Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 13, 247-256
eCollection

Independent Determinants of Disease-Related Quality of Life in COPD - Scope for Nonpharmacologic Interventions?

Affiliations

Independent Determinants of Disease-Related Quality of Life in COPD - Scope for Nonpharmacologic Interventions?

Sarah B Brien et al. Int J Chron Obstruct Pulmon Dis.

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.

Keywords: breathlessness; chronic obstructive pulmonary disease; depression; dysfunctional breathing; health status; illness perception; psychological; quality of life; survey.

Conflict of interest statement

Disclosure MT declares personal fees from GSK, Novartis, BI, and Aerocrine, outside the submitted work. The authors report no other conflicts of interest in this work.

Similar articles

See all similar articles

Cited by 2 PubMed Central articles

References

    1. Global Initiative for Chronic Obstructive Lung Disease (GOLD) Global Strategy for the Diagnosis, Management and Prevention of COPD. [Accessed April 25, 2017]. p. 2017. Available from: http://goldcopd.org/gold-2017-global-strategy-diagnosis-management-prevention-copd/
    1. Jones PW. Health status measurement in chronic obstructive pulmonary disease. Thorax. 2001;56(11):880–887. - PMC - PubMed
    1. Tsiligianni I, Kocks J, Tzanakis N, Siafakas N, van der Molen T. Factors that influence disease-specific quality of life or health status in patients with COPD: a systematic review and meta-analysis of Pearson correlations. Prim Care Respir J. 2011;20(3):257–268. - PMC - PubMed
    1. Kunik ME, Roundy K, Veazey C, et al. Surprisingly high prevalence of anxiety and depression in chronic breathing disorders. Chest. 2005;127(4):1205–1211. - PubMed
    1. Cleland JA, Lee AJ, Hall S. Associations of depression and anxiety with gender, age, health-related quality of life and symptoms in primary care COPD patients. Fam Pract. 2007;24(3):217–223. - PubMed

MeSH terms

Feedback