‘CAT’ score helps monitor response to pulmonary rehabilitation
MedWire News: The COPD assessment test (CAT), a new disease-specific measure of health status, is a simple and valuable tool for assessing response to pulmonary rehabilitation (PR), study findings suggest.
The research was undertaken by a UK team and is published in the journal Thorax.
For the study, Nicholas Hopkinson (Royal Brompton Hospital, London) and co-workers prospectively studied the introduction of the CAT score as an outcome measure at seven PR units in London, UK.
The CAT is a patient-completed instrument that contains eight questions covering the impact of COPD symptoms on quality of life, with scores of 0-10, 11-20, 21-30 and 31-40 representing mild, moderate, severe, and very severe clinical impact, respectively.
A total of 261 patients with COPD completed the CAT before and after undergoing a course of PR. They also completed a range of other validated outcome measures as well as a 5-point "anchor" question to assess the overall response to PR.
At baseline, the patient's mean age was 69.0 years, mean FEV1 was 51.1% predicted, mean Medical Research Council dyspnea score was 3.2, and mean CAT score was 20.5.
Following PR, the CAT score fell by 2.9 points on average, indicating a significant improvement in disease-specific quality of life.
Importantly, the change in CAT score generally mirrored patient's own assessment of their response to PR, falling by 3.8 points in those who said they felt "much better" and by 1.3 points in those who felt "a little better."
The change in CAT score after PR also correlated significantly with changes in another validated measures of health status, the Clinical COPD Questionnaire total score.
The authors conclude that the CAT score is responsive to PR, can discriminate between different levels of subjective response, and correlates with changes in other outcome measures.
They add: "Since the tool is quick to complete and score and can therefore be integrated into routine clinical practice, it offers the possibility of a closer integration between PR and other aspects of care."
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By Joanna Lyford