Evaluation of Health-Related Quality of Life in Low-Income Patients With COPD Receiving Long-term Oxygen Therapy

Sant'Anna, Cláudia Adriana; Stelmach, Rafaël; Feltrin, Maria Ignez Zanetti; Filho, Wilson Jacob; Chiba, Toshio; Cukier, Alberto

doi:10.1378/chest.123.1.136

Cited by 51 publications

(50 citation statements)

References 31 publications

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“…A relationship between the SGRQ total score and FEV 1, which is in agreement with several other studies, (5,(19)(20)(21)(22) was observed in this study. Our results did not show a relationship between body composition attributes and HRQoL.…”

Section: Discussionsupporting

confidence: 94%

“…(19,20) A recent study, carried out in Brazil, comparing low-income patients with COPD and hypoxemia who received LTOT through cylinders with COPD patients with less severe hypoxemia showed no significant differences in SGRQ scores. (5) Changing the oxygen delivery system from cylinders to concentrators improved the quality of life of the hypoxemic patients to the same level as that of the patients with less severe hypoxemia evaluated in this study. The effects of LTOT on HRQoL have not been clearly established.…”

Section: Discussionmentioning

confidence: 64%

“…In low-income countries, higher costs resulting from electricity consumption by concentrators can be an additional problem. (5) Our patients received oxygen delivered by heavy steel oxygen cylinders; small portable oxygen cylinders were not available. For this reason, problems with restricted mobility and personal isolation were probably more common and might have been one reason why the hypoxemic patients presented an improved HRQoL after the transition to oxygen concentrators.…”

Section: Discussionmentioning

confidence: 99%

“…(2)(3)(4) The association between health-related quality of life (HRQoL) and arterial oxygen tension (PaO 2 ) has been shown; however, the effect of LTOT on HRQoL remains unclear. (5)(6)(7)(8)(9) In addition to decreasing patient mobility and damaging social relationships, LTOT can cause disturbing noise, as well as nasal/ ear discomfort associated with the use of nasal tubes. It has also been associated with financial problems related to electricity consumption when concentrators are used.…”

Section: Introductionmentioning

confidence: 99%

“…Since the implementation of the policy of reimbursement for LTOT to some institutions, the number of oxygen cylinders has been declining; however, they are still quite common. (5) The oxygen cylinders used in Brazil weigh 70-78 kg, and supplies of small portable cylinders are uncommon.…”

Section: Introductionmentioning

confidence: 99%

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Influência do sistema de fornecimento de oxigênio na qualidade de vida de pacientes com hipoxemia crônica

et al. 2007

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Objective: To evaluate the health-related quality of life of patients with chronic obstructive pulmonary disease receiving long-term oxygen therapy (LTOT) at home through oxygen cylinders and compare these results with those obtained six months after the transition from oxygen cylinders to oxygen concentrators. Methods: A total of 45 patients were evaluated. Of those, 24 had chronic hypoxemia and 21 presented no evidence of hypoxemia. The patients with chronic hypoxemia had been regularly receiving LTOT for at least the last six months and were evaluated at baseline, while using cylinders, and six months after the transition from cylinders to concentrators. The non-hypoxemic patients were evaluated at the same time points as were the hypoxemic patients. In order to evaluate quality of life, a version of the Saint George's Respiratory Questionnaire (SGRQ), translated and validated for use in Brazil, was administered. Results: At baseline, quality of life, as evaluated using the total score and the symptom and impact domain scores of the SGRQ, was more impaired in the hypoxemic patients than in the non-hypoxemic patients. After six months of using the concentrators, the hypoxemic patients presented a significant improvement in the quality of life, and, at that time, no difference was found between the patients with and without hypoxemia. Conclusion: Our findings show that quality of life is impaired in patients with chronic obstructive pulmonary disease and chronic hypoxemia, that their quality of life can be improved through regular use of LTOT, and that the oxygen delivery system has an influence on this improvement.Keywords: Pulmonary disease, Chronic obstructive; Anoxemia; Oxygen inhalation therapy; Quality of life. ResumoObjetivo: Avaliar a qualidade de vida relacionada à saúde de pacientes com doença obstrutiva crônica das vias aéreas recebendo oxigenoretapia domiciliar prolongada (ODP) por meio de cilindros de oxigênio e comparar estes resultados com os obtidos após seis meses de modificação do sistema de fornecimento para concentradores de oxigênio. Métodos: Um total de 45 pacientes, 24 com hipoxemia crônica e 21 sem evidências de hipoxemia, foram avaliados. Os pacientes com hipoxemia crônica estavam recebendo ODP regularmente durante pelo menos os últimos seis meses e foram avaliados no momento basal, em uso de cilindro, e após seis meses de transição para concentradores. Os pacientes não hipoxêmicos foram avaliados no mesmo intervalo de tempo que os pacientes hipoxêmicos. Para avaliar a qualidade de vida foi utilizada a versão validada para língua portuguesa (Brasil) do Questionário Respiratório Saint George (Saint George's Respiratory Questionnaire -SGRQ). Resultados: No momento inicial, os pacientes hipoxêmicos apresentaram maior comprometimento da qualidade de vida, avaliada pelo escore total e pelos escores dos domínios sintomas e impacto do SGRQ, que os pacientes não hipoxêmicos. Após seis meses, houve melhora significativa da qualidade de vida dos pacientes hipoxêmicos e, neste momento, não...

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Influência do sistema de fornecimento de oxigênio na qualidade de vida de pacientes com hipoxemia crônica

et al. 2007

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Oxygen therapy during exercise training in chronic obstructive pulmonary disease

Nonoyama

Brooks

Lacasse

et al. 2007

Cochrane Database of Systematic Reviews

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Advanced Lung Disease: Quality of Life and Role of Palliative Care

Gilbert

Smith

2009

Mount Sinai J Medicine

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Advanced restrictive lung diseases remain a challenge for both the clinician and patient alike. Because there are few available treatment options that prolong survival for patients with diseases such as idiopathic pulmonary fibrosis, improvement in quality of life and palliation of significant symptoms become realistic treatment goals. Several validated instruments that assess quality of life and health-related quality of life have demonstrated the dramatic impact that lung disease has on patients. Quality-of-life assessments of patients with interstitial lung disease have commonly cited respiratory complaints as problematic, but other distressing symptoms often not addressed include fear, social isolation, anxiety, and depression. Not only do respiratory symptoms limit this patient population, but the awareness of decreased independence and ability for social participation also has an impact on the quality of life. Some patients describe a deepened spiritual well-being during their disease process; however, many patients' mental health suffers with experiences of fear, worry, anxiety, and panic. Many patients express desire for more attention to end-of-life issues from their physicians. Fears of worsening symptoms and suffocation exist with an expressed desire by most to die peacefully with symptom control. Interventions to improve quality of life are largely directed at symptom control. Pharmacologic and nonpharmacologic interventions have been helpful in relieving dyspnea. Studies have demonstrated that the use of supplemental oxygen in the face of advancing hypoxemia can have both positive and negative effects on quality of life. Patients using nasal prongs describe feelings of self-consciousness, embarrassment, and social withdrawal. Pulmonary rehabilitation is recommended, with some studies noting increased quality-of-life scores and decreased sensations of dyspnea. Sleep deprivation and poor sleep quality also have a negative impact on quality of life. Recognition and correction of nocturnal hypoxemia and other sleep disturbances should enhance quality of life in patients with restrictive lung disease; however, there is currently no evidence to support this claim. End-of-life care needs more attention by clinicians in the decision-making and preparatory phase. Physicians need to maintain their focus on quality-of-life issues as medical management shifts from curative therapies to comfort management therapies. Palliative care and hospice appear to be underused in patients with advanced diseases other than cancer. Because the only curative option for some end-stage restrictive lung diseases is lung transplantation, if transplantation is not an option, palliation of symptoms and hospice care may offer patients and families the opportunity to die with dignity and comfort.

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Evaluation of Health-Related Quality of Life in Low-Income Patients With COPD Receiving Long-term Oxygen Therapy

Cited by 51 publications

References 31 publications

Influência do sistema de fornecimento de oxigênio na qualidade de vida de pacientes com hipoxemia crônica

Influência do sistema de fornecimento de oxigênio na qualidade de vida de pacientes com hipoxemia crônica

Oxygen therapy during exercise training in chronic obstructive pulmonary disease

Advanced Lung Disease: Quality of Life and Role of Palliative Care

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