B Gupta, S Kant
B Gupta, S Kant. Health Related Quality Of Life (Hrqol) In COPD. The Internet Journal of Pulmonary Medicine. 2008 Volume 11 Number 1.
Over the past decade, more and more research on the development and validation of questionnaires has been undertaken to quantify the impact of disease on daily life and well-being from the COPD subject's point of view. Health-related quality of life is an important outcome of medical care. HRQOL incorporates several dimensions experienced by the patient that are affected by disease and health. COPD patients come to physicians seeking relief of symptoms that include breathlessness, cough, sputum production, and functional limitation due to exertional dyspnea. Therefore interventions that would reduce these symptoms and improve function of patients are of prime importance. HRQoL measures do not substitute for physiologic parameters, but can complement these by incorporating aspects of health and disease that are directly perceived by the patient.
In the past three decades, a number of important advances have been made in the treatment of patients with chronic obstructive pulmonary disease (COPD)
Increasingly, it has been recognised that health status, especially health-related quality of life, is an important outcome of medical care
HRQoL - Terms, definition and concepts
Health outcomes represent a broad group of end-points used in clinical research to assess the efficacy or effectiveness of interventions and to assess disease outcomes
Various definitions of HRQL exist. The World Health Organization (WHO) definition of health is “not merely the absence of disease, but complete physical, psychological, and social well-being”
Conceptually, HRQOL incorporates several dimensions experienced by the patient that are affected by disease and health
Over the past decade, more and more research on the development and validation of questionnaires has been undertaken to quantify the impact of disease on daily life and well-being from the COPD subject's point of view. This is because of recognition of the following factors:
Individual patients are most concerned about their symptoms (
HRQOL is a unique construct that is different from physiologic measures or survival
The goals of therapy have been expanded to include relief of symptoms and improvement in HRQOL in addition to the standard physiologic outcomes.
Why measure Health-Related Quality of Life in COPD?
Specific outcomes, such as spirometric measurements, may have greater appeal because of their relative simplicity and apparent link with pathophysiology. Besides, the combined effect of different treatments presumed to improve a particular physiologic parameter may not necessarily lead to better patient comfort and quality of life. Miravitlles
Health-related quality of life: instruments for measurement
A number of instruments have been developed to assess HRQoL. These can be classified into three main types: generic, disease-specific/situation-specific and Preference based questionnaires
General Health Questionnaires
Generic HRQOL instruments are broadly applicable to different health problems. Generic measures are broader in scope and applicability. The strengths of generic measures are that they are capable of detecting the effects of the diverse aspects one disease beyond those captured by a disease-specific measure and they are capable of comparing health status across multiple diseases
A number of generic health-related, quality-of-life instruments have been used to characterise COPD. The following is a discussion of the instruments that are most widely used.
Disease Specific Questionnaires
The disease- or condition-specific instruments focus on one condition and attempt to define its effects on a patient’s health status.
Finally, there is an additional health-status instrument that was developed for use among a subset of patients with COPD, those with chronic respiratory failure. The
Preference based questionnaires
The characteristics of selected general and disease-specific questionnaires for measuring HRQOL in patients with COPD are listed in
Health-related quality of life - linguistic validations
With a few exceptions, most questionnaires have been developed in English. There are many examples in the literature of the translation of HRQL questionnaires, but few publications describe the guidelines to be followed
Uses of HRQoL Questionnaire in COPD
There are at least three ways in which an HRQoL questionnaire can be used, namely as an
The number of publications on the use of HRQL questionnaires to measure the effect of interventions is increasing (
The usage of HRQoL questionnaires as a
In summary, HRQoL questionnaires in COPD may have a value to evaluate changes after intervention.
Health-Related Quality of Life and Resource Utilization