*Article* **Are Fatigue and Pain Overlooked in Subjects with Stable Chronic Obstructive Pulmonary Disease?**

**Koichi Nishimura 1,\*, Kazuhito Nakayasu 2, Mio Mori 1, Ryo Sanda 1, Ayumi Shibayama <sup>3</sup> and Masaaki Kusunose <sup>1</sup>**

	- ayuminarita3@ncgg.go.jp

**Abstract:** Although there have been many published reports on fatigue and pain in patients with chronic obstructive pulmonary disease (COPD), it is considered that these symptoms are seldom, if ever, asked about during consultations in Japanese clinical practice. To bridge this gap between the literature and daily clinical experience, the authors attempted to gain a better understanding of fatigue and pain in Japanese subjects with COPD. The Brief Fatigue Inventory (BFI) to analyse and quantify the degree of fatigue, the revised Short–Form McGill Pain Questionnaire 2 (SF-MPQ-2) for measuring pain and the Kihon Checklist to judge whether a participant is frail and elderly were administered to 89 subjects with stable COPD. The median BFI and SF-MPQ-2 Total scores were 1.00 [IQR: 0.11–2.78] and 0.00 [IQR: 0.00–0.27], respectively. They were all skewed toward the milder end of the respective scales. A floor effect was noted in around a quarter on the BFI and over half on the SF-MPQ-2. The BFI scores were significantly different between groups regarding frailty determined by the Kihon Checklist but not between groups classified by the severity of airflow limitation. Compared to the literature, neither fatigue nor pain are considered to be frequent, important problems in a real-world Japanese clinical setting, especially among subjects with mild to moderate COPD. In addition, our results might suggest that fatigue is more closely related to frailty than COPD.

**Keywords:** chronic obstructive pulmonary disease (COPD); the Brief Fatigue Inventory (BFI); the revised Short–Form McGill Pain Questionnaire 2 (SF-MPQ-2); the Kihon Checklist; fatigue; pain
