Relative impact of COPD and comorbidities on generic health-related quality of life: a pooled analysis of the COSYCONET patient cohort and control subjects from the KORA and SHIP studies

Abstract

BackgroundHealth-related quality of life (HRQL) is an important patient-reported outcome measure used to describe the burden of chronic obstructive pulmonary disease (COPD) which is often accompanied by comorbid conditions.MethodsData from 2275 participants in the COPD cohort COSYCONET and from 4505 lung-healthy control subjects from the population-based KORA and SHIP studies were pooled. Main outcomes were the five dimensions of the generic EQ-5D-3 L questionnaire and two EQ-5D index scores using a tariff based on valuations from the general population and an experience-based tariff.The association of COPD in GOLD grades 1–4 and of several comorbid conditions with the EQ-5D index scores was quantified by multiple linear regression models while adjusting for age, sex, education, body mass index (BMI), and smoking status.ResultsFor all dimensions of the EQ-5D, the proportion of participants reporting problems was higher in the COPD group than in control subjects. COPD was associated with significant reductions in the EQ-5D index scores (-0.05 points for COPD grades 1/2, -0.09 for COPD grade 3, -0.18 for COPD grade 4 according to the preference-based utility tariff, all p < 0.0001). Adjusted mean index scores were 0.89 in control subjects and 0.85, 0.84, 0.81, and 0.72 in COPD grades 1-4 according to the preference-based utility tariff and 0.76, 0.71, 0.68, 0.64, and 0.58 for control subjects and COPD grades 1-4 for the experience-based tariff respectively. Comorbidities had additive negative effects on the index scores; the effect sizes for comorbidities were comparable to or smaller than the effects of COPD grade 3. No statistically significant interactions between COPD and comorbidities were observed. Score differences between COPD patients and control subjects were most pronounced in younger age groups.ConclusionsCompared with control subjects, the considerable reduction of HRQL in patients with COPD was mainly due to respiratory limitations, but observed comorbidities added linearly to this effect. Younger COPD patients showed a greater loss of HRQL and may therefore be in specific need of comprehensive disease management.Trial registrationNCT01245933

Association of generic health-related quality of life (EQ-5D dimensions) and inactivity with lung function in lung-healthy German adults: results from the KORA studies F4L and Age

“…238 In females, associations found in the total population for mobility and usual activities with 239 FEV 1 and FVC remained significant (mobility: FEV 1 : β= -81 ml; FVC: β= -109 ml; usual 240 activities: FEV 1 : β= -86 ml; FVC: β=-106 ml) (S1 Table A2). Results for males showed similar 241 estimates, but were significant only for the association between FEV 1 were obtained when applying GLI z-scores (Tables A4 and A5 in S1 Tables). 247 248 Effect modification between EQ-5D dimensions and physical inactivity 249 Physical inactivity showed weak correlations with the EQ-5D dimensions, with the highest 250 correlations observed with anxiety/depression and mobility problems (Cramér's V 0.16 and 251 0.15, respectively).…”

“…Thus, prevention of inactivity appears to 28 be reasonable even in lung-healthy adults. 29 30 31Health-related quality of life (HRQL) is reduced in patients with chronic lung diseases such as 32 chronic obstructive pulmonary disease (COPD) [1][2][3]. While various factors, including 33 impaired lung function, can lead to a decrease in HRQL with increasing disease severity, 34 physical activity has been found to be associated with better HRQL as well as less hospital 35 admissions in COPD [2,[4][5][6].…”

“…Introduction age 80 years [12]. 48 While the association between lung function and HRQL is well established in patients with 49 manifest disease [1][2][3], the relation between respiratory function variability and HRQL in 50 lung-healthy subjects is less studied. 51 At a population level, two studies from the United Kingdom investigated the association 52 between FEV 1 and a 36-item questionnaire on general health status (Short Form-36, SF-36) 53 in adults aged 40-79 years and 50-74 years, respectively [13,14].…”

The health impacts of energy performance investments in low-income areas: a mixed-methods approach

“…Table 3 and Figure 4 show that the intervention was not significantly associated with a change in cardiorespiratory, COPD-related, cardiovascular or respiratory emergency admissions for people of all ages. The results include summaries of the raw, unadjusted data for the pre-and post-intervention phases, and the paired differences for those [18,527] 0.0543 (0.4788) [22,209] 0.0152 (0.9144) [12, [18,527] 0.0062 (0.1468) [22,209] 0.0054 (0.1526) [12, [18,527] 0.0179 (0.2709) [22,209] 0.0108 (0.5264) [12, [18,527] 0.0324 (0.3720) [22,209] 0.0045 (0.7374) [12, people who were in the study for both phases (irrespective of the lengths of residency periods). We subsequently included covariates and factors in univariate linear models for each outcome, and the adjusted comparisons are taken from models that retain all significant covariates and factors (listed at the end of Tables 3 and 4).…”

Perceived Satisfaction With Long-Term Oxygen Delivery Devices Affects Perceived Mobility and Quality of Life of Oxygen-Dependent Individuals With COPD

“…[6][7][8] However, because of the heterogeneity of COPD and the comorbid conditions that are often associated with it, researchers and practitioners have begun to use generic HRQOL measures in conjunction with disease-specific measures to evaluate outcomes of various interventions. [9][10][11][12] For example, Engström et al 13 argued that disease-specific HRQOL measures were not sufficient to examine the effect of COPD on life functions due to comorbidities frequently seen in the COPD population. In a study that assessed the HRQOL in individuals with varying severity of COPD, the researchers found that disease-specific HRQOL indicators correlated well with measures of lung function, but generic HRQOL indicators that measure emotional status and psychosocial function correlated poorly with measures of lung function.…”