Change in Generic and Disease-Specific Health-Related Quality of Life during a One-Year Period in Patients with Newly Detected Chronic Obstructive Pulmonary Disease

Abstract

Background: Although the health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD) has been assessed by generic or disease-specific HRQoL measures, the responsiveness of the generic HRQoL measures is generally weak. Objectives: To investigate the responses generated by generic and disease-specific HRQoL questionnaires, we prospectively followed the clinical course of patients with newly detected COPD after the initiation of treatment. Methods: A prospective, longitudinal study with a 1-year follow-up was designed. The forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), the Nottingham Health Profile (NHP) as a generic HRQoL measure, and the Chronic Respiratory Disease Questionnaire (CRQ) as a disease-specific HRQoL measure were measured at baseline and at 3, 6, and 12 months after the initiation of standard treatment. Results: Eighty-two patients completed the study. The FEV₁, FVC, and NHP and CRQ scores improved significantly during the first 3 months (p < 0.05). During the last 6 months, although the FEV₁ declined (p < 0.05), the HRQoL assessed by the NHP and CRQ remained elevated. Except for the score on the social isolation section of the NHP at 12 months, all HRQoL scores at 6 and 12 months were significantly improved compared to baseline (p < 0.05). Conclusion: In new patients with COPD, the NHP as well as the CRQ was able to detect changes in the HRQoL associated with effective medical interventions. The influence of the changes in airflow limitation on the HRQoL was weak.

Development and Psychometric Analysis of the Japanese Version of the Nottingham Health Profile: Cross-cultural Adaptation

“…This finding is compatible with previous results reported for patients with COPD (27). However, scores on the NHP commonly exhibit such end effects (28).…”

Health status in the TORCH study of COPD: treatment efficacy and other determinants of change

“…Disease-specific questionnaires like the St George's Respiratory Questionnaire (SGRQ) reflect a wide range of different health impacts in COPD [1], are designed to provide an overall measure of impairment, and are now used widely in randomized controlled trials in COPD. A number of relatively small longitudinal observational studies [2-5] have shown that a decline in health status may be seen over time, but there have been relatively few studies of long-term treatment effects on health status decline. The first of these was the Inhaled Steroids in Obstructive Lung Disease (ISOLDE) study, which showed that health status measured using the SGRQ deteriorated progressively over 3 years [6], an effect that was slowed by the inhaled corticosteroid (ICS) fluticasone propionate (FP) [7,8].…”

Psychiatric and somatic comorbidities are negatively associated with quality of life in physically ill patients

“…But operationalizing HRQoL poses several methodologic difficulties [7,8]. In addition to the problems of reliability and validity that are inherent in selfreport questionnaires, there is no consensus among researchers on whether HRQoL should be measured by generic or disease-specific approaches [7,9,10]. On the one hand, disease-specific HRQoL questionnaires offer the advantage of generally higher responsiveness [10].…”