Background: Chronic obstructive pulmonary disease (COPD) is a progressive disease resulting in a range of symptoms including breathlessness.

The Westmead Breathlessness Service (WBS) is a service specialising in nonpharmacological interventions to manage breathlessness in COPD; however there is growing evidence that patients with COPD have a range of symptoms that go beyond breathlessness.

Aim: To
1) describe the physical and psychological symptom burden for patients attending the WBS.

2) examine the influence of gender on the reported symptom burden

Methods: Single-centre observational study of patients who attended the WBS between March 2017 and May 2022. We obtained baseline demographic data and symptom burden using the Condensed Memorial Symptom Assessment Scale (CM-SAS). We modified the CM-SAS by adding 2 extra physical symptoms (cough and sputum) and 1 extra psychological symptom – feeling anxious. Descriptive data were analysed using SPSS and presented as mean (SD).

Results: 89 patients aged 72.5(7.7) years, 55% male, FEV1 predicted 34(11)%. Symptom burden was high in the population. Prevalent reported physical symptoms included shortness of breath (100%), lack of energy (80%), dry mouth (70%), sputum (70%), cough and drowsiness (both 67%). Prevalent reported psychological symptoms reported included worry (65%), feeling anxious (61%) and feeling sad (51%). 

Males and females differed slightly in reported symptoms. Females reported more bothersome pain and nausea, and more frequently reported worrying, feeling nervous and anxious.

Conclusion:
Patients attending the WBS reported a wide range of non-respiratory symptoms beyond the classic COPD symptoms of breathlessness, cough and sputum. 

Although having similar baseline demographics, females reported the bothersomeness of pain and nausea, and increased frequency of psychological symptoms more often than males.

Identifying and understanding gender differences in COPD symptoms will be important in managing this symptom burden. More research is required to develop gender specific assessments and management of symptoms related to severe COPD.