BioDrugs

, Volume 13, Issue 2, pp 127–133

Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Which Drugs Help Most?
Review Article

Abstract

The treatment of chronic obstructive pulmonary disease (COPD) is receiving increasing attention since the burden of this disease is expected to rise on a global scale in the coming decades. Preventing deterioration of lung function parameters has been the main goal of research in COPD management. In practice, however, the success of drug treatment is not dependent on lung function only, but also relies on the patients’ well-being. Therefore, an important role for health-related quality of life (HRQL) is emerging. Until now, several frequently prescribed drugs have been tested in trials using valid and disease-specific HRQL instruments. Evidence of beneficial effects on HRQL is available for the use of shortacting bronchodilators, theophylline and long-acting β-adrenergic bronchodilators in the treatment of COPD. One source reported beneficial effects of inhaled corticosteroid treatment on HRQL. The value of these and other drugs in the management of COPD will need to be assessed in the coming years.

References

  1. 1.
    Murray CJL, Lopez AD. Mortality by cause for eight regions of the world: global burden of disease study. Lancet 1997; 349: 1269–76PubMedCrossRefGoogle Scholar
  2. 2.
    Liu B-Q, Peto R, Chen Z-M, et al. Emerging hazards in China: retrospective proportional mortality study of one million deaths. BMJ 1998; 317: 1411–22PubMedCrossRefGoogle Scholar
  3. 3.
    Feinleib M, Rosenberg HM, Collins JG, et al. Trends in COPD and mortality in the United States. Am Rev Respir Dis 1989; 140:S9–S18PubMedGoogle Scholar
  4. 4.
    Stewart AL, Greenfield S, Hays RD, et al. Functional status and well-being of patients with chronic conditions: results from the medical outcomes study. JAMA 1989; 262: 907–13PubMedCrossRefGoogle Scholar
  5. 5.
    Osman IM, Godden DJ, Friend JA, et al. Quality of life and hospital readmission in patients with chronic obstructive pulmonary disease. Thorax 1997; 52: 67–71PubMedCrossRefGoogle Scholar
  6. 6.
    Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1995; 152: S77–S120Google Scholar
  7. 7.
    Pearson MG, Alderslade R, Allen SC. British Thoracic Society guidelines for the management of chronic obstructive pulmonary disease. Thorax 1997; 52 Suppl.5: S1–28Google Scholar
  8. 8.
    Siafakas NM, Vermeire P, Pride P, et al. Optimal assessment and management of chronic obstructive pulmonary disease (COPD): a consensus statement of the European Respiratory Society. Eur Respir J 1995; 8: 1398–1420PubMedCrossRefGoogle Scholar
  9. 9.
    Testa MA, Simonson DC. Assessment of quality of life outcomes. N Engl J Med 1996; 334: 835–40PubMedCrossRefGoogle Scholar
  10. 10.
    Schayck van CP, Rutten MPHM, Doorslaer van EKA, et al. Two-year bronchodilator treatment in patients with mild airflow obstruction: contradictory effects on lung function and quality of life. Chest 1992; 102: 1384–91PubMedCrossRefGoogle Scholar
  11. 11.
    Schayck van CP. Measurement of quality of life in patients with chronic obstructive pulmonary disease. Pharmacoeconomics 1997; 11: 13–18PubMedCrossRefGoogle Scholar
  12. 12.
    Tsukino M, Nishimura K, Ikeda A, et al. Physiologic factors that determine the health-related quality of life in patients with COPD. Chest 1996; 110: 896–903PubMedCrossRefGoogle Scholar
  13. 13.
    Curtis JR, Martin DP, Martin TR. Patient-assessed health outcomes in chronic lung disease. Am J Respir Crit Care Med 1997; 156: 1032–9PubMedGoogle Scholar
  14. 14.
    Toshima MT, Kaplan RM, Ries AL. Experimental evaluation of rehabilitation in chronic obstructive pulmonary disease: short-term effects on exercise endurance and health status. Health Psychol 1990; 9: 237–52PubMedCrossRefGoogle Scholar
  15. 15.
    Bergner M, Hudson LD, Conrad DA, et al. The cost and efficacy of home care for patients with chronic lung disease. Med Care 1988; 26: 566–79PubMedCrossRefGoogle Scholar
  16. 16.
    Wijkstra PJ, Altena van J, Kraan et al. Quality of life in patients with chronic obstructive pulmonary disease after rehabilitation at home. Eur Respir J 1994; 7: 269–73PubMedCrossRefGoogle Scholar
  17. 17.
    Wijkstra PJ, Ten Vergert EM, Altena van R, et al. Long term benefits of rehabilitation at home on quality of life and exercise tolerance in patients with chronic obstructive pulmonary disease. Thorax 1995; 50: 824–8PubMedCrossRefGoogle Scholar
  18. 18.
    Guyatt GH, Berman LB, Townsend M, et al. A measure of quality of life for clinical trials in chronic lung disease. Thorax 1987; 42: 773–8PubMedCrossRefGoogle Scholar
  19. 19.
    Jones PW, Quirk FH, Baveystock CM, et al. A self-complete measure of health status for chronic airflow limitation: the St. George’s Respiratory Questionnaire. Am J Rev Respir Dis 1992; 145: 1321–7Google Scholar
  20. 20.
    Hyland ME, Bott J, Singh S, et al. Domains, constructs and the development of the breathing problems questionnaire. Qual Life Res 1994 3: 245–56PubMedCrossRefGoogle Scholar
  21. 21.
    Hajiro T, Nishimura K, Tsukino M, et al. Comparison of discriminative properties among disease-specific qyestionnaires for measuring health-related quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998; 157: 785–90.PubMedGoogle Scholar
  22. 22.
    Wijkstra PJ, Ten Vergert EM, Mark van der ThW, et al. Reliability and validity of the chronic respiratory questionnaire (CRQ). Thorax 1994; 49: 465–7PubMedCrossRefGoogle Scholar
  23. 23.
    Hajiro T, Nishimura K, Jones PW, et al. A novel, short, and simple questionnaire to measure health-related quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1999; 159: 1874–8PubMedGoogle Scholar
  24. 24.
    Mahler D, Weinber D, Wells C, et al. The measurement of dyspnea: contents, interobserver agreement, and physiologic correlates of two new clinical indexes. Chest 1984; 85: 751–8PubMedCrossRefGoogle Scholar
  25. 25.
    Bestall JC, Paul EA, Garrod R, et al. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 1999; 54: 581–6PubMedCrossRefGoogle Scholar
  26. 26.
    Guyatt GH, Townsend M, Pugsley SO, et al. Bronchodilators in chronic airflow limitation: effects on airway function, exercise capacity, and quality of life. Am Rev Respir Dis 1987; 135: 1069–74PubMedGoogle Scholar
  27. 27.
    Mahler DA, Matthay RA, Snyder PE, et al. Sustained-release theophylline reduces dyspnea in nonreversible obstructive airways disease. Am Rev Respir Dis 1985; 131: 22–5PubMedGoogle Scholar
  28. 28.
    Rennard SI, Serby CW, Ghafouri M, et al. Extended therapy with ipratropium is associated with improved lung function in patients with COPD: a retrospective analysis of data from seven clinical trials. Chest 1996; 110: 62–70PubMedCrossRefGoogle Scholar
  29. 29.
    Jones PW, Bosh TK. Quality of life changes in COPD patients treated with salmeterol. Am J Respir Crit Care Med 1997; 155: 1283–9PubMedGoogle Scholar
  30. 30.
    Mahler DA, Donohue JF, Barbee RA, et al. Efficacy of salmeterol xinafoate in the treatment of COPD. Chest 1999; 115: 957–65PubMedCrossRefGoogle Scholar
  31. 31.
    Maesen BLP, Westermann CJJ, Duurkens VAM, et al. Formoterol induced responses in non-reversible chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1997; 155: A282Google Scholar
  32. 32.
    Tutluoglu B, Gurbuz N, Sahin S, et al. Effects of short term usage of formoterol on six minute walking test in COPD patients. Eur Resp J 1997; 10 Suppl.25: 65SGoogle Scholar
  33. 33.
    Barnes PJ, Belvisi MG, Mak JCW, et al. Tiotropium bromide (Ba 679 BR), a novel long-acting muscarinic antagonist for the treatment of obstructive airways disease. Life Sci 1995; 56: 853–9PubMedCrossRefGoogle Scholar
  34. 34.
    Maesen FPV, Smeets JJ, Sledsens TJH, et al. Tiotropium bromide, a new long-acting antimuscarinic bronchodilator: a pharmacodynamic study in patients with chronic obstructive pulmonary disease (COPD) (Dutch Study Group). Eur Respir J 1995; 8: 1506–13PubMedGoogle Scholar
  35. 35.
    Vestbo J, Sörensen T, Lange P, et al. Long-term effect of inhaled budesonide in mild and moderate chronic obstructive pulmonary disease: a randomised controlled trial. Lancet 1999; 353: 1819–23PubMedCrossRefGoogle Scholar
  36. 36.
    Pauwels RA, Lofdahl CG, Laitinen LA, et al. Long-term treatment with inhaled budesonide in persons with mild chronic obstructive pulmonary disease who continue smoking. N Engl J Med 1999; 340: 1948–53PubMedCrossRefGoogle Scholar
  37. 37.
    Calverley PMA, Burge PS, Jones PW, et al. Effect of 3 years treatment with fluticasone propionate in patients with moderately-severe COPD. Am J Respir Crit Care Med 1999; 159: A524Google Scholar
  38. 38.
    Spencer S, Anie K, Calverley PMA, et al. Rate of health status decline is reduced in COPD patients treated with fluticasone compared to placebo. Am J Respir Crit Care Med 1999; 159: A522Google Scholar
  39. 39.
    Seemungal TAR, Donaldson GC, Paul EA, et al. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998; 1418-22Google Scholar
  40. 40.
    Niewohner DE, Erbland ML, Deupree RH, et al. Effect of systemic glucocorticoids on exacerbations of chronic obstructive pulmonary disease. N Engl J Med 1999; 340: 1941–7CrossRefGoogle Scholar
  41. 41.
    Davies L, Angus RM, Calverley PMA. Oral corticosteroids in patients admitted to hospital with exacerbations of chronic obstructive pulmonary disease: a prospective randomised controlled trial. Lancet 1999; 354: 456–60PubMedCrossRefGoogle Scholar
  42. 42.
    Rasmussen JB, Gleenow C. Reduction in days of illness after long-term treatment with N-acetylcysteine controlled-release tablets in patients with chronic bronchitis. Eur Respir J 1988; 1:351–5Google Scholar
  43. 43.
    Boman G, Bäcker U, Larsson S, et al. Oral acteylcysteine reduces exacerbation rate in chronic bronchitis: report of trial organised by Swedish Society for Pulmonary Diseases. Eur Respir J 1983; 64: 405–15Google Scholar
  44. 44.
    Multicentre Study Group. Long-term oral acetylcysteine in chronic bronchitis: a double-blind controlled study. Eur J Respir Dis 1980; 61 Suppl.111: 93–108Google Scholar
  45. 45.
    Schayck CP van, Dekhuijzen PNR, Gorgels WJMJ, et al. Are anti-oxidant and ant-inflammatory treatment effective in different subgroups of COPD?: a hypothesis. Respir Med 1998; 92: 1259–64PubMedCrossRefGoogle Scholar
  46. 46.
    Ede van L, Yzermans CJ, Brouwer HJ. Prevalence of depression in patients with chronic obstructive pulmonary disease: a systematic review. Thorax 1999; 54: 688–92PubMedCrossRefGoogle Scholar
  47. 47.
    Prigatano GP, Wright EC, Levin D. Quality of life and its predictors in patients with mild hypoxaemia and chronic obstructive pulmonary disease. Arch Intern Med 1984; 144: 1613–19PubMedCrossRefGoogle Scholar
  48. 48.
    Borson S, McDonald GJ, Gayle T, et al. Improvement in mood, physical symptoms, and function with nortriptyline for depression in patients with chronic obstructive pulmonary disease. Psychosomatics 1992; 33: 190–201PubMedCrossRefGoogle Scholar
  49. 49.
    Jorenby DE, Leischow SJ, Nides MA, et al. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. N Engl J Med 1999; 340: 685–91PubMedCrossRefGoogle Scholar
  50. 50.
    Okubadejo AA, Jones PW, Wedzicha JA. Quality of life in patients with chronic obstructive pulmonary disease and severe hypoxaemia. Thorax 1996; 51: 44–7PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 2000

Authors and Affiliations

  • Niels H. Chavannes
    • 1
  • Constant P. van Schayck
    • 1
  1. 1.Department of General PracticeMaastricht UniversityMaastrichtThe Netherlands

Personalised recommendations