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Independent determinants of disease-related quality of life in COPD - scope for non-pharmacological interventions?

Independent determinants of disease-related quality of life in COPD - scope for non-pharmacological interventions?
Independent determinants of disease-related quality of life in COPD - scope for non-pharmacological interventions?

Purpose: Quality of Life (QoL) scores in COPD have a weak relationship with physiological impairment. We investigated factors associated with poor QoL, focusing on psychological measures potentially amenable to intervention.

Patients and methods: We utilised a pre-existing Birmingham (UK) COPD cohort to assess factors associated with QoL impairment (CAT scores). Univariate and multivariate regression models were constructed from three categories of variables: demographic, lung function/COPD-related symptoms, and psychosocial/behavioural factors

Results: Analyses were based on self-report questionnaire data from 735 participants. The multivariate model of variables independently associated with COPD Assessment Test (CAT) included: depression, dysfunctional breathing symptoms (Nijmegen score) and illness perception, in addition to COPD symptoms (wheeze, cough), exercise capacity, breathlessness, exacerbations and deprivation; this model explained 72% of CAT score variation. In a dominance analysis assessing the relative contribution of variables, similar contributions were made by breathlessness (20.2%), illness perception (19.8%), dysfunctional breathing symptoms (17.5%) and depression (12.5%) with other variables contributing < 5%.

 Conclusion: Psychological factors significantly contribute to disease-specific QoL impairment in COPD, and potentially explain the mismatch between objective physiological impairment and patients’ experience of their disease. Interventions targeting psychological factors, illness perception and dysfunctional breathing should be assessed.

1176-9106
247-256
Brien, Sarah B.
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Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Dickens, Andrew P.
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Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5
Jordan, Rachel E.
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Adab, Peymane
2f1ad47b-19bb-4b1d-a2d7-67193a2cf28f
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Brien, Sarah B.
4e8e97cd-7bc3-4efd-857e-20790040b80f
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Dickens, Andrew P.
4d4f4e0f-ec12-4671-82b7-078273250efc
Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5
Jordan, Rachel E.
811f2226-ee6f-4d19-86aa-0155519e0072
Adab, Peymane
2f1ad47b-19bb-4b1d-a2d7-67193a2cf28f
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953

Brien, Sarah B., Stuart, Beth, Dickens, Andrew P., Kendrick, Tony, Jordan, Rachel E., Adab, Peymane and Thomas, Mike (2018) Independent determinants of disease-related quality of life in COPD - scope for non-pharmacological interventions? International Journal of Chronic Obstructive Pulmonary Disease, 247-256. (doi:10.2147/COPD.S152955).

Record type: Article

Abstract

Purpose: Quality of Life (QoL) scores in COPD have a weak relationship with physiological impairment. We investigated factors associated with poor QoL, focusing on psychological measures potentially amenable to intervention.

Patients and methods: We utilised a pre-existing Birmingham (UK) COPD cohort to assess factors associated with QoL impairment (CAT scores). Univariate and multivariate regression models were constructed from three categories of variables: demographic, lung function/COPD-related symptoms, and psychosocial/behavioural factors

Results: Analyses were based on self-report questionnaire data from 735 participants. The multivariate model of variables independently associated with COPD Assessment Test (CAT) included: depression, dysfunctional breathing symptoms (Nijmegen score) and illness perception, in addition to COPD symptoms (wheeze, cough), exercise capacity, breathlessness, exacerbations and deprivation; this model explained 72% of CAT score variation. In a dominance analysis assessing the relative contribution of variables, similar contributions were made by breathlessness (20.2%), illness perception (19.8%), dysfunctional breathing symptoms (17.5%) and depression (12.5%) with other variables contributing < 5%.

 Conclusion: Psychological factors significantly contribute to disease-specific QoL impairment in COPD, and potentially explain the mismatch between objective physiological impairment and patients’ experience of their disease. Interventions targeting psychological factors, illness perception and dysfunctional breathing should be assessed.

Text
Brien COPD survey final for submission amended - Accepted Manuscript
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Accepted/In Press date: 10 November 2017
e-pub ahead of print date: 9 January 2018

Identifiers

Local EPrints ID: 416230
URI: http://eprints.soton.ac.uk/id/eprint/416230
ISSN: 1176-9106
PURE UUID: 7bfe415a-74aa-4b4c-86a9-2eaf163b3ea8
ORCID for Sarah B. Brien: ORCID iD orcid.org/0000-0003-1120-2364
ORCID for Beth Stuart: ORCID iD orcid.org/0000-0001-5432-7437
ORCID for Tony Kendrick: ORCID iD orcid.org/0000-0003-1618-9381

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Date deposited: 08 Dec 2017 17:30
Last modified: 16 Mar 2024 06:00

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Contributors

Author: Sarah B. Brien ORCID iD
Author: Beth Stuart ORCID iD
Author: Andrew P. Dickens
Author: Tony Kendrick ORCID iD
Author: Rachel E. Jordan
Author: Peymane Adab
Author: Mike Thomas

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