Changes in problematic activities of daily living in persons with COPD during 1 year of usual care

Nienke Nakken*, Daisy J. A. Janssen, Emiel F. M. Wouters, Esther H. A. van den Bogaart, Jean W. M. Muris, Geeuwke J. de Vries, Gerben P. Bootsma, Michiel H. M. Gronenschild, Jeannet M. L. Delbressine, Monique van Vliet, Martijn A. Spruit

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Introduction Persons with chronic obstructive pulmonary disease (COPD) are often limited in performing their activities of daily living (ADLs). However, it remains unknown whether and to what extent problematic ADLs change over time and whether exacerbation-related hospitalisations affect problematic ADLs. Therefore, we investigated self-reported problematic ADLs of persons with COPD during 1 year of usual care (i.e. without a specific experimental intervention).

Methods Stable persons with moderate to very severe COPD (n = 137) were included in this longitudinal study (registered in the Dutch Trial Register [NTR 3941]). Participants were visited at home at baseline and after 1 year. Participants with an exacerbation-related hospitalisation during follow-up were visited additionally within 2 weeks after hospital discharge. During all visits, participants' personalised problematic ADLs were assessed using the Canadian Occupational Performance Measure (COPM), and perceived performance and satisfaction of important problematic ADLs were rated on a 10-point scale.

Results In total, 90% of the participants reported at least one new important problematic ADL after 1 year. In the subgroup of participants with an exacerbation-related hospitalisation (n = 31), 92% of the participants reported new problematic ADLs 2 weeks after discharge and 90% reported new problematic ADLs again after 1 year. Only the satisfaction score of problematic ADLs as mentioned during baseline improved after 1-year follow-up in all participants (p = .002) and in participants without an exacerbation-related hospitalisation (n = 106; p = .014).

Conclusion Problematic ADLs changed during 1 year of usual care, which underlines the need for regular assessment of problematic ADLs and referral to treatment options like monodisciplinary occupational therapy and/or a comprehensive pulmonary rehabilitation programme.

Original languageEnglish
Pages (from-to)447-457
Number of pages11
JournalAustralian Occupational Therapy Journal
Issue number5
Publication statusPublished - Oct 2020


  • activities of daily living
  • chronic obstructive pulmonary disease
  • disease exacerbation
  • longitudinal studies
  • occupational therapy
  • LIFE

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