Quality of Life and Limitations in Daily Life of Stable COPD Outpatients in a Real-World Setting in Austria – Results from the CLARA Project

Abstract

Andreas Horner,1– 3 Otto C Burghuber,4 Sylvia Hartl,5 Michael Studnicka,6 Monika Merkle,7 Horst Olschewski,8 Bernhard Kaiser,1 Eva Maria Wallner,9 Bernd Lamprecht1,2 1Department of Pulmonology, Kepler University Hospital, Linz, Austria; 2Faculty of Medicine, Johannes Kepler University, Linz, Austria; 3Institute of General, Family and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria; 4First Department of Respiratory and Critical Care Medicine, and Ludwig Boltzmann Institute of COPD and Respiratory Epidemiology, Otto Wagner Hospital and Sigmund Freud University, Medical School, Vienna, Austria; 5Second Department of Respiratory and Critical Care Medicine, Otto Wagner Hospital and Sigmund Freud University, Medical School, Vienna, Austria; 6Department of Pulmonary Medicine, Paracelsus Medical University, Salzburg, Austria; 7Specialist Office for Pulmonology Dr. Merkle, Vienna, Austria; 8Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, and Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria; 9A. Menarini Pharma GmbH, Vienna, AustriaCorrespondence: Andreas HornerKepler University Hospital, Department of Pulmonology, Krankenhausstrasse 9, Linz A4021, AustriaTel [phone] – 6911Fax [phone] – 6915Email [email protected]: COPD patients suffer from respiratory symptoms and limitations in daily life. We aimed to characterize the impact of disease on overall health, daily life, and perceived well-being in COPD outpatients.Methods: We conducted a national, cross-sectional study among pulmonologists and general practitioners (GPs). The St. George’s Respiratory Questionnaire for COPD patients (SGRQ-C) was used. Inclusion criteria were a physician’s diagnosis of COPD and age ≥ 40 years. Subjects with a history of lung surgery, lung cancer or COPD exacerbation within the last four weeks were excluded.Results: Sixty-seven pulmonologists and 6 GPs enrolled 1175 COPD patients. Two hundred forty-eight of those did not fulfill GOLD criteria for COPD (FEV1/FVC < 0.7) and 77 were excluded due to missing data. Finally, 850 patients (62.8% men; mean age 66.2 ± 0.3 (SE) years; mean FEV1%pred. 51.5 ± 0.6 (SE)) were analyzed. Last year, 55.4% reported at least one exacerbation, and 12.7% were hospitalized for COPD exacerbation. Mean SGRQ-C total score was 43.1 ± 0.83 (SE) and mean component scores for symptoms, activity and impacts were 55.6, 55.4 and 30.5, respectively. Half of the patients (50.3%) reported not being able to do any sports and 78.7% stated that their respiratory symptoms did not allow them doing anything they would like to do. In patients with less severe COPD (FEV1pred ≥ 50% and non-frequent exacerbations), global health status was overrated, ie, estimated as better by the physician than by the patient, while it was underrated in more severe COPD.Conclusion: In Austria, the burden of disease in COPD outpatients tends to be underestimated in patients with milder airway obstruction and less exacerbations and overestimated in patients with more severe airway obstruction and frequent exacerbations. Our finding suggests that validated assessment of global health status might decrease these differences of perception.Keywords: chronic obstructive pulmonary disease, limitations, quality of life, St. Georges Respiratory Questionnaire

Keywords

• chronic obstructive pulmonary disease
• limitations
• quality of life
• st. george’s respiratory questionnaire