Community-Acquired Pneumonia: Symptoms and Burden of Illness at Diagnosis among US Adults Aged 50 Years and Older

  • Kathleen W. WyrwichEmail author
  • Holly Yu
  • Reiko Sato
  • David Strutton
  • John H. Powers
Original Research Article



Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality in older adults, yet few studies have comprehensively measured the burden of CAP symptoms and their impact from the patient perspective. Our Web-survey used the newly developed CAP burden of illness questionnaire (CAP-BIQ) designed to assess the presence of key symptoms, comorbid conditions affected by CAP, psychosocial impacts, productivity, and CAP-associated physician visits in US adults aged 50 years and older.


The CAP-BIQ was developed from semi-structured one-on-one interviews and finalized after cognitive debriefings with recently diagnosed CAP patients. The CAP-BIQ was then administered to 500 survey participants with a CAP diagnosis within the past 120 days confirmed by chest imaging recruited from a Web-based panel. Analyses of survey results were weighted for national representativeness, and were compared between relevant age, hospitalization status, and pneumonia-risk subgroups.


The survey participants’ mean age was 62.4 years; 45 % were men; and 39.6 % were hospitalized due to CAP. On average, the surveys were completed 56.9 days after pneumonia diagnosis. Nearly all participants reported tiredness, cough, body aches, weakness, shortness of breath, wheezing, and a weak appetite at the time of diagnosis (99.0, 96.8, 96.9, 94.1, 89.1, 85.8, and 78.5 %, respectively). There was generally greater symptom prevalence at diagnosis in younger, nonhospitalized, or high-risk subgroups when compared to their respective older, hospitalized, or low-risk counterparts. Most participants reported at least one cough-related and weakness-related impact on their daily life and activities from CAP. Over three quarters of the respondents (77.4 %) needed assistance from a friend or family member during their bout with pneumonia and a majority of respondents (83.6 %) were satisfied with the care they received from their doctors across the course of their illness.


This study systematically assessed CAP symptoms and their impacts using the CAP-BIQ, a questionnaire with established content validity. At CAP diagnosis, the range of patient-reported symptoms was broader than previous studies have reported. Additionally, the overwhelming need for caregiver assistance demonstrates the burden this illness places on older adults.


Chronic Obstructive Pulmonary Disease Cognitive Debriefing Body Ache Concept Elicitation Cognitive Debriefing Interview 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Disclosures and Acknowledgments

This study was funded by Wyeth, which was acquired by Pfizer Inc., in October 2009. HY, RS, and DS are employees of Pfizer Inc., KW is an employee of United BioSource Corporation, and was a paid consultant to Pfizer in connection with the development and execution of this study as well as manuscript development. JP was a paid clinical consultant to Pfizer on the study. All five authors participated in the study design, data collection process, analyses and interpretation, manuscript writng, and the decision to submit this article to Patient.

The authors acknowledge the valuable assistance of Elizabeth Nicole Bush in the development and execution of this study, and Anna Steenrod in the development of this manuscript as paid employees of United BioSource Corporation.


This study was funded by Wyeth, which was acquired by Pfizer Inc., in October 2009.

Supplementary material

40271_2013_13_MOESM1_ESM.doc (148 kb)
Supplementary material 1 (DOC 155 kb) (155 kb)
Supplementary material 1 (DOC 155 kb)


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Copyright information

© Springer International Publishing Switzerland 2013

Authors and Affiliations

  • Kathleen W. Wyrwich
    • 1
    Email author
  • Holly Yu
    • 2
  • Reiko Sato
    • 2
  • David Strutton
    • 2
  • John H. Powers
    • 3
  1. 1.United BioSource CorporationBethesdaUSA
  2. 2.Pfizer Inc.CollegevilleUSA
  3. 3.George Washington University School of MedicineWashington, DCUSA

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