Overestimation of Control

A central problem in disease management is that patients with COPD tend to overestimate their degree of symptom control. The survey showed that patients' self-perception of disease control was not in keeping with more objective measures of disease severity. One in four (25%) patients with the most severe degree of breathlessness said that their COPD had been completely or well controlled in the past year, as did 27% of patients with the next most severe level of breathlessness (Figure 29).

In addition (Figure 30):

• 42% of patients who said that their COPD had been "completely" or "well controlled" over the past year also said there was a three-month period during that time when they had shortness of breath every day.

• One in four (24%) of those who said their COPD had been "completely" or "well controlled" over the past year also said their condition restricts them "a lot" in normal physical exertion.

• More than a quarter of patients who said their COPD had been "completely" or "well controlled" over the past year also said they get short of breath while getting washed or dressing (28%) or doing light housework (29%).

This underscores the need for better education: if patients underestimate the severity of their condition, or do not realize that it can be better controlled, they may be less likely to seek the care they need.