve as an easy to administer sensitive tool in assessing stable COPD in outpatientclinics especially in low resource countries

The Relation of COPD Assessment Test (CAT) and BODE Index in Assessing Patients with COPD: Is Cat Alone Simple and Good Enough?

Chronic obstructive pulmonary disease (COPD) is a significant cause of disability and death worldwide. It is often evaluated with outcome measures like lung function test (LFT), health status and BODE (Body mass, Obstruction, Dyspnoea and Exercise capacity) index, to initiate appropriate treatment. Objectives: To determine the association between the BODE index and COPD assessment test (CAT) in COPD patients. To ascertain the utility of CAT alone as an assessment tool for COPD patients in primary care setting and low resource countries. Methods: A cross-sectional study of sixty (60) patients with clinical and lung function test diagnosis of COPD were recruited consecutively from the outpatient clinic. The body mass index (BMI) of the patients, CAT scores, modified medical research council dyspnoea scale and sixminute walk distance test (6MWDT) was assessed and recorded. The individual score was summed up to obtain the BODE index score for the particular patients. Results: The mean age was 68.8years (± 10.3). There was a strong correlation between the BODE index and CAT scores (r= 0.77 P <0.0001). Inter-rater agreement between the tools (CAT and BODE index) was moderate (k=0.46). The CAT questionnaire also correlated well with the modified medical research council dyspnea scale, the six-minute walk test and the forced expiratory volume in the first second. Conclusion: CAT can serve as a simple, easy to administer tool for the assessment of patients with COPD especially in low resource countries and primary care setting.