Treatment and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

• Published in: Quality of life research 2002-06, Vol.11 (4), p.329-338
• Main Authors: M. Miravitlles, J. L. Alvarez-Sala, R. Lamarca, Ferrer, M., F. Masa, H. Verea, R. Zalacain, C. Murio, F. Ros, R. Vidal
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - therapeutic use; Adrenergic beta-Antagonists - administration & dosage; Adrenergic beta-Antagonists - therapeutic use; Aged; Body mass index; Bronchodilator Agents - administration & dosage; Bronchodilator Agents - therapeutic use; Chronic diseases; Chronic obstructive pulmonary disease; Corticosteroids; Dosage; Drug therapy; Drugs; Dyspnea; Expectorants - administration & dosage; Expectorants - therapeutic use; Female; Humans; Inhalation administration; Ipratropium - administration & dosage; Ipratropium - therapeutic use; Male; Middle Aged; Oxygen Inhalation Therapy; Prescription drugs; Pulmonary Disease, Chronic Obstructive - drug therapy; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - therapy; Quality of Life; Questionnaires; Sickness Impact Profile; Spain; Steroids; Surveys and Questionnaires; Theophylline - administration & dosage; Theophylline - therapeutic use
• ISSN: 0962-9343; 1573-2649
• DOI: 10.1023/A:1015520110663

Treatments administered to patients with chronic obstructive pulmonary disease (COPD), especially when used in multiple combinations, are not free of interactions and side effects that can potentially impair health-related quality of life (HRQL). We studied HRQL and its relationship with treatment in a group of 441 patients with stage II or III COPD (age: 66.6 (SD: 8.3) years; FEV1: 32.4% (SD: 8.1%)) using the St George's Respiratory Questionnaire (SGRQ) and the 12-item short form (SF-12) Health Survey. The most prescribed drugs were ipratropium bromide (87.5%), inhaled corticosteroids (69.4%) and short-acting β-2 agonists (64.9%). Patients with stage III of the disease were receiving more drugs, particularly short-acting β-2 agonists (p = 0.002) and inhaled corticosteroids (p = 0.031). The use of theophyllines was associated with a worse total SGRQ score (β = 4.49; p < 0.001), although this negative association decreased with advanced age. A trend towards worse SGRQ scores was observed with the use of high doses of long-acting β-2 agonists (β = 3.22; p = 0.072). Patients receiving three drugs or more presented worse total SGRQ scores than patients receiving fewer drugs (β = 6.1, p < 0.001; and β = 7.64, p < 0.001, respectively). These findings suggest that the use of multiple drugs in the treatment of patients with COPD is associated with worse total SGRQ scores. The effect of drugs, their dosages and associations with other drugs on HRQL merit further research.