Health-related quality of life of patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis

Abstract

Idiopathic pulmonary fibrosis (IPF) is one of the most common forms of interstitial lung disease presenting in persons 50 years and older. Through a comprehensive review of available studies, we aimed to assess health-related quality of life (HRQoL) of people living with IPF and the instruments used in this assessment.Searches were conducted up to May, 2020. Quality appraisal and data extraction were performed using pre-designed forms. Narrative synthesis approach was used to report results of the systematic review and a random effects model was used for the meta-analysis. A leave-one-out sensitivity analysis was performed, and a trim and fill method was used to assess publication bias.The review included 134 studies. The most used instruments to measure HRQoL were St George's Respiratory Questionnaire (SGRQ), Short Form 36 (SF36) and EuroQoL (EQ5D). Standardised mean scores (95% confidence interval) for these instruments were as follows: SGRQ total score: 44.72 (42.21–47.22); SF36 physical component score (PCS): 37.00 (34.74–39.26) SF36 mental component score (MCS): 50.18 (48.41–51.95); King's Brief Interstitial Lung Disease questionnaire total score: 58.38 (55.26–61.51); and EQ5D utility: 0.73 (0.68–0.79). Analysis of standardised means for both SGRQ and SF36 demonstrated worse scores in physical health domains as compared to mental health domains.This systematic review confirms that IPF negatively affected HRQoL, mostly impacting the physical health domains. This study also demonstrated that a diverse number of instruments are used to evaluate HRQoL. In view of this diversity, a standardised approach to measurement of HRQoL for IPF is important to ensure that comparisons made are reliable.

Relationship between body composition, exercise capacity and health-related quality of life in idiopathic pulmonary fibrosis

“… 30 Many different instruments have been used to assess HRQL in patients with IPF, one of the most used is the SF-36, 3 31 which have been demonstrated as a valid questionnaire. 32 Patients with IPF have significantly impaired HRQL in both Physical and Mental Summary Scores, 3 32 however, recently Cox et al 31 showed that domain scores reflecting physical wellness (activity and symptoms) were generally worse than those reflecting emotional wellness (impact), which agrees with the findings of this study. No factor was associated with the Mental Summary Score of the SF-36.…”

Improvement in Eating Disorder Risk and Psychological Health in People with Class 3 Obesity: Effects of a Multidisciplinary Weight Management Program

“…The low SF-36 scores in this cohort were actually lower in all subscale scores than those reported for breast cancer survivors with lymphoedema where HRQoL would be expected to be much lower [ 62 ]. Previously reported SF-36 results for patients with cirrhosis and idiopathic pulmonary fibrosis have shown PCS scores comparable to our study’s cohort, while the MCS scores in our cohort were lower than those reports [ 63 , 64 ]. Additionally, even after a significant increase in these scores at 12 months, this cohort still had scores that were much lower than the Australian adult population norms [ 49 ].…”

Contemporary Concise Review 2020: Interstitial lung disease

“…Irrespective of the ILD phenotype, disease progression is commonly associated with high symptom burden, reduced quality of life and higher HRU, and negatively impacts mental health 60–63 . A systematic review and meta‐analysis of 134 studies aimed to assess health‐related quality of life (HRQoL) of people living with IPF and patient‐reported outcome measures used in IPF studies 64 . Analysis of standardized means for both St George's Respiratory Questionnaire and Short Form 36 demonstrated worse score in physical health domains compared to mental health domains.…”