Impact of Clinical Factors on Generic and Disease-Specific Quality of Life in COPD and Asthma-COPD Overlap with Exacerbations

Purpose. The health-related quality of life (HRQL) in chronic obstructive pulmonary disease (COPD) is worsened by frequent exacerbations, and it can be affected by the concomitant presence of bronchial asthma (asthma-COPD overlap (ACO)). The impacts of clinical factors associated with HRQL have not...

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Main Authors: Zsófia Lázár, Alpár Horváth, Gábor Tomisa, Lilla Tamási, Veronika Müller
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Pulmonary Medicine
Online Access:http://dx.doi.org/10.1155/2020/6164343
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author Zsófia Lázár
Alpár Horváth
Gábor Tomisa
Lilla Tamási
Veronika Müller
author_facet Zsófia Lázár
Alpár Horváth
Gábor Tomisa
Lilla Tamási
Veronika Müller
author_sort Zsófia Lázár
collection DOAJ
description Purpose. The health-related quality of life (HRQL) in chronic obstructive pulmonary disease (COPD) is worsened by frequent exacerbations, and it can be affected by the concomitant presence of bronchial asthma (asthma-COPD overlap (ACO)). The impacts of clinical factors associated with HRQL have not been compared in patients with COPD and ACO experiencing exacerbations. Patients and Methods. Patients with COPD (N =705) and ACO (N =148) belonging to C and D groups according to GOLD 2017 were recruited in stable condition. Demographic and clinical data were collected, spirometry was performed, and patients rated the intensity of respiratory symptoms during the previous week. The COPD Assessment Test (CAT) and the EQ-5D 3 level version (dimensions and visual analogue scale (VAS)) were used to assess disease-specific and generic HRQL, respectively. Fisher’s exact test, χ2 test, ANOVA, and Pearson correlation were used for analysis (mean±SD). Multiple linear regression was applied to identify variables related to CAT and EQ-5D VAS scores. Results. The CAT and EQ-5D VAS scores showed similarly low HRQL in COPD and ACO (20.7±6.7 vs. 21.1±6.3 (p=0.52) and 56.2±17.8 vs. 53.7±18.2 (p=0.11)). There was a weak correlation between CAT and EQ-5D VAS scores (COPD: r=−0.345, p<0.001; ACO: r=−0.245, p=0.003). More patients with COPD had problems related to anxiety/depression in EQ-5D (63.7% vs. 55.4%, p=0.06). Pack-years exerted a negative effect on HRQL measures both in ACO and COPD. Low HRQL in COPD was associated with female gender, dyspnea, cough, gastroesophageal reflux disease, and arrhythmia, while in ACO, it was related to arrhythmia, hypertension, and cough, but less to dyspnea. Conclusions. Patients with COPD and ACO experiencing exacerbations have low quality of life, which is influenced by smoking history, symptoms, and comorbidities. These findings have important implications for the development of therapeutic strategies to improve the health status of patients with these conditions.
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spelling doaj-art-5afbd4446fd34ceeabba4eb66023d8792025-02-03T01:03:59ZengWileyPulmonary Medicine2090-18362090-18442020-01-01202010.1155/2020/61643436164343Impact of Clinical Factors on Generic and Disease-Specific Quality of Life in COPD and Asthma-COPD Overlap with ExacerbationsZsófia Lázár0Alpár Horváth1Gábor Tomisa2Lilla Tamási3Veronika Müller4Dept. Pulmonology, Semmelweis University, 25-29 Tömő Str. 1083 Budapest, HungaryDept. Pulmonology, Semmelweis University, 25-29 Tömő Str. 1083 Budapest, HungaryDept. Pulmonology, Semmelweis University, 25-29 Tömő Str. 1083 Budapest, HungaryDept. Pulmonology, Semmelweis University, 25-29 Tömő Str. 1083 Budapest, HungaryDept. Pulmonology, Semmelweis University, 25-29 Tömő Str. 1083 Budapest, HungaryPurpose. The health-related quality of life (HRQL) in chronic obstructive pulmonary disease (COPD) is worsened by frequent exacerbations, and it can be affected by the concomitant presence of bronchial asthma (asthma-COPD overlap (ACO)). The impacts of clinical factors associated with HRQL have not been compared in patients with COPD and ACO experiencing exacerbations. Patients and Methods. Patients with COPD (N =705) and ACO (N =148) belonging to C and D groups according to GOLD 2017 were recruited in stable condition. Demographic and clinical data were collected, spirometry was performed, and patients rated the intensity of respiratory symptoms during the previous week. The COPD Assessment Test (CAT) and the EQ-5D 3 level version (dimensions and visual analogue scale (VAS)) were used to assess disease-specific and generic HRQL, respectively. Fisher’s exact test, χ2 test, ANOVA, and Pearson correlation were used for analysis (mean±SD). Multiple linear regression was applied to identify variables related to CAT and EQ-5D VAS scores. Results. The CAT and EQ-5D VAS scores showed similarly low HRQL in COPD and ACO (20.7±6.7 vs. 21.1±6.3 (p=0.52) and 56.2±17.8 vs. 53.7±18.2 (p=0.11)). There was a weak correlation between CAT and EQ-5D VAS scores (COPD: r=−0.345, p<0.001; ACO: r=−0.245, p=0.003). More patients with COPD had problems related to anxiety/depression in EQ-5D (63.7% vs. 55.4%, p=0.06). Pack-years exerted a negative effect on HRQL measures both in ACO and COPD. Low HRQL in COPD was associated with female gender, dyspnea, cough, gastroesophageal reflux disease, and arrhythmia, while in ACO, it was related to arrhythmia, hypertension, and cough, but less to dyspnea. Conclusions. Patients with COPD and ACO experiencing exacerbations have low quality of life, which is influenced by smoking history, symptoms, and comorbidities. These findings have important implications for the development of therapeutic strategies to improve the health status of patients with these conditions.http://dx.doi.org/10.1155/2020/6164343
spellingShingle Zsófia Lázár
Alpár Horváth
Gábor Tomisa
Lilla Tamási
Veronika Müller
Impact of Clinical Factors on Generic and Disease-Specific Quality of Life in COPD and Asthma-COPD Overlap with Exacerbations
Pulmonary Medicine
title Impact of Clinical Factors on Generic and Disease-Specific Quality of Life in COPD and Asthma-COPD Overlap with Exacerbations
title_full Impact of Clinical Factors on Generic and Disease-Specific Quality of Life in COPD and Asthma-COPD Overlap with Exacerbations
title_fullStr Impact of Clinical Factors on Generic and Disease-Specific Quality of Life in COPD and Asthma-COPD Overlap with Exacerbations
title_full_unstemmed Impact of Clinical Factors on Generic and Disease-Specific Quality of Life in COPD and Asthma-COPD Overlap with Exacerbations
title_short Impact of Clinical Factors on Generic and Disease-Specific Quality of Life in COPD and Asthma-COPD Overlap with Exacerbations
title_sort impact of clinical factors on generic and disease specific quality of life in copd and asthma copd overlap with exacerbations
url http://dx.doi.org/10.1155/2020/6164343
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