Study Shows Psychological Factors Affect Quality of Life in Patients With COPD

Psychological factors negatively affect quality-of-life scores in chronic obstructive pulmonary disease (COPD) patients, according to a recent study published in the International Journal of Chronic Obstructive Pulmonary Disease.

While quality of life varies greatly among patients with COPD, it is often unrelated to physiological impairment. The study examined factors that are associated with poor quality of life, focusing on psychological measures that can easily be controlled with intervention and treatment.

The researchers analyzed Birmingham (UK) COPD cohort data to determine factors affecting quality of life. The population was divided into 3 patient groups, including patients with diagnosed COPD on general practitioner registers, newly identified COPD patients from a linked case-finding study, and participants from the case-finding study with chronic respiratory symptoms without airflow obstruction.

Patients received questionnaires every 6 months over a 3-year period assessing the Medical Research Council breathlessness scale, lung function, muscle strength, and exercise capacity. Another questionnaire was administered during that time which focused on depression, anxiety, dysfunctional breathing, illness perceptions, and agoraphobia avoidance.

The results showed a wide variation of perceived quality of life impairment due to COPD in the population. Depression, anxiety, and negative health beliefs have significant impacts on patients’ experience with COPD. Illness perception has been found to be a determinant of behavior that has improved treatment adherence and functional recovery in patients. While psychological issues are common in patients with COPD, there is little evidence in supporting the use of intervention. Small studies have shown that relaxation, cognitive behavioral therapy, self-management and antidepressant medication can improve quality of life.

The authors concluded that there are many factors affecting quality of life in COPD patients. Many treatments to improve quality of life are nonpharmacologic approaches, including pulmonary rehabilitation being an effective way to manage the disease. Further research on psychological intervention needs to be pursued.

“The clinical focus in COPD is generally directed toward biologic factors such as physiologic impairment and airways inflammation, with a predominant focus on pharmacologic interventions,” the authors concluded. “However, along with smoking cessation, nonpharmacologic approaches are also very important in improving patient outcomes, with pulmonary rehabilitation now recognized as being a key element in overall disease management.”

References

Brien SB, Stuart B, Dickens AP. Independent determinants of disease-related quality of life in COPD—scope for nonpharmacologic interventions? Int J Chron Obstruct Pulmon Dis. 2018;13(1):247-256.