Health-related quality of life associates with change in FEV1 in COPD: results from the COSYCONET cohort View Full Text


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Article Info

DATE

2020-05-29

AUTHORS

Johanna I. Lutter, Rudolf A. Jörres, Kathrin Kahnert, Larissa Schwarzkopf, Michael Studnicka, Stefan Karrasch, Holger Schulz, Claus F. Vogelmeier, Rolf Holle

ABSTRACT

BackgroundForced expiratory volume in one second (FEV1) characterizes the pathophysiology of COPD and different trajectories of FEV1 decline have been observed in patients with COPD (e.g. gradual or episodic). There is limited information about the development of patient-reported health-related quality of life (HRQL) over the full range of the natural history of COPD. We examined the longitudinal association between change in FEV1 and change in disease-specific and generic HRQL.MethodsWe analysed data of 1734 patients with COPD participating in the COSYCONET cohort with up to 3 years of follow-up. Patients completed the Saint George’s Respiratory Questionnaire (SGRQ) and the EQ-5D Visual Analog Scale (EQ VAS). Change score models were used to investigate the relationship between HRQL and FEV1 and to calculate mean changes in HRQL per FEV1 change categories [decrease (≤ − 100 ml), no change, increase (≥ 100 ml)] after 3 years. Applying hierarchical linear models (HLM), we estimated the cross-sectional between-subject difference and the longitudinal within-subject change of HRQL as related to a FEV1 difference or change.ResultsWe observed a statistically significant deterioration in SGRQ (total score + 1.3 units) after 3 years, which was completely driven by the activity component (+ 4 units). No significant change was found for the generic EQ VAS. Over the same period, 58% of patients experienced a decrease in FEV1, 28% were recorded as no change in FEV1, and 13% experienced an increase. The relationship between HRQL and FEV1 was found to be approximately linear with decrease in FEV1 being statistically significantly associated with a deterioration in SGRQ (+ 3.20 units). Increase in FEV1 was associated with improvements in SGRQ (− 3.81 units). The associations between change in FEV1 and the EQ VAS were similar. Results of the HLMs were consistent and highly statistically significant, indicating cross-sectional and longitudinal associations. The largest estimates were found for the association between FEV1 and the SGRQ activity domain.ConclusionsDifference and change in FEV1 over time correlate with difference and change in disease-specific and generic HRQL. We conclude, that deterioration of HRQL should induce timely re-examination of physical status and lung function and possibly reassessment of therapeutic regimes.Trial registrationNCT01245933. Date of registration: 18 November 2010. More... »

PAGES

148

Journal

TITLE

BMC Pulmonary Medicine

ISSUE

1

VOLUME

20

Author Affiliations

  • Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, GmbH – German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany
  • Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ziemssenstr. 1, 80336, Munich, Germany
  • Department of Internal Medicine V, University of Munich (LMU), Comprehensive Pneumology Center, Member of the German Center for Lung Research, Ziemssenstr. 1, 80336, Munich, Germany
  • Department of Pneumology, Paracelsus Medical University Salzburg, Universitätsklinikum Salzburg, Müllner Hauptstrasse 48, 5020, Salzburg, Austria
  • Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Member of the German Center for Lung Research (DZL), Baldingerstrasse, 35043, Marburg, Germany
  • Institute of Epidemiology, Helmholtz Zentrum München (GmbH) – German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany
  • Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Ludwig-Maximilians-University Munich (LMU), Marchioninistr. 15, 81377, Munich, Germany
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s12890-020-1147-5

    DOI

    http://dx.doi.org/10.1186/s12890-020-1147-5

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/32471493


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        "description": "BackgroundForced expiratory volume in one second (FEV1) characterizes the pathophysiology of COPD and different trajectories of FEV1 decline have been observed in patients with COPD (e.g. gradual or episodic). There is limited information about the development of patient-reported health-related quality of life (HRQL) over the full range of the natural history of COPD. We examined the longitudinal association between change in FEV1 and change in disease-specific and generic HRQL.MethodsWe analysed data of 1734 patients with COPD participating in the COSYCONET cohort with up to 3 years of follow-up. Patients completed the Saint George\u2019s Respiratory Questionnaire (SGRQ) and the EQ-5D Visual Analog Scale (EQ VAS). Change score models were used to investigate the relationship between HRQL and FEV1 and to calculate mean changes in HRQL per FEV1 change categories [decrease (\u2264 \u2212\u2009100\u2009ml), no change, increase (\u2265 100\u2009ml)] after 3 years. Applying hierarchical linear models (HLM), we estimated the cross-sectional between-subject difference and the longitudinal within-subject change of HRQL as related to a FEV1 difference or change.ResultsWe observed a statistically significant deterioration in SGRQ (total score\u2009+\u20091.3\u2009units) after 3 years, which was completely driven by the activity component (+\u20094\u2009units). No significant change was found for the generic EQ VAS. Over the same period, 58% of patients experienced a decrease in FEV1, 28% were recorded as no change in FEV1, and 13% experienced an increase. The relationship between HRQL and FEV1 was found to be approximately linear with decrease in FEV1 being statistically significantly associated with a deterioration in SGRQ (+\u20093.20\u2009units). Increase in FEV1 was associated with improvements in SGRQ (\u2212\u20093.81\u2009units). The associations between change in FEV1 and the EQ VAS were similar. Results of the HLMs were consistent and highly statistically significant, indicating cross-sectional and longitudinal associations. The largest estimates were found for the association between FEV1 and the SGRQ activity domain.ConclusionsDifference and change in FEV1 over time correlate with difference and change in disease-specific and generic HRQL. We conclude, that deterioration of HRQL should induce timely re-examination of physical status and lung function and possibly reassessment of therapeutic regimes.Trial registrationNCT01245933. Date of registration: 18 November 2010.", 
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    23 schema:description BackgroundForced expiratory volume in one second (FEV1) characterizes the pathophysiology of COPD and different trajectories of FEV1 decline have been observed in patients with COPD (e.g. gradual or episodic). There is limited information about the development of patient-reported health-related quality of life (HRQL) over the full range of the natural history of COPD. We examined the longitudinal association between change in FEV1 and change in disease-specific and generic HRQL.MethodsWe analysed data of 1734 patients with COPD participating in the COSYCONET cohort with up to 3 years of follow-up. Patients completed the Saint George’s Respiratory Questionnaire (SGRQ) and the EQ-5D Visual Analog Scale (EQ VAS). Change score models were used to investigate the relationship between HRQL and FEV1 and to calculate mean changes in HRQL per FEV1 change categories [decrease (≤ − 100 ml), no change, increase (≥ 100 ml)] after 3 years. Applying hierarchical linear models (HLM), we estimated the cross-sectional between-subject difference and the longitudinal within-subject change of HRQL as related to a FEV1 difference or change.ResultsWe observed a statistically significant deterioration in SGRQ (total score + 1.3 units) after 3 years, which was completely driven by the activity component (+ 4 units). No significant change was found for the generic EQ VAS. Over the same period, 58% of patients experienced a decrease in FEV1, 28% were recorded as no change in FEV1, and 13% experienced an increase. The relationship between HRQL and FEV1 was found to be approximately linear with decrease in FEV1 being statistically significantly associated with a deterioration in SGRQ (+ 3.20 units). Increase in FEV1 was associated with improvements in SGRQ (− 3.81 units). The associations between change in FEV1 and the EQ VAS were similar. Results of the HLMs were consistent and highly statistically significant, indicating cross-sectional and longitudinal associations. The largest estimates were found for the association between FEV1 and the SGRQ activity domain.ConclusionsDifference and change in FEV1 over time correlate with difference and change in disease-specific and generic HRQL. We conclude, that deterioration of HRQL should induce timely re-examination of physical status and lung function and possibly reassessment of therapeutic regimes.Trial registrationNCT01245933. Date of registration: 18 November 2010.
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    29 schema:keywords COPD
    30 COSYCONET cohort
    31 ConclusionsDifferences
    32 EQ-5D visual analog scale
    33 EQ-VAS
    34 FEV1
    35 FEV1 decline
    36 FEV1 differences
    37 George's Respiratory Questionnaire
    38 HRQL
    39 MethodsWe
    40 Respiratory Questionnaire
    41 ResultsWe
    42 SGRQ activity domain
    43 Saint George's Respiratory Questionnaire
    44 VAS
    45 activity component
    46 activity domains
    47 analog scale
    48 associates
    49 association
    50 categories
    51 change categories
    52 change score models
    53 changes
    54 cohort
    55 components
    56 correlates
    57 data
    58 decline
    59 decrease
    60 deterioration
    61 deterioration of HRQL
    62 development
    63 differences
    64 different trajectories
    65 domain
    66 estimates
    67 expiratory volume
    68 full range
    69 function
    70 generic HRQL
    71 health-related quality
    72 hierarchical linear models
    73 history
    74 improvement
    75 increase
    76 information
    77 larger estimates
    78 life
    79 life associates
    80 linear model
    81 longitudinal associations
    82 lung function
    83 mean change
    84 model
    85 natural history
    86 pathophysiology
    87 pathophysiology of COPD
    88 patient-reported health-related quality
    89 patients
    90 period
    91 physical status
    92 quality
    93 questionnaire
    94 range
    95 reassessment
    96 regime
    97 relationship
    98 results
    99 same period
    100 scale
    101 score model
    102 significant changes
    103 significant deterioration
    104 status
    105 subject changes
    106 subject differences
    107 therapeutic regimes
    108 time correlate
    109 trajectories
    110 visual analog scale
    111 volume
    112 years
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