Quality of Life With Chronic Obstructive Pulmonary Disease: the Influence of Level of Patient Care

• Published in: Archivos de bronconeumología (English ed.) 2004-10, Vol.40 (10), p.431-437
• Main Authors: de Miguel Díez, J., Izquierdo Alonso, J.L., Rodríguez González-Moro, J.M., de Lucas Ramos, P., Bellón Cano, J.M., Molina París, J.
• Format: Article
• Language: eng ; spa
• Subjects: Adult; Aged; Aged, 80 and over; Atención primaria; Calidad de vida; COPD; Cross-Sectional Studies; EPOC; Female; Health Status Indicators; Humans; Level of care; Male; Middle Aged; Neumología; Nivel de asistencia; Pneumology; Primary Health Care; Pulmonary Disease, Chronic Obstructive - therapy; Quality of Life; Surveys and Questionnaires
• ISSN: 1579-2129; 0300-2896; 1579-2129
• DOI: 10.1016/S1579-2129(06)60351-0

The aim of the study was to determine the factors related to the health-related quality of life (HRQL) of patients with stable chronic obstructive pulmonary disease (COPD) and to assess the degree of influence of level of patient care (primary or specialized). An observational descriptive, cross-sectional, multicenter study was carried out. The study sample was a randomized selection taken from a stratified sample of patients treated by primary care physicians and pneumologists from each Spanish region. Only those patients whose level of health care was indicated and whose diagnosis of COPD was confirmed by spirometry were enrolled in the study. Five hundred sixty patients were assessed, 100 from primary health care and 460 from pneumology practices. No significant differences between the 2 levels of care were found in the scores on the HRQL questionnaire (Spanish version of the St George's Respiratory Questionnaire). There was a weak correlation between patients' perception of health and lung function parameters. Factors related to HRQL in the multivariate analysis were dyspnea, the presence of COPD exacerbations in the previous year, consequent visits to the emergency department, age, and degree of airflow restriction, but not level of patient care. Stable COPD patients' HRQL is not related to their level of care, be it primary or specialized, but is related to other factors such as dyspnea, presence of exacerbations or consequent visits to the emergency department, age, and degree of airflow restriction. El estudio se realizó con el propósito de determinar los factores que se relacionan con la calidad de vida relacionada con la salud (CVRS) de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) estable y evaluar si existen diferencias según el nivel de asistencia de los pacientes (neumología o atención primaria). Se trata de un estudio observacional, descriptivo, transversal y multicéntrico. La selección de la muestra se realizó mediante un muestreo aleatorizado estratificado por población regional entre médicos de familia y neumólogos de todo el territorio nacional. Para este trabajo se seleccionó a aquellos en los que se registró el nivel de asistencia y en los que el diagnóstico de EPOC se confirmó por espirometría. Se evaluó a 560 pacientes, 100 en atención primaria y 460 en neumología. No se detectaron diferencias significativas en las puntuaciones obtenidas en el cuestionario de calidad de vida (versión española del Cuestionario Respi