MedWire News: Multiple unreported chronic obstructive pulmonary disease (COPD) exacerbations have a significant negative effect on patients’ health-related quality of life (HRQoL), study results show.
Writing in the European Respiratory Journal, J Bourbeau (McGill University, Montréal, Québec, Canada) and colleagues explain that unreported, and therefore untreated, exacerbations are common in COPD patients, and are associated with reduced short-term HRQoL.
But they add that “the intermediate to long-term effects of unreported exacerbations on HRQoL have not been studied.”
To investigate, Bourbeau and team studied 491 stable COPD patients in China who were followed-up for 1 year. The patients were aged at least 30 years, had a post-bronchodilator FEV1/forced vital capacity ratio of less than 0.7, and a FEV1 of less than 80% of predicted.
All the participants completed the St George’s Respiratory Questionnaire (SGRQ) at baseline and at the end of the study to evaluate any changes in HRQoL.
In total, 466 unreported and 410 reported exacerbations, defined as the worsening of at least one symptom for at least 48 hours, occurred during follow-up.
Analysis revealed that patients who experienced only one unreported exacerbation during the study period had an adjusted mean increase of just 1.22 points on the SGRQ after 1 year compared with patients who did not experience any exacerbations, indicating comparable HRQoL between these two groups.
However, patients who suffered at least two unreported exacerbations had an adjusted mean increase of 4.61 points on the SGRQ after 1 year compared with those who did not experience any exacerbations, indicating significantly reduced HRQoL in the former group.
Bourbeau and team conclude: “Unreported exacerbations, although associated with fewer symptoms worsening than reported exacerbations, have a non-negligible negative impact on the change of HRQoL at 1 year.”
They add: “Development and evaluation of self-management programs emphasizing early recognition of exacerbations and consequent action appear to be warranted.”
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