J.LAU1, S.LEONG1, H.XU1, H.Y.NEO1
Tan Tock Seng Hospital1
Chronic obstructive pulmonary disease(COPD) is a progressive disease with a high symptom burden. Optimising quality of life(QoL) and reducing exacerbations remains a mainstay of its treatment. We aim to identify variables associated with poor QoL in patients with COPD.
A multi-centre cross-sectional study. We recruited patients with stable COPD of GOLD classification ≥2 from specialist clinics and a pulmonary rehabilitation service. Data collected include lung functional parameters, disease severity, nutritional status, depression, anxiety and comorbidity burden using validated scores. QoL was assessed using the Chronic Respiratory Questionnaire(CRQ). Pearson correlational analysis was applied to evaluate the association between variables.
Of 136 patients enrolled, 94.9% were men and 80.8% of Chinese ethnicity. The mean age was 71±8.69 years and mean predicted FEV1 of 43±14.8%. Majority(52.2%) had GOLD stage 3 disease and 18.4% at stage 4. Age, body mass index, modified Medical Research Council dyspnoea scale, predicted FEV1, number of exacerbations requiring hospitalisation, serum albumin levels, Charlson Comorbidity Index and level of physical activity, measured by the International Physical Activity Questionnaire, had at best mild correlation with CRQ scores(r<0.3). Anxiety and depression, assessed by the Hospital Anxiety and Depression Scale(HADS), had moderate correlation with CRQ across all domains(r=0.43-0.72) except dyspnoea(r=0.15-0.29). The COPD Assessment Test(CAT) had moderate correlation with all CRQ domains(r=0.37-0.57), and moderate correlation with anxiety(r=0.42) and depression(r=0.44).
Physical activity, disease severity, nutrition and comorbidity poorly correlate with QoL. Conversely, anxiety and depression are strongly associated with poor QoL Further studies are needed to evaluate if treatment targeting these would improve patients’ outcomes.