Quality-of-life in a long-term multicentre trial in chronic nonspecific lung disease: Assessment at baseline

Abstract

Quality-of-life (QOL) in patients with respiratory illness is a topic of increasing interest to clinicians and researchers. In a multicentre trial, which studies the long-term effects of three medication regimens (β-agonist plus either placebo, anticholinergic agent or corticosteroid, all by inhalation) in patients with chroinc nonspecific lung disease ((CNSLD): asthma and chronic obstructive pulmonary disease (COPD)), quality-of-life was included as an additional outcome measure. We wanted to provide a baseline assessment of quality-of-life in 274 adult patients with a mild to moderate degree of CNSLD. Quality-of-life was measured using a set of six standardized tests: Anxiety, Depression and Sleep Disorders, Optimism and Stigma, and Activities of Daily Living were assessed via scales with adequate validity and reliability, as established in previous work in Dutch patients with CNSLD. We found that quality-of-life was mildly impaired in these patients. Although differences with a reference group were present throughout, these were not significant, probably due to selection of relatively young, clinically stable, and highly motivated patients for our study. Quality-of-life scores showed higher correlation coefficients (0.20 < r < 0.38) to symptom scores than did results of pulmonary function tests (r < 0.15). In logistic regression models, absence from work and hospitalizations due to CNSLD were partly determined by quality-of-life scores. These results are in line with other behavioural research in patients with CNSLD: the response of the patient to the illness, in combination with more objective characteristics of the illness, determines the impact of CNSLD on the quality-of-life of the patient. In the clinical management of and research on patients with CNSLD, quality-of-life should be taken into account. There is also a need for co-operation between behavioural and medical experts in the development of a disease-specific quality-of-life instrument for patients with CNSLD.