LAUSR

Introduction: Breathing pattern disorders (BPD) contribute to breathlessness in respiratory disease. The Nijmegen Questionnaire (NQ) is used as a screening tool for BPD with a score >23 suggesting functional respiratory complaints and the accuracy of the NQ in COPD is unknown. We compared the predictive value of the NQ to clinical assessment and describe our findings of the prevalence of BPD in COPD. Methods: Patients with poorly controlled COPD were identified in a community respiratory clinic and evaluated for disease control and comorbidities. Screening for BPD was conducted by the NQ and examination by a specialist physiotherapist. Results: 25 of 53 patients (43%) were identified as having BPD by both clinical evaluation and a NQ score >23. There were no patients with a NQ score >23 without BPD confirmed by clinical assessment. The mean NQ scores in those with and without clinically confirmed BPD were 31 (Range 18-45, SD ±8) and 14 (Range 2-22, SD ±7, p value = 23 gave positive and negative predictive values of 100% and 92% respectively for detecting BPD. BPD were present throughout the spectrum of COPD severity, though more prevalent in those with moderate disease was not statistically significant (ANOVA analyses p=0.71). Conclusion: BPD are a common comorbidity in highly symptomatic COPD and may be more prevalent in moderate COPD. The use of a NQ score of >23 may be a useful tool in screening for BPD in COPD and compares favourably with clinical evaluation. Screening for BPD should be part of assessment of patients with highly symptomatic COPD; the recognition of which gives alternative treatment options in COPD.