Qualitative Literature Review Exploring the Patient Experience of Shortness of Breath in COPD and Asthma
Author(s)
Sharan Randhawa, MSc1, Lucia De Prado Gomez, Pharm D, MSc2, Heer Shah, MSc1, Holly Harris, MSc1, Asha Lehane, MSc3, Rebecca Williams-Hall, MMedSci1, Jane R. Wells, BSc, MSc4.
1Patient Centered Outcomes, Adelphi Values PCO, Macclesfield, United Kingdom, 2Global Medical Affairs, Sanofi, Cambridge, MA, USA, 3Patient Centered Outcomes, Adelphi Values PCO, London, United Kingdom, 4Patient Informed Development and Health Value Translation, Sanofi, Reading, United Kingdom.
1Patient Centered Outcomes, Adelphi Values PCO, Macclesfield, United Kingdom, 2Global Medical Affairs, Sanofi, Cambridge, MA, USA, 3Patient Centered Outcomes, Adelphi Values PCO, London, United Kingdom, 4Patient Informed Development and Health Value Translation, Sanofi, Reading, United Kingdom.
OBJECTIVES: Shortness of breath (SOB) is an important symptom of chronic obstructive pulmonary disease (COPD) and asthma. Understanding the patient experience of SOB can support development of clinical trial endpoint strategies and assessment of treatment benefits.
METHODS: A qualitative literature review was conducted to identify studies reporting on the patient experience of SOB in COPD and asthma. Data describing the impact of SOB on daily life were extracted and synthesized to develop a conceptual model.
RESULTS: Seventeen articles, including patients with COPD or asthma and ranging in disease severity, were reviewed. SOB was reported to impact multiple domains of health-related quality of life (HRQoL): physical functioning (e.g., walking), daily activities (e.g., housework), emotional well-being (e.g., anxiety/worry/panic, fear, stress), social functioning (e.g., loneliness and reduced participation), sleep (e.g., night-time awakenings and disrupted rest), and productivity. The association between SOB and these impacts was primarily unidirectional; however, a bidirectional association was identified for some activities (e.g., walking, climbing stairs, eating/drinking, housework, personal hygiene/grooming) and the above-listed emotional impacts, with patients reporting these to also trigger and exacerbate SOB. This reciprocal influence highlights the cyclical and burdensome nature of SOB in daily life. The experience of SOB amongst patients with COPD and asthma was comparable, supporting the development of a single, unified conceptual model.
CONCLUSIONS: SOB impacts a broad range of HRQoL domains, with many of these impacts also acting as triggers that exacerbate SOB, creating a cyclical burden for patients. These findings support the development of trial endpoint strategies and the design of measurement tools that capture outcomes meaningful to patients and reflective of their lived experiences.
METHODS: A qualitative literature review was conducted to identify studies reporting on the patient experience of SOB in COPD and asthma. Data describing the impact of SOB on daily life were extracted and synthesized to develop a conceptual model.
RESULTS: Seventeen articles, including patients with COPD or asthma and ranging in disease severity, were reviewed. SOB was reported to impact multiple domains of health-related quality of life (HRQoL): physical functioning (e.g., walking), daily activities (e.g., housework), emotional well-being (e.g., anxiety/worry/panic, fear, stress), social functioning (e.g., loneliness and reduced participation), sleep (e.g., night-time awakenings and disrupted rest), and productivity. The association between SOB and these impacts was primarily unidirectional; however, a bidirectional association was identified for some activities (e.g., walking, climbing stairs, eating/drinking, housework, personal hygiene/grooming) and the above-listed emotional impacts, with patients reporting these to also trigger and exacerbate SOB. This reciprocal influence highlights the cyclical and burdensome nature of SOB in daily life. The experience of SOB amongst patients with COPD and asthma was comparable, supporting the development of a single, unified conceptual model.
CONCLUSIONS: SOB impacts a broad range of HRQoL domains, with many of these impacts also acting as triggers that exacerbate SOB, creating a cyclical burden for patients. These findings support the development of trial endpoint strategies and the design of measurement tools that capture outcomes meaningful to patients and reflective of their lived experiences.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
CO196
Topic
Clinical Outcomes, Patient-Centered Research
Topic Subcategory
Clinical Outcomes Assessment
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)