COPD significantly reduces health-related quality of life
MedWire News: Chronic obstructive pulmonary disease (COPD) is associated with significant reductions in health-related quality of life (HRQL), even among patients with mild airway obstruction, European research confirms.
"Many studies have reported impaired HRQL in patients with COPD, and a poor HRQL has been shown to be associated with high levels of dyspnea, physical impairment, depression, and anxiety, [and] a poor prognosis in terms of readmission to hospital and death," write Paul Jones (St George's University of London, UK) and team in the journal Respiratory Medicine.
However, they add: "To our knowledge, the impact of COPD on… HRQL in a broadly sampled, multi-national population has not been previously studied."
To address this, the researchers studied 1817 COPD patients, aged 40-80 years, from primary care centers in Belgium, France, Germany, Italy, The Netherlands, Spain, and the UK. The patients had been diagnosed with COPD at least 6 months earlier and had a post-bronchodilator FEV1/forced vital capacity ratio of less than 70%.
All of the participants were assessed for HRQL during a single visit using the St George's Respiratory Questionnaire-COPD specific (SGRQ-C), with scores ranging from 0 (no impairment) to 100 (worst possible), as well as the short form health survey (SF-12), and the Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue scale.
Overall, the patients' mean score on the SGRQ-C was 44.7, indicating significant HRQL impairment, with very little variation in mean scores among the countries studied.
Mean SGRQ-C scores were significantly and positively associated with COPD severity. Indeed, patients with stage I COPD (n=223) had a mean SGRQ-C score of 38.5, stage II patients (n=868) had a mean score of 40.4, stage III patients (n=551) a mean score of 50.2, and stage IV patients (n=144) a mean score of 58.6. Data were incomplete for the remaining 31 patients.
The researchers also found that patients experiencing an exacerbation (13%) at the time of the interview had a higher mean SGRQ score than those with stable disease, at 54.9 versus 43.3. And those with at least three comorbidities had a higher mean score than those without any comorbidities, at 49.9 versus 42.3.
Scores on the SF-12 and FACIT-F were consistent with those on the SGRQ-C, the researchers note.
Jones and team conclude: "This large observational European study confirms that health status is significantly impaired in COPD patients across all severities."
They add that "a measurement of HRQL should be routinely included in the assessment and monitoring of COPD patients in primary care."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Mark Cowen