Independent determinants of disease-related quality of life in COPD – scope for nonpharmacologic interventions?
Sarah B Brien, Beth Stuart, Andrew P Dickens, et al.
Int J Chron Obstruct Pulmon Dis 2018;13:247–56.
Understanding key features that impair quality of life (QoL) in chronic obstructive pulmonary disease (COPD) patients may provide insight into potentially modifiable factors that could be targeted to reduce the effect of disease and aid patients’ long-term management. Often, the QoL scores indicated in COPD patients have weak correlations with its physiologic factors, making this difficult to achieve. In this cross-sectional study, Sarah B Brien, from the University of Southampton, and her colleagues analyse data from the Birmingham COPD cohort study to investigate factors independently associated with impaired QoL in patients with COPD. Several factors were highlighted as having a significant association with the COPD Assessment Test (CAT) scores, including but not limited to depression, illness perception and exercise capacity. By conducting a dominance analysis, breathlessness (20.2%) and illness perception (19.8%) were highlighted as the largest contributors to patient CAT scores, followed by dysfunctional breathing symptoms (17.5%) and depression (12.5%). Other variables contributed ≥5% to these CAT scores. The authors concluded that psychological factors are some of the main contributors to QoL impairment in patients with COPD. By exploring interventions targeted towards these main contributors, we can hope to improve QoL in COPD patients and improve their experience