Confounders Effecting Quality of Life of COPD Patients in European Union: A Systematic Review

Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a respiratory disease characterized by restriction in expiratory airflow. It is among one of the major causes of illness and death globally. COPD causes severe negative effects on physical and mental health. It has a drastic effect upon the health-related quality of life of patients. Numerous factors contribute towards morbidity of COPD that include smoking, obesity, air pollutants and comorbid conditions (cardiovascular diseases, diabetes mellitus, arterial hypertension, infections). Aims and Objectives: The current systematic review was conducted with the aim to determine the health-related quality of life of COPD patients as well as the confounders of quality of life. Methodology: A systematic review was conducted of 22 studies. The electronic databases used to search the articles were Pubmed, Scopus, Science Direct, ProQuest, Web of Science. Total 1880 studies were found, out of which only 22 studies met the inclusion criteria. All the studies included are within 2017-2022. Patients met inclusion criteria have less than 70% FEV1/FVC ratio and diagnosis of patients was according to the GOLD staging system. Majority study design were observational, some were cross sectional, experimental and randomized clinical trials. Mean age of patients observed was 40-85 years. To assess the quality of life of COPD patient specific questionnaires has been used like SGRQ, CAT, CCQ, EQ-5D-5L. Results: Included studies shows that the quality of life of COPD is compromised physically as well as mentally. It is due to less physical activities, smoking habits, psychological issues, comorbidities like diabetes mellitus, cardiovascular diseases, arterial hypertension. Conclusion: All the studies concluded that COPD patients diagnosed on basis of GOLD criteria and their quality of life is assessed via disease specific questionnaires that majorly includes SGRQ, CAT, CCQ, EQ-5D-5L. And it shows that quality of life of COPD decreases overall. However, the major confounders of reduced quality of life in COPD patients were: Smoking, raised BMI, high cholesterol, Depression/ anxiety, traffic related air pollutants, malnutrition and co-morbid conditions such as hypertension, asthma, anemia and diabetes mellitus.