Quality of life of patients with asthma and COPD in general practice

Abstract

Objectives: To investigate impairments in Quality of Life (QoL), and their determinants, in patients with mild to moderate asthma and chronic obstructive pul-monary disease (COPD) under treatment in general practice.Methods: In a cross-sectional study, 340 adult patients with asthma and COPD completed a self-administered questionnaire containing a generic (COOP-WONCA charts) and a disease-specific (QOL-RIQ) instrument, both especially developed for measuring QoL in primary care. Symptoms, exacerbations, medication use, FEV1, and comorbidity were also measured.Results: For both COOP-WONCA charts and QOL-RIQ: two-thirds of the patients reported some impairment; about 10% of these patients reported moderate to severe impairment. For the five COOP-WONCA charts the relationships between QoL scores and clinical characteristics ranged from r2=0.24 (physical fitness) to r2=0.12 (social activities). For the total QOL-RIQ score the variance (r2=0.31) was mostly explained by disease-related characteristics, especially the degree of dyspnoea. Patients with more impairment on the COOP-WONCA charts or the QOL-RIQ are characterised as more frequently having comorbidity, a diagnosis of COPD and exacerbations, chronic cough and/or production of phlegm, and more severe dyspnoea. However, a large group of patients remain who have more impairment without having these characteristics.Discussion: The majority of these patients reported impairment of their QoL, although this impairment was only minor for both the generic COOP-WONCA charts and for the disease-specific QOL-RIQ. Most of the variation in QoL is determined by factors other than those considered relevant for treatment and follow-up. Of the known factors, dyspnoea is most related with impaired QoL. For these patients, the general practitioner should focus on minimising dyspnoea to ensure optimal QoL.