Background COPD patients suffer from respiratory symptoms and limitations in daily life. We aimed to characterize the impact of disease on overall health, daily life, and perceived well-being in COPD outpatients. Methods We conducted a national, cross-sectional study among pulmonologists and general practitioners (GPs). The St. George’s Respiratory Questionnaire for COPD patients (SGRQ-C) was used. Inclusion criteria were a physician’s diagnosis of COPD and age ≥40 years. Subjects with a history of lung surgery, lung cancer or COPD exacerbation within the last four weeks were excluded. Results Sixty-seven pulmonologists and 6 GPs enrolled 1175 COPD patients. Two hundred forty-eight of those did not fulfill GOLD criteria for COPD (FEV 1 /FVC <0.7) and 77 were excluded due to missing data. Finally, 850 patients (62.8% men; mean age 66.2 ± 0.3 (SE) years; mean FEV 1 %pred. 51.5 ± 0.6 (SE)) were analyzed. Last year, 55.4% reported at least one exacerbation, and 12.7% were hospitalized for COPD exacerbation. Mean SGRQ-C total score was 43.1 ± 0.83 (SE) and mean component scores for symptoms, activity and impacts were 55.6, 55.4 and 30.5, respectively. Half of the patients (50.3%) reported not being able to do any sports and 78.7% stated that their respiratory symptoms did not allow them doing anything they would like to do. In patients with less severe COPD (FEV 1 pred ≥50% and non-frequent exacerbations), global health status was overrated, ie, estimated as better by the physician than by the patient, while it was underrated in more severe COPD. Conclusion In Austria, the burden of disease in COPD outpatients tends to be underestimated in patients with milder airway obstruction and less exacerbations and overestimated in patients with more severe airway obstruction and frequent exacerbations. Our finding suggests that validated assessment of global health status might decrease these differences of perception.

Summary Objective Assessment of treatment routine and outcome for ranolazine in clinical practice as second-line treatment for stable angina pectoris (AP). Design and setting Multicenter, prospective, uncontrolled, non-interventional study at 88 sites including internal specialists, cardiologists, pneumologists, angiologists and primary care practices in Austria. Participants In this study 292 patients receiving ranolazine in the course of routine treatment on top of beta blockers or calcium channel blockers after failure of first-line therapy. Main outcome measures Dosage and symptoms were recorded at two visits (at intervals of 12 weeks), complemented by treatment rationale and disease characteristics at baseline. Disease intensity was quantified by angina symptoms, nitrate use and by Canadian Cardiovascular Society (CCS) grading. Quality of life (QoL) was assessed through a 10-grade scale. Data were analyzed by descriptive statistics. Results Ranolazine was prescribed in order to improve exercise capacity (84.3%), reduce symptoms (83.2%) and reduce AP (77.1%). Of the patients 87.3% received the recommended starting dose of 375 mg and subsequent dose changes were reported for 39.8%. The number of AP attacks was reduced from 5.3 ± 4.5 to 0.8 ± 1.3 per week; nitrate use was reduced from 3.4 ± 4.1 to 0.4 ± 0.9 applications per week. Of the patients 94.0% reported improved exercise capacity and 93.7% reduced symptoms. For the majority of patients, the CCS improved from grade II to I and QoL improved accordingly. Of the patients 3 experienced adverse drug reactions and 95.5% continued ranolazine. Conclusion In this real-world study, ranolazine was shown to be effective, safe and well tolerable. Symptoms of AP were improved, as illustrated by the reduced number of angina attacks, reduced rate of nitrate use, reduced CCS scores and improved QoL.

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ObjectivesAlthough substantial progress in the treatment of stable angina pectoris (sAP) has been made, little is known about the functional status and quality of life (QoL) of patients in different healthcare systems.Design and methodsWe undertook a survey using the Seattle Angina Questionnaire (SAQ) (five domains scored form 0—worst assessment to 100—best assessment) to assess symptoms, QoL (including limitation of activities), demographics, geographic distribution and individual disease data in patients with stable coronary artery disease in Austrian cardiology practices.ResultsA total of 660 patients with sAP with a mean age of 69.2 years were included. SAQ scores were 67.5±24.4 for physical limitation, 65.5±26.6 for angina stability, 79.3±23.2 for angina frequency, 86.3±16.2 for treatment satisfaction and 63.7±24.2 for overall QoL. Multiple regression identified male gender, but also female gender, Eastern Austrian residence and high body mass index as predictive factors for SAQ scoring. A total of 35.6% of the patients reported at least one desirable activity that was limited through AP symptoms.ConclusionsActivity and QoL assessments are in accordance with published literature: The number and the diversity of desired activities indicate the need to focus on patient’s individual activity level to improve symptom management.

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