Aetiology and disease severity are among the determinants of quality of life in bronchiectasis

Terpstra, Lotte; Biesenbeek, Sonja; Altenburg, Josje; Boersma, Wim

doi:10.1111/crj.13054

Cited by 18 publications

(14 citation statements)

References 29 publications

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“…Terpstra et al [20] reported signi cantly worse QoL in BE patients with COPD than in other BE patients. In their study population of 200 BE patients (aged 69.5 years), the mean number of exacerbations was one per year, with zero hospitalisations and a mean mMRC score of 2.68 (SD 1.09).…”

Section: Discussionmentioning

confidence: 97%

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Poor Physical Capacity in Bronchiectasis Patients Is Correlated with Poor Quality of Life

Mäntylä

Mazur

Törölä

et al. 2020

Preprint

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Background: Bronchiectasis (BE) is an increasing burden on healthcare systems, and there is an urgent need for improved treatments, better clinical care and for clinical and translational research on this condition. Reducing the number of exacerbations is one of the key goals in BE management. Patients who suffer from frequent exacerbations are likely to experience more exacerbations, which have negative effects on quality of life (QoL), healthcare utilisation and mortality. Thus, we aimed to investigate the risk factors associated with quality of life (QoL) in a cohort of Finnish non-cystic fibrosis BE patients.Methods: A cross-sectional study is part of the EMBARC. Recruitment occurred between August 2016 and March 2018 from three clinics in Helsinki University Central Hospital, Finland. The study included 95 adult patients (mean age was 69 (SD± 13) years). Seventy nine percent were women. A disease-specific quality of life-bronchiectasis (QoL-B) questionnaire was applied, and scores in the lowest quarter (24%) indicate poor QoL. The bronchiectasis severity index (BSI) and FACED score were used. The severity of dyspnoea was examined using the modified Medical Research Council (mMRC) dyspnoea scale. Results: Almost all (82%) presented with chronic sputum production and exacerbation, with a median rate of 1.7 (SD ±1.6). Exacerbations (OR 1.7), frequent exacerbations (OR 4.9, p < 0.01), high BSI score (OR 1.3, p < 0.01) and extensive disease (OR 3.7, p = 0.05) were predictive of poor QoL. Frequent exacerbations were associated with bronchial bacterial colonisation, low forced expiratory volume in one second (FEV1) and radiological disease severity. Based on the BSI, 34.1% of our cohort had severe disease, whereas 11.6% were classified as severe according to the FACED score. The mMRC dyspnoea score (r = -0.57) and BSI (r = -0.60) were negatively correlated with physical domain in QoL-B questionnaire. Conclusion: Frequent exacerbations, radiological disease severity and high BSI score were predictive of poor QoL. Reduced physical capacity was correlated with dyspnoea and severity of disease. Interventions to reduce bacterial colonisation and to maintain physical functioning should be used to minimize exacerbations and to improve QoL.Study registration: University of Helsinki, faculty of medicine; 148/16.08.2017; Registered 16 August 2017; https://researchportal.helsinki.fi/

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Section: Discussionmentioning

confidence: 97%

“…The mean mMRC score in our population was 2.0, but there was a median of two exacerbations per year. Previously, BSI was proposed as a tool for scoring the severity of BE and FACED as a tool for predicting mortality [20] [21].…”

Section: Discussionmentioning

confidence: 99%

Poor Physical Capacity in Bronchiectasis Patients Is Correlated with Poor Quality of Life

Mäntylä

Mazur

Törölä

et al. 2020

Preprint

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“…However, the QoL of bronchiectasis patients with COPD has rarely been evaluated. One European study analyzed bronchiectasis patients' QoL according to etiology, and patients with COPD-related bronchiectasis were shown to have lower QoL compared with patients with bronchiectasis caused by other etiologies ( 35 ). However, because that study evaluated QoL according to etiology, COPD patients whose COPD was not considered to be the cause of bronchiectasis were not included in the COPD group.…”

Section: Discussionmentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease Is Associated With Decreased Quality of Life in Bronchiectasis Patients: Findings From the KMBARC Registry

Kim

Jeong

et al. 2021

Front. Med.

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Most studies have evaluated the impact of non-cystic fibrosis bronchiectasis (hereafter referred to as bronchiectasis) on quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD) using COPD cohorts. Accordingly, the impact of COPD on QoL in patients with bronchiectasis is not well-elucidated. We used the Korean Multicenter Bronchiectasis Audit and Research Collaboration (KMBARC) registry between August 2018 and December 2019, a prospective observational cohort that enrolled patients with bronchiectasis in Korea. We evaluated co-occurrence exposure to COPD in bronchiectasis patients, and the primary outcome was QoL according to the Bronchiectasis Health Questionnaire (BHQ). We also investigated factors associated with decreased QoL, defined as the lowest quartile of the total BHQ score. Of 598 patients with bronchiectasis, 372 (62.2%) had COPD. Bronchiectasis patients with COPD had a significantly lower total BHQ score compared with those without COPD [median = 63.1 (interquartile range: 54.8–68.6) vs. 64.8 (57.4–70.8), p = 0.020]. Multivariable analysis revealed that dyspnea [adjusted odds ratio (aOR) = 3.21, 95% confidence interval (CI) = 1.21–8.60], depression (aOR = 1.28, 95% CI = 1.16–1.44), and fatigue (aOR = 1.05, 95% CI = 1.01–1.09) were significantly associated with decreased QoL in bronchiectasis patients with COPD. In conclusion, bronchiectasis patients with COPD had significantly decreased QoL than patients without COPD. In bronchiectasis patients with COPD, dyspnea, depression, and fatigue were associated with decreased QoL.

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“…QoL-B respiratory symptoms domain was most commonly used in clinical trials and was able to discriminate patients based on demographics (Polverino et al, 2020), disease severity (Olveira et al, 2014a, Quittner et al, 2015, Visser et al, 2019Liu et al, 2019), exacerbations (Olveira et al, 2014a, Dhar et al, 2019, Visser et al, 2019, Brown et al, 2019, bacteriology (Olveira et al, 2014a, Terpstra et al, 2019, Dhar et al, 2019, Brown et al, 2019, Ewen et al, 2019, Asakura et al, 2020, sputum volume (Polverino et al, 2018, Dhar et al, 2019, dyspnoea (Dhar et al, 2019, haemoptysis (Olveira et al, 2014a) and exercise capacity (Quittner et al, 2015). Discriminant validity for the other 7 domains was also reported.…”

Section: Bronchiectasis Specific Hrqol Questionnairesmentioning

confidence: 99%

“…Discriminant validity for the other 7 domains was also reported. Studies reported that some of the QoL-B domain scores were able to discriminate patients based on demographics (Polverino et al, 2018, Olveira et al, 2014a, McCullough et al, 2011, Terpstra et al, 2019, disease severity (Dhar et al, 2019, Quittner et al, 2015, Olveira et al, 2014a, Visser et al, 2019, exacerbations (Dhar et al, 2019, Visser et al, 2019, Olveira et al, 2014a, Alcaraz-Serrano et al, 2020 and bacteriology (Polverino et al, 2018, Visser et al, 2019, Olveira et al, 2014a, Asakura et al, 2020, haemoptysis (Olveira et al, 2014a), dyspnoea (De Camargo et al, 2020), adherence to treatments (McCullough et al, 2014 and exercise capacity (Quittner et al, 2015). The BHQ was able to discriminate patients based on demographics (Choi et al, 2020, Diggins et al, 2020, disease severity, exacerbations and hospital admissions in the preceding 12 months (Spinou et al, 2017b).…”

Section: Bronchiectasis Specific Hrqol Questionnairesmentioning

confidence: 99%

Psychometrics of health-related quality of life questionnaires in bronchiectasis: a systematic review and meta-analysis

et al. 2021

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IntroductionUnderstanding the psychometric properties of health related quality of life (HRQoL) questionnaires can help inform selection in clinical trials.ObjectiveTo assess the psychometric properties of HRQoL questionnaires in bronchiectasis.MethodsA literature search was conducted. HRQoL questionnaires were assessed for psychometric properties (reliability, validity, minimal clinically important difference (MCID), floor/ceiling effects). Meta-analyses assessed the associations of HRQoL with clinical measures and responsiveness of HRQoL in clinical trials.Results166 studies and 12 HRQoL questionnaires were included. The BHQ, LCQ, CAT and SF-36 had good internal consistency in all domains reported (Cronbach's α≥0.7) across all studies and the QoL-B, SGRQ, CRDQ and SOLQ had good internal consistency in all domains in the majority of (but not all) studies. The BHQ, SGRQ, LCQ and CAT had good test-retest reliability in all domains reported ((intraclass correlation coefficient) ICC ≥0.7) across all studies and the QoL-B, CRDQ and SOLQ had good test-retest reliability in all domains in the majority of (but not all) studies. HRQoL questionnaires were able to discriminate between demographics, important markers of clinical status, disease severity, exacerbations and bacteriology. For HRQoL responsiveness, there was a difference between the treatment and placebo effect.ConclusionSGRQ was the most widely used HRQoL questionnaire in bronchiectasis studies and it had good psychometric properties, however good psychometric data are growing on bronchiectasis specific HRQoL questionnaires, QoL-B and BHQ. Future studies should focus on the medium-long term test-retest reliability, responsiveness and MCID in these HRQoL questionnaires which show potential in bronchiectasis.

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Aetiology and disease severity are among the determinants of quality of life in bronchiectasis

Cited by 18 publications

References 29 publications

Poor Physical Capacity in Bronchiectasis Patients Is Correlated with Poor Quality of Life

Poor Physical Capacity in Bronchiectasis Patients Is Correlated with Poor Quality of Life

Chronic Obstructive Pulmonary Disease Is Associated With Decreased Quality of Life in Bronchiectasis Patients: Findings From the KMBARC Registry

Psychometrics of health-related quality of life questionnaires in bronchiectasis: a systematic review and meta-analysis

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