Pain as a subdomain of quality of life (QoL)
| Author | Aim | Setting and sample | N (patients with COPD) | Mean age(SD) in years | FEV1% of predicted (SD) | GOLD-stage | QOL instrument | Main outcome (SD) | MMAT score |
|---|---|---|---|---|---|---|---|---|---|
| Mahler et al25 (1995)**** USA | To examine longitudinal changes in clinical parameters in patients with COPD | Secondary care Patients recruited from the outpatient pulmonary department of 3 hospitals | 110 | 67 (8) | 44 (17) | – | SF-20 | 38.9 (32.9) | 75% 4.1:+ 4.2:+ 4.3:+ 4.4:− |
| Mahler et al24 (1995)* USA | To evaluate the SF-36 as an instrument for measuring HRQoL in patients with symptomatic COPD | Secondary care Patients with COPD and no significant comorbidity recruited from an outpatient pulmonary department | 50 | 72 (8) | 48.2 (21.9) | GOLD 1:18% GOLD 2: 20% GOLD 3&4: 62% | SF-36 | 70.5 (24.2) | 75% 4.1:+ 4.2:+ 4.3:+ 4.4− |
| Hoang Thi et al26 (1997)**** France | To seek factors predicting HRQoL in patients with severe COPD on LTOT | Primary care Patients on LTOT monitored at home by a region organisation for medical assistance of patients with COPD | 61 | 66.0 (6.4) | – | GOLD 1:− GOLD 2:− GOLD 3&4:100% | DHP | 46.6 (38.1) | 75% 4.1:+ 4.2:+ 4.3:+ 4.4:− |
| Monso et al27 (1998)* Spain | To identify physiological parameters related to QoL in severe patients with COPD using LTOT | Secondary care Patients with COPD on LTOT recruited from outpatient pulmonary department of a university hospital | 47 | 65.2 (8.2) | 31.8 (11.9) | GOLD 1:− GOLD 2:− GOLD 3&4:100% | NHP | 35.1 (31.6) | 75% 4.1:+ 4.2:+ 4.3:+ 4.4:− |
| Schlenk et al28 (1998)* USA | To examine HRQoL as measured by the SF-36 across patient populations with chronic disorders and to compare QoL in these participants with normative data on healthy persons | Primary care Sample comprised from 6 studies of persons with chronic disorders. Patients with COPD were recruited from a pilot study designed to determine the effect of home-based PR on HRQoL | 13 | 66.7 (3.7) | – | – | SF-36 | 58.54 (24.16) | 25% 4.1:− 4.2:− 4.3:+ 4.4:− |
| Hajiro et al29 (1999)* Japan | To compare categorisations of the level of dyspnoea with the staging of disease severity as defined by the FEV1 in representing how HRQoL is distributed in patients with COPD | Secondary care Patients (100% male) with stable COPD recruited from outpatient pulmonary department of a university hospital | 194 | 70 (8) | 41.5 (15.6) | GOLD 1:29% GOLD 2:32% GOLD 3:39% GOLD 4:− | SF-36 | 65.5 (21.3) | 100% 4.1:+ 4.2:+ 4.3:+ 4.4:− |
| Stavem et al30 (1999)* Norway | To assess relationships between health status and measures of dyspnoea, lung function and exercise capacity in patients with COPD | Secondary care Patients with COPD recruited from outpatient pulmonary department of a hospital | 59 | 57 (9) | 54 (17) | GOLD 1:42% GOLD 2:36% GOLD 3:22% GOLD 4:− | SF-36 | 64.0 (27.6) | 100% 4.1:+ 4.2:+ 4.3:+ 4.4:+ |
| Gore et al31 (2000)* UK | To examine if patients with severe COPD are relatively disadvantaged in terms of medical and social care compared to patients with inoperable lung cancer | Secondary care Patients attending for follow-up at the outpatient pulmonary department of a hospital | 50 | 70.5 (5.5) | – | GOLD 1:− GOLD 2:− GOLD 3&4:100% | SF-36 | – (only figures presented) | 100% 4.1:+ 4.2:+ 4.3:+ 4.4:+ |
| Kaelin et al32 (2001)*** USA | To examine the efficacy of a programme using symptom limited interval training combined with strength training on 6MWT, increases in exercise capacity and QoL | Secondary care Patients with primary diagnosis of COPD entering a PR programme at an outpatient pulmonary department | 50 | 68.4 (6.9) | 39.5 (11.5) | – | HSQ | pre-PR: 65.9 (26.7) post-PR: 69.5 (21.6) NS | 50% 4.1:+ 4.2:+ 4.3:− 4.4:− |
| Boueri et al33 (2001)*** USA | To evaluate the effects of a 3-week comprehensive PR programme on QoL in patients with COPD | Tertiary care Patients with COPD, referred for PR at the outpatient pulmonary department of a pulmonary tertiary care centre | 37 | 66 (7.3) | 29.6 (10.9) | – | SF-36 | pre-PR; 77.5 (27.4) post-PR; 83.2 (18.5) p=0.100 | 75% 4.1:+ 4.1:+ 4.3:+ 4.4:− |
| de Torres et al34 (2002)*** USA | To investigate the capacity of several of the most frequently used outcome measurements to detect changes after PR in a population of patients with severe COPD who qualified for LVRS | Secondary care 7 hospitals participating in a trial comparing LVRS and standard medical treatment. Population consisted of the first 37 consecutive patients with severe COPD selected for LVRS | 37 | 63 (6) | – | GOLD 1:− GOLD 2:− GOLD 3&4:100% | SF-36 | pre-PR:87 (18) post-PR:87 (18) NS | 50% 4.1:+ 4.2:+ 4.3:− 4.4:− |
| Ambrosino et al35 (2002)**** Italy | To evaluate the perceived health and cognitive status in survivors of COPD exacerbations requiring mechanical ventilation | Secondary care Patients (P): patients with COPD at their first episode of acute on chronic respiratory failure requiring mechanical ventilation. Controls (C): stable patients with COPD on LTOT (>6 months) with no previous ICU admission | 97 P:63 C:34 | 68 (7) 67 (7) | 30 (16) 36 (19) | GOLD 1:− GOLD 2:− GOLD 3&4: 100% | NHP | P:21.2 (28.4) C:13.7 (19.2) p=0.17 | 50% 3.1:+ 3.2:+ 3.3:− 3.4:− |
| Sant'Anna et al36 (2003)* Brazil | To assess HRQoL in low an income population of patients with hypoxaemia and COPD receiving LTOT | Tertiary care Patients (P): patients with COPD and LTOT recruited from an outpatient pulmonary department of a tertiary care university hospital Controls (C): patients with COPD but no severe hypoxaemia | 69 P:36 C:33 | 63.5 (10.8) 63.1 (9.2) | 32.1% (14.4) 35.7% (13.9) | – | SF-36 | P:56.9 (32.4) C:68.1 (28.9) NS | 75% 3.1:+ 3.2:+ 3.3:− 3.4:+ |
| Van Manen et al37 (2003)* Netherlands | To determine the influence of COPD on HRQoL independent of comorbidity | Primary care Patients (P): patients with COPD and comorbidity Controls(C): patients with COPD and comorbidity | 148 P:107 C:41 | – | – | GOLD 1:24% GOLD 2:39% GOLD 3&4:37% | SF-36 | P:83.6 (23.2) C:88.8 (18.5) | 75% 3.1:+ 3.1:+ 3.3:+ 3.4:− |
| Sato et al38 (2004)*/*** Japan | To investigate the responsiveness of the SF-36 in patients with COPD and asthma | Secondary care Patients recruited from the outpatient pulmonary department of an universal hospital | Cross-sectional Pre-treatment 152 In-treatment 123 Longitudinal 136 | 69.1 (7.4) 70.1 (7.3) 69.1 (7.4) | 44.9 (17.3) 49.9 (18.1) 44.9 (17.3) | – | SF-36 | Cross-sectional Pre-treatment 73.4 (24.3) In-treatment: 80.3 (22.8) p=0.02 Longitudinal 73.8 (25.3) | 75% 4.1:+ 4.2:+ 4.3:+ 4.4:− |
| Katsura et al39 (2005)* Japan | To evaluate the effects of body weight on both generic and disease specific HRQoL of patients with COPD | Secondary care Patients (88% male) with stable COPD recruited from outpatient pulmonary department | 83 | 74.6 (6.4) | 53.9 (22.2) | – | SF-36 | – (only figures presented) | 75% 4.1:+ 4.2:+ 4.3:+ 4.4:− |
| Rutten-van Molken et al40 (2006)* Netherlands | To assess the discriminative properties of the EQ-5D with respect to COPD severity according to the GOLD criteria in a large multinational study | Secondary care Patients recruited form an outpatient pulmonary department | 1235 | 64.5 (8.4) | 48.8 (12.2) | GOLD 1:0.0% GOLD 2:50.7% GOLD 3:41.8% GOLD 4:7.4% | EQ-5D | – (only figures presented) | 75% 4.1:+ 4.2:+ 4.3:+ 4.4:− |
| Punekar et al41 (2007)* USA, 5 EU countries | To assess and compare health status among patients with COPD presenting for treatment in 6 countries and in 2 healthcare settings using a generic health status instrument | Population based, primary(PC) and secondary care(SC) Physicians were randomly selected. Patient selection: the first 6 consecutive patients diagnosed and treated for COPD presenting for consultation during the next 10 working days | 2703 PC: 1381 SC:1322 | 66 (10.8) 66 (11.3) | – | PC GOLD 1:37% GOLD 2:31% GOLD 3:32% GOLD 4:− SC: GOLD 1:25% GOLD 2:36% GOLD 3:39% GOLD 4:− | EQ-5D | PC Any problems: 53% SC Any problems: 56% | 100% 4.1:+ 4.2:+ 4.3:+ 4.4:+ |
| Bailey et al42 (2008)** USA | To examine the relationship between improvements in 6MWT and QoL in patients with COPD following a PR programme | Secondary care Patients with COPD that completed an outpatient PR programme | 139 | 68 (11.8) | 44.7 (20.0) | – | SF-36 | pre-PR; 63.1 (22.4) post-PR; 70.1 (62.5) p=0.212 | 75% 4.1:+ 4.2:+ 4.3:+ 4.4:− |
| Habraken et al43 (2009)* Netherlands | To compare self-reported HRQoL data of patients with COPD with GOLD stage 4 and patients with end stage NSCLC | Secondary and tertiary care Patients identified from medical records of the outpatient pulmonary department of 4 hospitals and 1 tertiary pulmonary centre | 82 | 69.5 (6.7) | – | GOLD 1:− GOLD 2:− GOLD 3:− GOLD 4:100% | SF-36 | 62 (IQR 41–100) | 75% 4.1:+ 4.2:+ 4.3:+ 4.4:− |
| Kil et al44 (2010)* South Korea | To determine the prevalence of depression and examine its impact on HRQoL among older patients with COPD | Secondary care Patients recruited from the outpatient pulmonary department of an academic hospital | 91 | 69.3 (8.2) | 58.9 (19.5) | GOLD 1:14.2% GOLD 2:51.7% GOLD 3:29.7% GOLD 4:4.4% | SF-36 | 63.0 (30.1) | 50% 4.1:− 4.2:+ 4.3:+ 4.4:− |
| Rascon-Anguilar et al45 (2011)* USA | To evaluate HRQoL in patients with COPD compared with those with both COPD and gastroesophageal reflux disease (GERD) symptoms | Secondary care Patients presenting at the outpatient pulmonary department for routine healthcare: Patients (P): patients with COPD with GERD symptoms. Controls (C): patients with COPD without GERD symptoms | 86 P:32 C:54 | 66.0 (9.9) 68.8 (7.0) | 40.7 (17.6) 45.9 (16.0) | – | SF-36 | P:51.7 (28.8) C:66.7 (27) p<0.02 | 100% 3.1:+ 3.2:+ 3.3:+ 3.4:+ |
| Janssen et al4 (2011)* Netherlands | To assess health status and care dependency in patients with advanced COPD or CHF and to identify correlates of an impaired health status | Secondary care Patients recruited from outpatient pulmonary department of 1 academic and 5 general hospitals | 105 | 66.3 (9.2) | 34.1 (13.5) | GOLD 1:− GOLD 2:− GOLD 3:26.7% GOLD 4:73.3% | SF-36 EQ-5D | SF-36_BP: 70.9 (29.5) EQ-5D: Any problems: 45.7% | 100% 4.1:+ 4.2:+ 4.3:+ 4.4:+ |
| Cedano et al46 (2012)* Brazil | To evaluate and correlate the QoL of patients with COPD on LTOT with their sociodemographic and clinical characteristics and level of dependence | Secondary care Convenience sample of patients on LTOT followed at the oxygen therapy outpatient pulmonary department | 80 | 69.6 (9.1) | 37.4 (14.1) | GOLD 1:− GOLD 2:− GOLD 3:− GOLD 4:100% | SF-36 | 61.2 (27.4) | 75% 4.1:+ 4.2:+ 4.3:+ 4.4:− |
| Arimura et al47 (2013)* Japan | To evaluate the clinical usefulness of a concise two-question instrument to assess depressive symptoms in patients with COPD and to determine whether the instrument was related to the SF-8 | Secondary care Patients recruited as a consecutive sample of clinically stable patients with COPD visiting the outpatient pulmonary department of five hospitals | 52 | 72.7 (7.5) | 62.5 (25.7) | GOLD 1:23% GOLD 2:40% GOLD 3:25% GOLD 4:12% | SF-8 | 52.2 (10.0) | 75% 4.1:+ 4.2:+ 4.3:+ 4.4:− |
*Cross–sectional study; **retrospective study; ***prospective intervention study (controlled and non-controlled); ****prospective observational study.COPD, chronic obstructive pulmonary disease; CHF, chronic heart failture; DHP, Duke Health Profile; EQ-5D, EuroQol-5 Dimensions; FEV1, forced expiratory volume in 1 s; HRQoL, health-related quality of life; HSQ, Health Status Questionnaire; ICU, intensive care unit; MMAT, Mixed Method Appraisal Tool; NSCLC, non-small-cell lung carcinoma; NHP, Nottingham Health Profile; PR, SF-36, Short-Form health survey-36.