Health-related quality of life in patients under long-term oxygen therapy: a home-based descriptive study

Abstract

Long-term home oxygen therapy (LTOT) improves survival of hypoxic patients with chronic respiratory insufficiency. However, the health-related quality of life (HRQL) of these patients, when LTOT is initiated, is severely impaired. The present study aims to describe the health-related quality of life (HRQL) of patients under LTOT, assessed at home, to identify parameters relevant to HRQL, and to describe changes over a 1-yr period. Seventy-nine patients (aged 68 +/- 11 years, under LTOT for 34 +/- 24 months) underwent pulmonary function testing, measurement of average daily distance walked, SaO2, dyspnoea scores (Borg scale and oxygen-cost diagram), and Hospital Anxiety and Depression scores. After 1 yr, measurements were repeated, and HRQL was measured with the St George Respiratory Questionnaire (SGRQ). Forced expiratory volume in 1 s (FEV1% of predicted) was 36 +/- 19; SaO2 (room air) was 87 +/- 5%, daily distance walked was 1202 +/- 1140 m; 21% suffered from anxiety and 27% from depression. After 1 yr, pulmonary function tests, dyspnoea or prevalence of anxiety or depression were unchanged. Mortality was high (31% 1-yr mortality). Daily distance walked (rho = -0.55, P = 0.01 vs. SGRQ) and number of days spent in hospital (rho = 0.5, P = 0.01 vs. SGRQ) were the parameters with the highest correlation with HRQL scores. Quality of life was poor in these patients, with high rates of emotional disorders. Restoring and maintaining sufficient exercise capacity for everyday life activities through outpatient rehabilitation programmes and support for emotional disturbances should be major goals in the care of these patients.

Repercussões tardias de um programa de reabilitação pulmonar sobre os índices de ansiedade, depressão, qualidade de vida e desempenho físico em portadores de DPOC

“…Variations in the levels of anxiety in patients with COPD have been reported in 21% to 96% of the cases. (18,19) Half of our patients had depression. Other authors have found rates between 27% and 79%.…”

The Efficiency of Long Term Oxygen Therapy in COPD

“…Janssens and colleagues [28] found an improvement in the quality of life of 79 subjects by the SGRQ they applied at the beginning and end of the first year. In the NOTT study, there was an improvement in the neuropsychological functions and qual-ity of life of the group receiving continuous oxygen treatment; however quality of life was not evaluated by the SGRQ [4].…”

Relationship of muscle strength with activities of daily living and quality of life in individuals with chronic obstructive pulmonary disease

“…Studies have shown that patients present weight loss, and a loss of lean body mass resulting in peripheral muscle dysfunction, decreased muscle strength, exercise tolerance, with a reduction in muscle strength proportional to the reduction in muscle mass (4,5,6), in addition to respiratory muscle weakness (7).…”