Authorship and contributorship
Older peoples’ perception of tests used in the assessment and management of COPD and asthma
Article first published online: 20 MAR 2013
© 2013 John Wiley & Sons Ltd
The Clinical Respiratory Journal
Volume 7, Issue 4, pages 367–374, October 2013
How to Cite
McDonald, V. M., Simpson, J. L., McElduff, P. and Gibson, P. G. (2013), Older peoples’ perception of tests used in the assessment and management of COPD and asthma. The Clinical Respiratory Journal, 7: 367–374. doi: 10.1111/crj.12017
Vanessa M. McDonald: project conception, study design, data collection, data analysis, data interpretation, writing and revisions of the manuscript.
Jodie L. Simpson: project conception, study design, data analysis, data interpretation, writing and revisions of the manuscript.
Patrick McElduff: analysed data, reviewed all versions of the manuscript.
Peter G. Gibson: project conception, study design, data interpretation, writing/revision of manuscript.
Participants gave written informed consent and the study was approved by the Hunter New England Research Ethics and the University of Newcastle Research Ethics committees.
Conflicts of interest
Dr Vanessa McDonald was supported by the National Health and Medical Research Council (NHMRC) Centre for Respiratory and Sleep Medicine and the Cooperative Research Centre for Asthma and Airways. She has been reimbursed for participation in symposia funded by AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline and Novartis. She has participated in studies funded by GlaxoSmithKline and Novartis. Dr Jodie Simpson has no conflicts of interest to declare. Dr Patrick McElduff has no conflict of interest to declare. Professor Peter Gibson holds an NHMRC Practitioner Fellowship. He has been reimbursed for participation in symposia funded by AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline and Novartis. He has participated in studies funded by Pharmaxis and GlaxoSmithKline.
- Issue published online: 23 SEP 2013
- Article first published online: 20 MAR 2013
- Manuscript Accepted: 16 DEC 2012
- Manuscript Revised: 2 DEC 2012
- Manuscript Received: 15 JUL 2012
- National Health and Medical Research Council
- asthma ;
- elderly ;
- patient preference
Outcome assessment is an important part of the management of airways disease, yet older adults may have difficulty with the burden of testing. This study evaluated the patient perception of tests used for the assessment of airways disease in older people.
Older adults (>55 years) with obstructive airway disease and healthy controls (N = 56) underwent inhaler technique assessment, skin allergy testing, venepuncture, fractional exhaled nitric oxide (FENO) and gas diffusion measurement, exercise testing, sputum induction, and questionnaire assessment. They then completed an assessment burden questionnaire across five domains: difficulty, discomfort, pain, symptoms and test duration.
Test perception was generally favourable. Induced sputum had the greatest test burden perceived as being more difficult (mean 0.83, P = 0.001), associated with more discomfort (mean 1.3, P < 0.001), more painful (0.46, P = 0.019), longer test duration (0.84, P < 0.001) and worsening symptoms (0.55, P = 0.001) than the questionnaires. FENO had a more favourable assessment but was assessed to be difficult to perform. Inhaler technique received the most favourable assessment.
Older adults hold favourable perceptions to a range of tests that they might encounter in the course of their care for airway disease. The newer tests of sputum induction and FENO have some observed difficulties, in particular sputum induction. The results of this study can inform current practice by including details of the test and its associated adverse effects when conducting the test, as well as providing clear explanations of the utility of tests and how the results might aid in patient care.