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Utilization of Chronic Obstructive Pulmonary Disease Assessment Test (CAT) in Patients with COPD in Low Resource Countries

Background: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disorder commonly assessed by spirometry and health related quality of life (HRQoL) questionnaires. COPD assessment test (CAT) is a new questionnaire used for HRQoL evaluation especially in a clinic setting. 
Aims: To assess HRQoL using the CAT, and to determine the relationship of CAT to other measures of COPD such as pulmonary function test (PFT), dyspnea and six minutes walking distance test (6MDWT) among patients with COPD in Nigeria. 
Settings and Design: Cross-sectional study.  
Methods: Sixty stable patients with a clinical and spirometric diagnosis of COPD according to the GOLD criteria were recruited into the study. Spirometry was performed according to ATS/ERS guidelines. Health status, dyspnea and functional capacity of the patients were assessed using the CAT questionnaire, modified medical research council (MMRC) dyspnea scale and six-minute walking distance (6MDWT) respectively. 
Results: The mean age was 68.8 years ± 10.3. Sixty percent of the study participants were male. The mean BMI was 21.6 ± 4.8 kg/m2, 37(61.7%) of the patients were ex-smokers, 3.3% were current smokers and 35% were never smokers. In terms of frequency of exacerbations 18.3% had ≤ 1 per year and 5.0% had ≥ 2 per year. The CAT was strongly associated with 6MWDT (r = 0.85P < 0.001), FEV1% predicted (r= 0.67, P< 0.001) and with MMRC (r=0.64, p<0.01). 
Conclusions: CAT scores correlated well with percent FEV1, dyspnea and exercise tolerance which measures various aspect of COPD. It may serve as an easy to administer sensitive tool in assessing stable COPD in outpatient clinics especially in low resource countries.