Lung Function and Health Status in Patients of Chronic Obstructive Pulmonary Disease on Treatment with Tiotropium

ABSTRACT

Introduction: Chronic obstructive pulmonary disease (COPD) is a group of chronic and slowly progressive respiratory disordercharacterized by reduced maximum expiratory flow during forced exhalation. Tiotropium, a long-acting antimuscarinic agent,has well-known documented effect on improving lung function and quality of life (QOL). There are many studies globally ontiotropium and its effect on lung function, but limited studies available in our Indian set up. Hence, we planned this study.Materials and Methods: Patients were recruited from chest clinic and outpatient department from the Department of Medicineof University College of Medical Sciences and GTB Hospital. It was a prospective observational cohort study conducted fromNovember 2017 to April 2019. Tiotropium was given as meter dose inhaler in dose of 18 µg per dose, in schedule as prescribedby the Global Initiative for Chronic Obstructive Lung Disease-2017 guidelines. Patients were followed up for 3 months withperiodic assessment of lung functions, Saint George’s Respiratory Questionnaire (SGRQ) score, and symptoms assessment.Results: A total of 65 patients were recruited for study which included 57 (87.7%) males and 8 (12.3%) females. Among thepulmonary function tests measured, there is a significant change in mean forced expiratory volume (FEV1) at the end of followup period compared to FEV1 at baseline. There is a significant change in mean forced vital capacity at the end of follow-upstudy compared to start of the study. There was no significant change in mean SGRQ score after 1 month of start of drug,but significant statistical change observed at end of the 3rd month of the study compared to the 1st month that implies SGRQscore decreased and patients health status and QOL improved. There is a significant change in mean SGRQ score at the endof follow-up study compared to baseline. In our study, 16 patients (24.6%) complained of dry mouth, 7 (10.7%) complained ofpharyngitis or throat irritation, and 3 (4.6%) patients complained of constipation.Conclusion: There was a statistically significant change in lung functions and improvement in QOL scores as assessed bySGRQ at the end of the study compared to baseline by use of inhaled tiotropium in COPD patients