Predictive factors over time of health-related quality of life in COPD patients

Abstract

Background: Health-related quality of life (HRQoL) should be seen as a tool that provides an overall view of the general clinical condition of a COPD patient. The aims of this study were to identify variables associated with HRQoL and whether they continue to have an influence in the medium term, during follow-up. Methods: Overall, 543 patients with COPD were included in this prospective observational longitudinal study. At all four visits during a 5-year follow-up, the patients completed the Saint George's Respiratory Questionnaire (SGRQ), pulmonary function tests, the 6-min walk test (6MWT), and a physical activity (PA) questionnaire, among others measurements. Data on hospitalization for COPD exacerbations and comorbidities were retrieved from the personal electronic clinical record of each patient at every visit. Results: The best fit to the data of the cohort was obtained with a beta-binomial distribution. The following variables were related over time to SGRQ components: age, inhaled medication, smoking habit, forced expiratory volume in one second, handgrip strength, 6MWT distance, body mass index, residual volume, diffusing capacity of the lung for carbon monoxide, PA (depending on level, 13 to 35% better HRQoL, in activity and impacts components), and hospitalizations (5 to 45% poorer HRQoL, depending on the component). Conclusions: Among COPD patients, HRQoL was associated with the same variables throughout the study period (5-year follow-up), and the variables with the strongest influence were PA and hospitalizations.

COPD-Related Factors Affect the Quality of Life of Patients

“…Most of the studies used a multicenter, cross-sectional analytical design, with studies' periods ranged from 3 months to 6 years. Five studies used a multicenter, prospective analytical design, with 6-month to 5-year period [14][15][16][17][18]. The minimal sample size used in the studies was n = 42, and the maximum one was 5619.…”

“…Indeed, Monteagudo and colleagues revealed that patients taking multiple medications and ending respiratory rehabilitation had improved HRQL at 1-year follow-up [14]. Recently, Esteban and colleagues showed that using 2 out of longacting beta agonists, long-acting muscarinic antagonists, and inhaled corticosteroid, or 3 of them was significantly associated with HRQL scores [17]. Amini and colleagues demonstrated that appropriate inhaler technique was associated with better HRQL in patients with COPD [19].…”

“…Pulmonary function was significantly associated with HRQL [6,17,24]. It was shown that residual volume, diffusing capacity of the lung for carbon In brief, dyspnea had significantly and independently the highest impact on HRQL in comparison with other COPD-related factors and co-morbidities [12, 14-16, 24, 26].…”

Impact of Lung Function and Exacerbations on Health-Related Quality of Life in COPD Patients Within One Year: Real-World Analysis Based on Claims Data

“…[16][17][18] On the other hand, exacerbations also negatively affect HRQoL. [19][20][21][22] Nonetheless, the longitudinal association between these two clinical factors and HRQoL is not fully understood, [23][24][25] especially with regard to GOLD ABCD groups. Although the relationship between clinical factors and HRQoL has often been analyzed for GOLD I-IV, there are few published reports regarding ABCD groups, even though classification by ABCD groups is more closely associated with HRQoL.…”

Long-term weight gain in obese COPD patients participating in a disease management program: a risk factor for reduced health-related quality of life

“…Improving HRQoL is an explicit goal in German disease management guidelines [ 10 ]. Factors that predict current HRQoL in COPD include, but are not limited to, previous HRQoL results, physical activity, exacerbations, and specific symptoms [ 11 , 12 ]. Preventing BMI increase or finding ways to normalize it may therefore represent a key management aspect that is treated insufficiently in several COPD disease guidelines [ 13 , 14 ] or is covered rather casually [ 15 ].…”