COPD patients struggle to be honest with their doctor

Wednesday, 13 Sep 2017

As many as nine out of 10 people with COPD have admitted to lying or not being honest with their clinician about their condition, according to a survey that reveals a huge and concerning communication gap between patients and their doctors.

The finding occurred despite both parties stating that they regarded the patient–physician relationship as an important factor when evaluating the impact of COPD on quality of life.

The study authors, led by Bartolome Celli, a Professor of Medicine at Harvard Medical School, said a lack of frankness between patients and their caregivers was a recipe for poor outcomes.

“If communication between the two figures is not open, they cannot truly understand one another and the necessary countermeasures for greater control of the pathology cannot be implemented,” he said.

The findings of the MIRROR study were launched at the European Respiratory Society congress in Milan, Italy and published in the International Journal of COPD.

The researchers used “mirrored” questionnaires to ask over 1,000 patients, GPs and respiratory physicians the same questions about the condition.

Physicians were asked to respond to the questionnaire using a recently seen patient who “represented the majority of COPD patients usually managed” as a reference point.

The results revealed that just 11% of patients said they had quite an honest relationship with their doctors, while 89% said their relationship was generally not honest.

Factors that patients were typically not honest about included saying that they had stopped smoking when they hadn’t, or were doing recommended exercises when they were not.

Interestingly, almost half of the GPs and respiratory physicians surveyed said they thought their patients were honest.

The survey results also showed that while doctors and patients both regarded COPD as a major health problem, there was a difference in opinion when it came to the impact of symptoms on quality of life in severe disease.

Clinicians tended to focus on clinical features of the disease such as dyspnea, cough and sputum, placing less importance on chest tightness and fatigue compared to their patients.

The researchers advised clinicians to “become aware of the impact on non-conventional domains that patients perceive as being importantly affected by COPD, so that they can be integrated into management plans.”

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