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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Minerva Pneumologica 2011 December;50(4):247-55
Health-related quality of life in patients with chronic obstructive pulmonary disease: effects of home-care program
Zamarrón C., Morete E.
Division of Respiratory Medicine, Hospital Clínico Universitario, Universidad de Santiago de Compostela, Santiago, Spain
AIM: Aim of this study was to determine the effect of a hospital-based home-care program (HCP) on the health related quality of life (HRQL) of chronic obstructive pulmonary disease (COPD) patients.
METHODSWe prospectively studied 18 patients with COPD; (16 men and 2 women) with a mean age of 69.4±10.3 years and a body mass index of 26.6±4.2 kg/m2. All subjects had severe COPD and at least two hospital admissions for exacerbation in the previous year. The HCP consisted of home visits by a nurse every month, telephone calls every 10 days, and home or hospital visits on demand. The program lasted for a period of 12 months. HRQL by Medical Outcomes Study Short Form-36 (SF36) and Saint George Respiratory Questionnaire (SGRQ) were assessed at baseline and at 12-months. After-intervention values were compared to data from 84 control subjects from the general population.
RESULTS: With respect to SGRQ after completing the HCP, there were significant improvements in total score (14.2±2.8 vs. 11.8±4.6; P=0.027), activity (14.9±4.8 vs. 11.2±4.8; P=0.031) and impact (17.4±4.6 vs. 11.7±4.5; P=0.001) dimensions but not in symptom dimensions (12.6±4.4 vs. 13.6±7.5; P=ns). With respect to SF36, significant improvement was found in mental health (57.1±20 vs. 75.7±9.2; P=0.01) and energy/vitality dimensions (46.5±14 vs. 54.7±7.2; P=0.05). Compared to the control subjects from the general population, the COPD patients in our study had impaired health status for all dimensions. However, after our HCP, COPD patients present nearly normal values for mental health dimension.
CONCLUSION: Health-related quality of life of COPD patients improved after hospital based home care program and these changes are relevant in several health dimensions.