Independent determinants of disease-related quality of life in COPD – scope for nonpharmacologic interventions?
Independent determinants of disease-related quality of life in COPD – scope for nonpharmacologic interventions?
Purpose: quality-of-life (QoL) scores in chronic obstructive pulmonary disease (COPD) have a weak relationship with physiologic impairment. We investigated factors associated with poor QoL, focusing on psychological measures potentially amenable to intervention.
Patients and methods: we utilized a pre-existing Birmingham (UK) COPD cohort to assess factors associated with QoL impairment (COPD Assessment Test [CAT] scores). Univariate and multivariate regression models were constructed from three categories of variables: demographic, lung function/COPD-related symptoms, and psychosocial/behavioral factors.
Results: analyses were based on self-report questionnaire data from 735 participants. The multivariate model of variables independently associated with 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 physiologic impairment and patients’ experience of their disease. Interventions targeting psychological factors, illness perception, and dysfunctional breathing should be assessed.
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Brien, Sarah B.
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Stuart, Beth
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Dickens, Andrew P.
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Kendrick, Tony
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Jordan, Rachel E.
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Adab, Paymane
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Thomas, Mike
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9 January 2018
Brien, Sarah B.
4e8e97cd-7bc3-4efd-857e-20790040b80f
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Dickens, Andrew P.
012518e5-59d2-4912-98c9-825618e5981e
Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5
Jordan, Rachel E.
1a70964c-42a2-4132-8f79-7485e14e839b
Adab, Paymane
b7a85f2d-7c98-407e-85d3-49d9cacf0851
Thomas, Mike
dca1e679-6576-4c87-8ba1-9b2b54f62c26
Brien, Sarah B., Stuart, Beth, Dickens, Andrew P., Kendrick, Tony, Jordan, Rachel E., Adab, Paymane and Thomas, Mike
(2018)
Independent determinants of disease-related quality of life in COPD – scope for nonpharmacologic interventions?
International Journal of Chronic Obstructive Pulmonary Disease, 13, , [13].
(doi:10.2147/COPD.S152955).
Abstract
Purpose: quality-of-life (QoL) scores in chronic obstructive pulmonary disease (COPD) have a weak relationship with physiologic impairment. We investigated factors associated with poor QoL, focusing on psychological measures potentially amenable to intervention.
Patients and methods: we utilized a pre-existing Birmingham (UK) COPD cohort to assess factors associated with QoL impairment (COPD Assessment Test [CAT] scores). Univariate and multivariate regression models were constructed from three categories of variables: demographic, lung function/COPD-related symptoms, and psychosocial/behavioral factors.
Results: analyses were based on self-report questionnaire data from 735 participants. The multivariate model of variables independently associated with 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 physiologic impairment and patients’ experience of their disease. Interventions targeting psychological factors, illness perception, and dysfunctional breathing should be assessed.
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COPD-152955-independent-determinants-of-disease-related-quality-of-life-_010818
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Accepted/In Press date: 10 November 2017
Published date: 9 January 2018
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Local EPrints ID: 491828
URI: http://eprints.soton.ac.uk/id/eprint/491828
PURE UUID: 559eb1a1-eb9e-46ef-90d2-97eb69b1e906
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Date deposited: 04 Jul 2024 16:53
Last modified: 12 Jul 2024 01:44
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Author:
Andrew P. Dickens
Author:
Rachel E. Jordan
Author:
Paymane Adab
Author:
Mike Thomas
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