Abstract
Background:Improvement in health-related quality of life (HRQoL) is one of the main goals in treating chronic obstructive pulmonary disease (COPD). Impaired HRQoL in COPD is associated with increased morbidity and mortality, hospitalisations and burden on our health-care system. The Clinical COPD Questionnaire (CCQ) is a validated, reliable, short questionnaire for the evaluation of disease-specific HRQoL in patients with COPD in primary care.Aims:To investigate factors that might be associated with CCQ outcome in COPD in a primary care setting.Methods:In a population of COPD patients in primary care, multiple regression analyses were used to assess associations between CCQ outcome and depression, heart failure, FEV1% predicted, FEV1/FVC, age, sex, body mass index and current smoking.Results:Data from 341 patients (mean age 68.1±10.3, COPD GOLD class I–III) were used for analyses. Together, heart failure and depression explained 23% of the variance in CCQ total score (P<0.001, N=93). Heart failure was most strongly associated with CCQ functional score (27% explained variance, P<0.001, N=100), whereas depression was most strongly associated with CCQ mental score (22% explained variance, P<0.001, N=93).Conclusions:CCQ outcomes are higher in COPD patients with heart failure and depression. These findings might imply that heart failure and depression affect HRQoL of patients with COPD, and thus emphasise the importance of a holistic approach of this complex disease, leading to a correct diagnosis of COPD and its comorbidities, to achieve better tailored treatment of chronic patients.
Highlights
From a total of 553 patients in the ‘extended care project for chronic obstructive pulmonary disease (COPD)’ database, who were selected as described in the Materials and Methods section, 341 patients were diagnosed with COPD on the basis of respiratory symptoms and spirometry (Figure 1)
We found that heart failure and depression were associated with Clinical COPD Questionnaire (CCQ) scores
We found that heart failure and depression were associated with CCQ outcome
Summary
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide, and is estimated to become the third most common cause of death in 2020.1,2 Since healthrelated quality of life (HRQoL) is impaired in COPD, one of the main goals in COPD treatment is improving it.[2,3,4,5,6,7] Impaired HRQoL has been shown to be associated with increased morbidity, mortality,[8] hospitalisations[9] and health-care consumption.[10,11,12,13,14,15]These associations are independent of the level of airway obstruction measured by spirometry.[11,14] spirometry has been regarded as the standard method for grading COPD severity, patient-reported outcomes should be used to provide information about the effect of COPD on patients’ daily life.[2,16] COPD treatment effects can be measured by disease-specific HRQoL questionnaires.[7,16]The Clinical COPD Questionnaire (CCQ) is a validated, reliable, short questionnaire for the evaluation of disease specific HRQoL in patients with COPD.[17]. Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide, and is estimated to become the third most common cause of death in 2020.1,2 Since healthrelated quality of life (HRQoL) is impaired in COPD, one of the main goals in COPD treatment is improving it.[2,3,4,5,6,7] Impaired HRQoL has been shown to be associated with increased morbidity, mortality,[8] hospitalisations[9] and health-care consumption.[10,11,12,13,14,15]. These findings might imply that heart failure and depression affect HRQoL of patients with COPD, and emphasise the importance of a holistic approach of this complex disease, leading to a correct diagnosis of COPD and its comorbidities, to achieve better tailored treatment of chronic patients
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