EuroQoL in assessment of the effect of pulmonary rehabilitation COPD patients

Respir Med. 2008 Nov;102(11):1563-7. doi: 10.1016/j.rmed.2008.06.016. Epub 2008 Aug 9.


Background: The effect of pulmonary rehabilitation on EuroQol in COPD patients has not been investigated previously.

Methods/materials: Two hundred and twenty nine consecutive COPD patients who had completed a 7-week pulmonary rehabilitation programme were assessed with EuroQol five-dimension questionnaire (EQ-5D), endurance shuttle walk test (ESWT), and the St George's Respiratory Questionnaire (SGRQ) before and after the programme, and at the 3-month follow-up visit.

Results: Two hundred and two (88.4%) patients had FEV(1)<50% predicted and all but four (1.7%) had dyspnoea score at least 3 on MRC scale. At completion of the programme, statistical significant improvements were seen for ESWT 157.3s; p<0.001, EQ-5D utility score -0.019; p=0.03, EQ-5D VAS -2.1; p=0.056, SGRQ total score -2.8 units; p<0.001. The effects of rehabilitation on ESWT and SGRQ were maintained at 3-month follow-up (158.9s and -2.9 units), while the effect on EQ-5 utility decreased (0.013; p=0.18). At baseline, there was a maximum score ("ceiling effect") for EQ-5D utility and EQ VAS in 29 (12.7%) and five (2.2%) of the patients, respectively. After rehabilitation these number increased to 41 (17.9%) and seven (3.1%).

Conclusions: In COPD patients receiving rehabilitation, responsiveness of EQ-5D utility was poor. One explanation might be a "ceiling effect" of this instrument.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Exercise Test / methods*
  • Exercise Tolerance / physiology*
  • Female
  • Forced Expiratory Volume / physiology
  • Humans
  • Male
  • Patient Selection
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / psychology
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Quality of Life / psychology*
  • Respiratory Function Tests / methods
  • Severity of Illness Index
  • Surveys and Questionnaires*
  • Walking / physiology*