Rethinking COPD Exacerbations: a global patient perspective

Introduction: The term ’exacerbation’ has been challenged by patients, researchers and clinicians. Objectives: We sought to understand the patient perspectives of the term ’exacerbation’ and alternatives. Methods: A survey was sent out via the European Lung foundation. It consisted of a combination of Likert scale questions, multiple choice and free text, and distributed globally via Survey Monkey®. Results: A total of 633 respondents (68% women) took part from 27 countries and 16 native languages. The majority of participants (64.9%) never or rarely used the term ‘exacerbation’ when speaking with a nurse or doctor. The term ‘flare up’ was most favoured by 26.6%, followed by ‘crisis’ (22.9%); ‘attack’ (20.1%); ‘exacerbation’ (15.5%) and lastly ‘chest infection’ (9.8%). ‘Crisis’ was easier to understand when compared directly with ‘exacerbation’. From the perspective of each native language, 63.8% overall agreed that ‘crisis’ was appropriate in describing the worsening of their symptoms. Conclusion: Individual patient perspectives need to be considered in COPD whilst the term ‘exacerbation’ is not accepted by patients. Future considerations of terms include crisis and flare-up.