Patients with chronic obstructive pulmonary disease (COPD) have a high burden of illness and poor quality of life. Despite clear evidence that such patients frequently lack engagement in health-promoting behaviors and tend to devalue future health consequences, almost no work has investigated whether these patients make predictive errors about future health states nor investigated the association of such errors on future health-related quality of life. In this prospective cohort study among 207 University of Pennsylvania Health System patients followed for at least 12 months, patients will make predictions of their own future physical and emotional symptom burden and lifespan and will have their actual symptom burden and lifespan measured over the study period. The research team will assess the accuracy with which patients with severe COPD make predictions, whether predictive errors may be linked to patients’ quality of life, and how patients form these predictions. Qualitative work among patients with differing expectations will enable the team to explore the sources and impact of their predictions. In parallel and nested within this cohort study, the research team will also conduct a cross-sectional study of 50 current and former smokers to explore which patient attributes are most predictive of medication non-adherence, using electronic monitoring devices to track patients' adherence. Collectively, findings from this study will inform the design of future decision interventions aimed at improving health outcomes among patients with COPD.
National Heart, Lung, and Blood Institute