Correlation of health-related quality of life with other disease severity indices in Indian chronic obstructive pulmonary disease patients

Seema Aziyakath Shavro¹, Punitha Ezhilarasu¹, Jebamani Augustine¹, Joel J Bechtel², Devasahayam J Christopher^3
1College of Nursing, Christian Medical College, Vellore, South India; ²Pulmonologist and Critical Care Physician, Grand Junction, CO, ³Department of Pulmonary Medicine, Christian Medical College, Vellore, South India

Background: Improvement in quality of life (QOL) has become a focus for the management of incurable chronic diseases, including chronic obstructive pulmonary disease (COPD). This study investigates factors influencing the QOL of patients with COPD in India.
Methods: Seventy-three consecutive COPD patients visiting an outpatient pulmonary clinic underwent health-related QOL (HRQOL) assessment using the World Health Organization’s QOL abbreviated questionnaire and St George’s Respiratory Questionnaire (SGRQ). Symptom severity and grade of dyspnea were estimated by the Chronic Lung Disease Severity Index (CLD) and Medical Research Council assessments, and patient demographic data were collected. Spirometry and 6-minute walk tests were performed to assess lung function and functional status.
Results: Patients with COPD showed significantly reduced HRQOL when measured by the World Health Organization’s QOL abbreviated questionnaire and the SGRQ. CLD estimate for severity of lung disease (P < 0.001), Medical Research Council assessment for dyspnea (P < 0.01), and duration of illness (P < 0.05) showed close correlation with HRQOL. Worsening forced expiratory volume in 1 second and 6-minute walk test results closely correlated with poorer HRQOL (P < 0.01). No association between QOL and age, quantum of smoking, education, comorbid illnesses, or occupational exposure was found.
Conclusion: This study showed that Indian patients with COPD had reduced HRQOL. Longer disease duration, patient perception of disease severity, and worsening dyspnea impacted negatively on HRQOL.

Keywords: quality of life, COPD, disease severity, India, questionnaire