Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.
PLoS One. 2023 Oct 26;18(10):e0293342. doi: 10.1371/journal.pone.0293342. eCollection 2023.
The present study aimed to evaluate HRQOL and to explore the factors associated with poor HRQOL among patients with COPD.
In the present cross-sectional study, the validated St George's Respiratory Questionnaire for COPD patients (SGRQ-C) was used to evaluate HRQOL among 702 patients with COPD at two major hospitals in Jordan in the period between January and April 2022. Quantile regression analysis was used to explore the factors associated with HRQOL among the study participants.
According to SGRQ-C, the HRQOL of the study participants was greatly impaired with a total SGRQ of 55.2 (34-67.8). The highest impairment in the HRQOL was in the impact domain with a median of 58.7 (29-76.3). Increased number of prescribed medications (β = 1.157, P<0.01), older age (β = 0.487, P<0.001), male gender (β = 5.364, P<0.01), low education level (β = 9.313, P<0.001), low and moderate average income (β = 6.440, P<0.05, and β = 6.997, P<0.01, respectively) were associated with poorer HRQOL. On the other hand, being married (β = -17.122, P<0.001), living in rural area (β = -6.994, P<0.01), non-use of steroids inhalers (β = -3.859, P<0.05), not receiving long acting muscarinic antagonists (LAMA) (β = -9.269, P<0.001), not receiving LABA (β = -8.243, P<0.001) and being adherent to the prescribed medications (β = -6.016, P<0.001) were associated with improved HRQOL. Furthermore, lower disease severity (stage A, B, and C) (β = -23.252, -10.389, and -9.696 respectively, P<0.001), and the absence of comorbidities (β = -14.303, P<0.001) were associated with better HRQOL.
In order to maximize HRQOL in patients with COPD, future COPD management interventions should adopt a multidisciplinary approach involving different healthcare providers, which aims to provide patient-centered care, implement personalized interventions, and improve medication adherence, particularly for patients who are elderly, males, have low socioeconomic status, receive multiple medications and have multiple comorbid diseases.
本研究旨在评估 COPD 患者的生活质量,并探讨与生活质量较差相关的因素。
本横断面研究使用经过验证的圣乔治呼吸问卷(SGRQ-C)评估了 2022 年 1 月至 4 月期间在约旦的两家主要医院的 702 名 COPD 患者的生活质量。使用分位数回归分析探讨了研究参与者生活质量相关的因素。
根据 SGRQ-C,研究参与者的生活质量受到严重损害,总 SGRQ 评分为 55.2(34-67.8)。生活质量受损最严重的是影响领域,中位数为 58.7(29-76.3)。处方药物数量增加(β=1.157,P<0.01)、年龄较大(β=0.487,P<0.001)、男性(β=5.364,P<0.01)、低教育水平(β=9.313,P<0.001)、低和中等平均收入(β=6.440,P<0.05,和β=6.997,P<0.01)与较差的生活质量相关。另一方面,已婚(β=-17.122,P<0.001)、居住在农村地区(β=-6.994,P<0.01)、不使用吸入性皮质类固醇(β=-3.859,P<0.05)、未接受长效抗毒蕈碱拮抗剂(LAMA)(β=-9.269,P<0.001)、未接受长效β2 受体激动剂(LABA)(β=-8.243,P<0.001)和遵医嘱服药(β=-6.016,P<0.001)与生活质量改善相关。此外,疾病严重程度较低(A、B 和 C 期)(β=-23.252,-10.389 和-9.696,P<0.001)和无合并症(β=-14.303,P<0.001)与更好的生活质量相关。
为了使 COPD 患者的生活质量最大化,未来的 COPD 管理干预措施应采用多学科方法,涉及不同的医疗保健提供者,旨在提供以患者为中心的护理,实施个性化干预,并提高药物依从性,特别是对于老年、男性、社会经济地位较低、接受多种药物治疗和患有多种合并症的患者。