Impact of Lung Transplantation on Recipient Quality of Life

Copeland, Catherine; Vock, David M.; Pieper, Karen S.; Mark, Daniel B.; Palmer, Scott M.

doi:10.1378/chest.12-0971

Cited by 62 publications

(44 citation statements)

References 34 publications

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“…Similar findings were reported by Finlen Copeland et al 2 in a secondary analysis of QoL data, gathered before and after lung transplantation, among a cohort of 131 patients enrolled in a cytomegalovirus prevention trial. In that study, the SF-36 PCS scores improved considerably after lung transplantation, but the SF-36 MCS scores did not.…”

Section: Discussionsupporting

confidence: 87%

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Development and psychometric properties of the Pulmonary-specific Quality-of-Life Scale in lung transplant patients

Hoffman

Stonerock

Smith

et al. 2015

The Journal of Heart and Lung Transplantation

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BACKGROUND The Pulmonary-specific Quality-of-Life Scale (PQLS) was developed to measure quality of life (QoL) among patients awaiting lung transplant. The objective of this study was to determine the psychometric properties of the PQLS, identify empirically derived sub-scales, and examine ability to detect changes in pulmonary-specific QoL scores after lung transplantation. METHODS Data were derived from the INSPIRE trial, a dual-site randomized controlled trial of coping skills training in 389 lung transplant candidates (obstructive [48.3%], restrictive [24.2%], cystic fibrosis [13.6%], and other [13.9%]). Cronbach alpha was calculated to assess the internal reliability of the PQLS (n = 388). Test-retest reliability was assessed with correlation coefficients between baseline and 12-week post-baseline scores for the usual care control condition (n = 140). Convergent validity was assessed with correlation coefficients between the PQLS and established measures of QoL and emotional distress, 6-minute walk test distance, forced expiratory volume in 1 second, and use of supplemental oxygen at rest (n = 388). Change from baseline to 6 months post-transplantation was assessed with repeated measures analysis of variance (n = 133). RESULTS The PQLS was internally reliable and stable across 12 weeks. The PQLS correlated strongly with QoL measures (e.g., Shortness of Breath Questionnaire, r = 0.78, p < 0.0001), moderately with mood and anxiety (e.g., Beck Depression Inventory-II, r = 0.59, p < 0.0001), and modestly with lung disease severity (e.g., 6-minute walk test, r = −0.41, p < 0.0001). PQLS scores improved by nearly 2 SDs after transplant. CONCLUSIONS These results demonstrated the reliability, validity, and sensitivity to change of the PQLS for measuring pulmonary QoL among patients with advanced lung disease and the responsiveness of the PQLS to changes in QoL after lung transplantation.

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Section: Discussionsupporting

confidence: 87%

“…1 In recognition of the high costs (financial and human) associated with lung transplantation and the high frequency of significant post-transplant complications, quality of life (QoL) has become an increasingly important clinical end-point to evaluate treatment effectiveness. 2 …”

mentioning

confidence: 99%

Development and psychometric properties of the Pulmonary-specific Quality-of-Life Scale in lung transplant patients

Hoffman

Stonerock

Smith

et al. 2015

The Journal of Heart and Lung Transplantation

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“…SF-36 is a validated tool to assess QOL in a variety of clinical conditions including pulmonary disorders, malignancy, lung transplantation, and lung surgery [23,24]. Patient responses are summed to produce scores for 8 domains, as shown in tables 3 and 4, and can range between 0 and 100 (worse to better).…”

Section: Methodsmentioning

confidence: 99%

Therapeutic Bronchoscopy Improves Spirometry, Quality of Life, and Survival in Central Airway Obstruction

et al. 2015

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Background: Central airway obstruction (CAO) occurs in patients with primary or metastatic lung malignancy and nonmalignant pulmonary disorders and results in significant adverse effects on respiratory function and quality of life. Objectives: The objective of this study was to assess the effect of therapeutic bronchoscopic interventions on spirometry, dyspnea, quality of life, and survival in patients with CAO. Methods: We prospectively studied patients who underwent therapeutic rigid bronchoscopy for CAO. Spirometry, San Diego Shortness of Breath questionnaire (SOBQ), and SF-36 questionnaire responses were obtained before the procedure and at follow-up 6-8 weeks after the procedure. Results: Fifty-three patients (24 malignant and 29 nonmalignant CAO), who underwent successful rigid bronchoscopic intervention, were enrolled. Airway stent placement and various debulking techniques including mechanical debridement and heat therapy were used. After bronchoscopy, there was a significant increase in forced vital capacity (2.2 ± 0.91 l before, 2.7 ± 0.80 l after, p = 0.009) and forced expiratory volume at 1 s (1.4 ± 0.60 l before, 1.8 ± 0.67 l after, p = 0.002). The SOBQ score improved from 55.8 ± 30.1 before the procedure to 37.9 ± 27.25 after the procedure (p = 0.002). In the SF-36, there was an improvement in almost all domains, with statistically significant improvement seen in several domains. Benefits were seen independent of the etiology of CAO, site of intervention or stent placement. The patients with malignant CAO, in whom airway patency could not be achieved, had a poor survival. Conclusions: Alleviation of CAO with therapeutic rigid bronchoscopy results in improvement in spirometry, shortness of breath, quality of life, and survival.

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“…Several studies have been performed with health‐outcome measurement instruments that capture a specific element of HRQoL. In the short term, most patients are found to experience meaningful improvements after lung transplantation 5, 6, 7, 8, 9, 10. However, the generalizability of these studies is constrained by methodological problems such as cross‐sectional design, short‐term follow‐up, and small sample sizes.…”

Section: Introductionmentioning

confidence: 99%

Patient-reported health outcomes in long-term lung transplantation survivors: A prospective cohort study

Parizi

Krabbe

Verschuuren

et al. 2018

American Journal of Transplantation

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During the last three decades lung transplantation (LTx) has become a proven modality for increasing both survival and health‐related quality of life (HRQoL) in patients with various end‐stage lung diseases. Most previous studies have reported improved HRQoL shortly after LTx. With regard to long‐term effects on HRQoL, however, the evidence is less solid. This prospective cohort study was started with 828 patients who were on the waiting list for LTx. Then, in a longitudinal follow‐up, 370 post‐LTx patients were evaluated annually for up to 15 years. For all wait‐listed and follow‐up patients, the following four HRQoL instruments were administered: State‐Trait Anxiety Inventory, Zung Self‐rating Depression Scale, Nottingham Health Profile, and a visual analogue scale. Cross‐sectional and generalized estimating equation (GEE) analysis for repeated measures were performed to assess changes in HRQoL during follow‐up. After LTx, patients showed improvement in all HRQoL domains except pain, which remained steady throughout the long‐term follow‐up. The level of anxiety and depressive symptoms decreased significantly and remained constant. In conclusion, this study showed that HRQoL improves after LTx and tends to remain relatively constant for the entire life span.

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Impact of Lung Transplantation on Recipient Quality of Life

Cited by 62 publications

References 34 publications

Development and psychometric properties of the Pulmonary-specific Quality-of-Life Scale in lung transplant patients

Development and psychometric properties of the Pulmonary-specific Quality-of-Life Scale in lung transplant patients

Therapeutic Bronchoscopy Improves Spirometry, Quality of Life, and Survival in Central Airway Obstruction

Patient-reported health outcomes in long-term lung transplantation survivors: A prospective cohort study

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