PURPOSE: The World Health Organization - Government of India (WHO-GOI) Guidelines - 2003 for management of chronic obstructive pulmonary diseases (COPD) is a consensus statement. However, the outcome and impact of its implementation on quality of life (QOL) among COPD patients has not been studied so far. Present study evaluated the same.
METHODS: Study included 90 COPD patients diagnosed as per criteria laid down under said guidelines. The patients were randomized to intervention group (n=50) and control group (n=40). All were treated and followed up for 6 months. A pulmonary physician reviewed patients of both the groups, at least 3 times in 6 months period. St. George's Respiratory Questionnaire (SGRQ) was measured at baseline and at 6 months. Patients in control group visited the center on a “need to” basis and were prescribed conventional treatment by the doctor on duty.
RESULTS: Forty two patients in the intervention group and 32 in the control group completed 3 visits over the period of 6 months and were included in analysis. Mean age in the intervention group and control group was 60 (range 36–80) and 61 years (range 35–83) respectively. The ratio of smokers versus non smokers was 40:2 in intervention group and 29:3 in controls. The severity as per the guidelines was moderate in 74% and severe in 26% in intervention group while it was moderate in 64% and severe in 36% cases in control group.
CONCLUSION: There was no significant difference in the baseline QOL variables in both the groups. Follow up QOL scores were significantly better as compared to baseline values (repeated measure ANOVA, p<0.001). QOL of the patients treated under guidelines management protocol were significantly better (p<0.001) than those in the control group with conventional treatment. There was statistically significant (p<0.001) improvement in respiratory QOL scores favoring intervention group patients.
CLINICAL IMPLICATIONS: The consensus derived recommendations of WHO-GOI Guidelines for COPD-2003 are beneficial for management of COPD patients over conventional management.
DISCLOSURE: Prasanta Mohapatra, No Financial Disclosure Information; No Product/Research Disclosure Information