Moderate and severe exacerbations have a significant impact on health-related quality of life, utility, and lung function in patients with chronic obstructive pulmonary disease: A meta-analysis

Guo, Jiangzhou; Chen, Yaping; Zhang, Weidong; Tong, Shuai; Dong, Jige

doi:10.1016/j.ijsu.2020.04.010

Cited by 23 publications

(18 citation statements)

References 25 publications

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“… 53 Countering this, exacerbations were also postulated to have a negative impact on FEV 1 . 21 All in all, the relationship between FEV 1 and exacerbations has been shown to be mostly consistent, but exceptions also exist 54 and, for example, not all exacerbations inevitably lead to a decline in FEV 1. 55 As exacerbations and FEV 1 appear to be connected, further research with a larger sample size could allow analysis of the combined interactional change in both clinical factors on HRQoL change.…”

Section: Discussionmentioning

confidence: 99%

“…For this subgroup, a MID reduction in disease-specific quality of life can be counteracted if one or more severe exacerbations can be prevented. Guo et al 21 also recently stressed a need for effective prevention as exacerbations do have a sustainable and lasting impact on HRQoL. In the literature, lower mMRC, fewer exacerbations in history, and FEV 1 decrease were shown to affect exacerbation risk.…”

Section: Discussionmentioning

confidence: 99%

“…[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.…”

Section: Introductionmentioning

confidence: 99%

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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

Stöber

Lutter

Schwarzkopf

et al. 2021

COPD

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Purpose Real-world evidence on the impact of forced expiratory volume in one second (FEV 1 ) and exacerbations on health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD) is sparse especially with regard to GOLD ABCD groups. This study investigates how changes in FEV 1 and exacerbations affect generic and disease-specific HRQoL in COPD patients over one year. Methods Using German claims data and survey data, we classified 3016 COPD patients and analyzed their health status by GOLD groups AB and CD. HRQoL was measured with the disease-specific COPD assessment test (CAT) and the visual analog scale (VAS) from the generic Euro-Qol 5D-5L. We applied change score models to assess associations between changes in FEV 1 (≥100 mL decrease/no change/≥100 mL increase) or the development of severe exacerbations with change in HRQoL. Results FEV 1 decrease was associated with a significant but not minimal important difference (MID) deterioration in disease-specific HRQoL (mean change [95% CI]: CAT +0.74 [0.15 to 1.33]), while no significant change was observed in the generic VAS. Experiencing at least one severe exacerbation also had a significant impact on CAT deterioration (+1.58 [0.52 to 2.64]), but again not on VAS. Here, GOLD groups AB showed not only a statistically but also a clinically relevant MID deterioration in CAT (+2.1 [0.88 to 3.32]). These particular patient groups were further characterized by a higher probability of being male, having a higher mMRC and Charlson index, and a lower probability of having higher FEV 1 or BMI values. Conclusion FEV 1 decline and the occurrence of ≥1 severe exacerbation are significantly associated with overall deterioration in disease-specific HRQoL. Preventing severe exacerbations particularly in patients without previous severe exacerbations (ABCD groups A and B) may help to stabilize the key patient-reported outcome HRQoL.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

Stöber

Lutter

Schwarzkopf

et al. 2021

COPD

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“…In particular, the affected population of COPD is mainly elderly people, which are typically poor in education and financial situation with few knowledge about COPD. In some cases, patients prefer to tolerate the symptoms of COPD rather than seek for medical treatment, which results in a relatively long treatment compliance and affect the overall treatment effect (8,9). COPD causes irreversible lung injury, progressive pulmonary dysfunction, and progressive airflow limitation.…”

Section: Discussionmentioning

confidence: 99%

Effect of a two-way quality feedback nursing model on patients with chronic obstructive pulmonary disease

et al. 2020

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Background: In recent years, the incidence of chronic obstructive pulmonary disease (COPD) has been increasing gradually, becoming a relatively intractable public health problem faced by all of society. The corresponding conventional nursing interventions are not effective for the rehabilitation of COPD patients and cannot meet clinical needs. In this study, a new nursing model, a two-way quality feedback nursing model, was applied for the treatment of COPD patients.Methods: This retrospective study included 120 moderate COPD patients admitted to our hospital between January 2018 and December 2018, and the patients were equally divided into the experimental group (n=60) and the control group (n=60) according to the nursing strategy received by patients. The control group received routine nursing care, the two-way quality feedback nursing model was applied in the experimental group, and the nursing effects in the two groups were compared. Results:The patient compliance of the experimental group to nursing care was 91.67%, that of the control group was 78.33% (P<0.05), and the scores for social relationship, environmental impact, psychological condition, and physiological condition of quality of life (QoL) in the experimental group at discharge were higher than those in the control group (P<0.05). Conclusions:The application of the two-way quality feedback nursing model in COPD patients could improve patient compliance and significantly improve the QoL of patients, with good application value.

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“…Whilst lung function is only moderately correlated with respiratory symptoms, these findings do suggest the potential for respiratory symptoms to impact on clinical outcomes, in addition to the strong associations with depressive symptoms and quality of life seen in our study. Although respiratory symptoms have been reported to have an impact on quality of life in the general population [33,34], there are few published data on their associations with mental health outcomes in PWH. Although a negative impact of respiratory symptoms on mental health would be hypothesized, we cannot rule out the possibility that poor mental health may result in behaviours (e.g.…”

Section: Discussionmentioning

confidence: 99%

Respiratory symptoms and chronic bronchitis in people with and without HIV infection

Sabin¹,

Kunisaki

Bagkeris³

et al. 2020

HIV Medicine

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High rates of respiratory symptoms and chronic bronchitis (CB) are reported in people with HIV infection (PWH). We investigated the prevalence of respiratory symptoms and CB in PWH and HIV-negative people in the Pharmacokinetic and clinical Observations in PeoPle over fiftY (POPPY) study. Methods Assessment of respiratory symptoms and CB was undertaken using the modified form of the St. George's Respiratory Questionnaire for chronic obstructive pulmonary disease (COPD). Univariate (v 2 tests, Mann-Whitney U tests and Spearman's rank correlation) and multivariable (linear and logistic regression) analyses were performed to consider associations of respiratory symptoms with demographic, lifestyle and HIV-related parameters, and with depressive symptoms and quality of life. Results Among the 619 participants, respiratory Symptom scores were higher in older and younger PWH compared to older HIV-negative people, with median (interquartile range) scores of 17.7 (6.2, 39.5), 17.5 (0.9, 30.0) and 9.0 (0.9, 17.5), respectively (P = 0.0001); these differences remained significant after confounder adjustment. Sixty-three participants (10.2%) met the criteria for CB [44 (14.0%) older PWH, 14 (9.2%) younger PWH, and five (3.3%) older HIV-negative people; P = 0.002], with these differences also remaining after adjustment for confounding variables, particularly smoking status [older vs. younger PWH: odds ratio (OR) 4.48 (95% confidence interval (CI) 1.64, 12.30); P = 0.004; older PWH vs. HIV-negative people: OR 4.53 (95% CI 1.12, 18.28); P = 0.03]. Respiratory symptoms and CB were both associated with greater depressive symptom scores and poorer quality of life. No strong associations were reported between CB and immune function, HIV RNA or previous diagnosis of any AIDS event. Conclusions Respiratory symptoms and CB are more common in PWH than in demographically and lifestylesimilar HIV-negative people and are associated with poorer mental health and quality of life.

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Moderate and severe exacerbations have a significant impact on health-related quality of life, utility, and lung function in patients with chronic obstructive pulmonary disease: A meta-analysis

Cited by 23 publications

References 25 publications

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

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

Effect of a two-way quality feedback nursing model on patients with chronic obstructive pulmonary disease

Respiratory symptoms and chronic bronchitis in people with and without HIV infection

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