Impact of comorbidities on COPD-specific health-related quality of life

Burgel, Pierre‐Régis; Escamilla, R.; Pérez, Thierry; Carré, Philippe; Caillaud, D.; Chanez, Pascal; Pinet, C.; Jébrak, G.; Brinchault, Graziella; Court-Fortuné, Isabelle; Paillasseur, Jean-Louis; Roche, N.

doi:10.1016/j.rmed.2012.10.002

Cited by 113 publications

(120 citation statements)

References 38 publications

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“…The goal of symptom management is to reduce frequency, minimize severity, and relieve distress 10 . As there is no cure for COPD, symptom control is necessary for improvement of patients' health-related quality of life 19 , and nurses have a key role in symptom management as they are involved in all stages of care 20 . Recently, the GOLD guidelines highlighted the importance of symptom assessments 1 .…”

Section: Introductionmentioning

confidence: 99%

Symptom burden in stable COPD patients with moderate or severe airflow limitation

et al. 2014

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Running head: Symptom burden in moderate or severe airflow limitations Symptom burden in stable COPD patients with moderate or severe airflow limitations. AbstractObjectives. To describe a multidimensional symptom profile in patients with stable chronic obstructive pulmonary disease (COPD) and determine whether symptom experience differed between patients with moderate or severe airflow limitations.Background. Patients with severe airflow limitation experience numerous symptoms, but

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Section: Introductionmentioning

confidence: 99%

Symptom burden in stable COPD patients with moderate or severe airflow limitation

et al. 2014

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“…This confirms previous findings on the importance of these three dimensions of the disease. [24] Chronic and progressive dyspnea is the most characteristic symptom of COPD with a major impact on health status [25] and disease prognosis. [26] The clinical impact of exacerbations on various aspects of the disease has been demonstrated in numerous studies.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of clinical variables according to follow-up times in COPD: results from ON-SINT cohort

Lόpez-Campos

Fernández-Villar

Represas-Represas

et al. 2017

European Clinical Respiratory Journal

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Background: COPD is a chronic disease traditionally associated with increased symptoms as lung function deteriorates. Follow-up times in previous cohort studies were limited to a few years. Interestingly, newer longer observational studies show a more comprehensive picture on disease progression over time. Therefore, the question on the relevancy of the follow-up time in cohort studies remains open. Methods: The ON-SINT study is an observational, retrospective, nationwide, real-life cohort study, in which patients diagnosed with COPD were recruited between December 2011 and April 2013 by primary care (PC) and secondary care (SC) physicians. Patients were evaluated at the inclusion visit and at the initial visit when the diagnosis of COPD was first established. Distribution of lung function decline over the years was studied comparing those cases with longer follow-up times, with the median of the distribution as the cutoff point. Results: The sample included 1214 patients of which 857 (70.6%) were recruited by PC and 357 (29.4%) by SC physicians. Median follow-up time was 6.26 years. Mean annual change in the complete cohort were –4.5 (222) ml year–1 for FVC and 5.5 (134) ml year–1 for FEV1. We confirm the variable distribution of FEV1 decline and found that longer follow-up periods reduce this variability. Of note, FEV1 decline was different between groups (shorter: 19.7 [180.4] vs longer: –9.7 [46.9]; p = 0.018). Further, our data revealed differences in the clinical presentation according to follow-up times, with special emphasis on dyspnea (OR: 1.035; 95%CI: 1.014–1.056), exacerbations (OR 1.172; 95%CI 1.045–1.315) and CAT scores (OR 1.047; 95%CI 1.019–1.075) being associated with longer follow-up times. Conclusions: This study describes the impact of follow-up periods on lung function variability, and reveals differences in clinical presentation according to follow-up times, with special emphasis on dyspnea, exacerbations and CAT scores.

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“…A lack of symptom control will result in significant deterioration of health-related quality of life and suffering (Newcomb 2010). Since there is no cure for COPD (Rabe et al 2007) or other chronic diseases, symptom control is necessary for the improvement of people's health (Burgel et al 2013).…”

Section: Symptom Management Modelmentioning

confidence: 99%

Symptom burden among people with chronic disease

Eckerblad¹

2015

Linköping University Medical Dissertations

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Introduction: Chronic diseases tend to increase with old age. Older people with chronic disease are commonly suffering from conditions which produce a multiplicity of symptoms and a decreased health-related quality of life. Nurses have a responsibility to prevent, ease or delay a negative outcome through symptom management, or assist in achieving an acceptable level of symptom relief. Aim: The overall aim of the thesis was to describe different aspects of symptom burden from the perspective of community-dwelling people with chronic disease. Methods: This thesis is based upon four papers that used both quantitative and qualitative data to describe different aspects of symptom burden, experienced by people with chronic diseases. Paper (I) is a cross-sectional study with 91 participants diagnosed with chronic obstructive pulmonary disease. Papers (II and IV) are based upon secondary outcome data from a randomized controlled trial with 382 community-dwelling older people with multimorbidity. Paper (II) is a cross-sectional study and Paper (IV) has a descriptive and an explorative design reporting on the trajectory of symptom prevalence and symptom burden. Paper (III) is a qualitative study with participants from the AGe-FIT. Results: Among people diagnosed with COPD the most prevalent symptoms with the highest symptom burden scores were shortness of breath, dry mouth, cough, sleep problems, and lack of energy, with just a few differences between participants with moderate and severe airflow limitation (I). For older people with multimorbidity, pain was the symptom with the highest prevalence and burden. Other highly prevalent symptoms were lack of energy and a dry mouth. Poor vision, likelihood of depression, and diagnoses of the digestive system were independently related to the total symptom burden score (II). The symptoms experienced by the older people were persistent and the symptom burden remained high over time (IV). The experience of living with a high symptom burden was described as an endless struggle. The analysis revealed an overall theme, “To adjust and endure” and three sub-themes, “to feel inadequate and limited”, “to feel dependent”, and “to feel dejected” (III). Conclusions: The results of this thesis indicate the importance of early symptom identification. People with chronic diseases have an unmet need for optimized treatment that focuses on the total symptom burden, and not only disease specific symptoms. A large proportion of older people with multimorbidity suffer a high and persistent symptom burden, and the prevalence and trajectory of pain are high. Older people sometimes think their high age is the reason they experience a diversity of symptoms, and they do not always communicate these to their health-care provider

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Impact of comorbidities on COPD-specific health-related quality of life

Abstract: These data suggest that in the presence of dyspnea and exacerbation, depression is the most important contributor to HRQoL impairment measured by SGRQ in COPD subjects, whereas other comorbidities and FEV(1) have only limited impact.

Cited by 113 publications

References 38 publications

Symptom burden in stable COPD patients with moderate or severe airflow limitation

Symptom burden in stable COPD patients with moderate or severe airflow limitation

Evaluation of clinical variables according to follow-up times in COPD: results from ON-SINT cohort

Symptom burden among people with chronic disease

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