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Clinical Investigations: ASTHMA |

Evaluation of Health-Related Quality of Life in Low-Income Patients With COPD Receiving Long-term Oxygen Therapy*

Cláudia Adriana Sant’Anna, Ferreira, PT; Rafael Stelmach, MD; Maria Ignez Zanetti Feltrin, PT; Wilson Jacob Filho, MD; Toshio Chiba, MD; Alberto Cukier, MD, FCCP
Author and Funding Information

*From the Division of Respiratory Diseases, Heart Institute (InCor)/Hospital das Clínicas and the Division of General Internal Medicine, University of Sao Paulo School of Medicine, Brazil.

Correspondence to: Alberto Cukier, MD, FCCP, Al. Jau, 263 apto 101, 01420-000, Sao Paulo, Brazil; e-mail: pnealberto@incor.usp.br



Chest. 2003;123(1):136-141. doi:10.1378/chest.123.1.136
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Published online

Study objective: To assess health-related quality of life (HRQL) in a low-income population of patients with hypoxemia and COPD receiving long-term oxygen therapy (LTOT).

Design: Cross-sectional study.

Setting: Large, tertiary care, university teaching hospital.

Patients or participants: Thirty-six patients with COPD requiring LTOT (mean age, 63.5 years; mean FEV1, 32.1% of predicted; Pao2, 50.2 mm Hg) and 33 control subjects with COPD but no severe hypoxemia (mean age, 63.1 years; FEV1, 35.7%; Pao2, 66.5 mm Hg).

Interventions: Patients underwent pulmonary function testing to assess physiologic function and the degree of respiratory impairment. A baseline dyspnea index (BDI) was used to determine levels of dyspnea, and a 6-min walk test was performed to evaluate physical performance and exercise capacity. The St. George Respiratory Questionnaire (SGRQ) and the Medical Outcomes Study Short-Form 36-item questionnaire (SF-36) were used to assess health status and HRQL.

Measurements and results: The scores on the SGRQ and SF-36 indicated severe impairment. Patients receiving LTOT showed a trend toward worse scores on most dimensions of the SGRQ and SF-36, but differences between groups were only statistically significant for the physical functioning and social functioning dimensions of the SF-36. Dyspnea, as measured by the BDI, significantly correlated with all questionnaire domains except the SF-36 pain index.

Conclusions: The HRQL of these low-income patients with COPD was markedly impaired, with more pronounced impairment in those receiving LTOT. The severity of dyspnea was a significant predictor of various components of quality of life in these patients.


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