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Factors determining the quality of life of patients with COPD in primary care

Servicio de Neumología, Institut Clínic del Tòrax (IDIBAPS), Hospital Clínic, Villarroel 170 (UVIR, esc 2, planta 3) 08036 Barceona, marcm{at}clinic.ub.es

Jesús Molina

Grupo de Respiratorio de la Sociedad Madrileña de Medicina de Familia y Comunitaria

Karlos Naberan

Grupo de Investigación del Instituto Aragones Ciencias de la Salud (IACS)

Josep Maria Cots

Societat Catalana de Medicina de Familia i Comunitaria. Facultat de Medicina, Universitat de Barcelona

Fernando Ros

Departamento Médico BayerHealthcare, Barcelona

Carles Llor

Societat Catalana de Medicina de Familia i Comunitaria. Facultat de Medicina, Universitat Rovira i Virgili, Tarragona

Objectives: To describe the health-related quality of life (HRQL) in a cohort of COPD patients recruited in primary care and identify the variables of the patients and the treatment associated with impaired HRQL.

Method: Multicenter, observational study of patients with COPD recruited in Primary Care centers. Data regarding HRQL measured by the St. George's respiratory questionnaire (SGRQ) are presented. The total population was divided into two subgroups, high and Low SGRQ, using the median of the total SGRQ score. Univariate analysis and logistic regression analysis with calculation of adjusted odds ratios were used to investigate the factors significantly associated with a higher SGRQ score (poor HRQL).

Results: A total of 27 investigators included 222 valid patients with a mean age of 68.2 years (SD = 9.9) and a mean FEV1(%) of 49.2% (SD = 15.4%). The median total SGRQ score was 39.5 and patients with a high score had a longer evolution of COPD (p < 0.0001), more severe dyspnea (p < 0.0001) and a worse FEV1(%) (46.3% vs. 51.9%; p = 0.008). Factors independently associated with the total SGRQ score were cough and dyspnea, duration of COPD and treatment with inhaled steroids.

Conclusion: Patients with COPD controlled in primary care demonstrate an important impairment in HRQL, with chronic cough and dyspnea being associated with more impaired HRQL. Strategies aimed at modifying these factors should significantly improve the well-being of COPD patients.

Key Words: COPD • quality of Life • St. George's respiratory questionnaire • exacerbations

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