CHEST Guidelines-Disease-Severity-and-Quality-of-Life-in-Patients-W

Disease-Severity-and-Quality-of-Life-in-Patients-W

Pdf Summary

This study investigates the relationship between disease severity metrics and quality of life (QOL) in patients with idiopathic pulmonary fibrosis (IPF), using data from the IPF-PRO Registry. The registry includes data from 859 patients, collected between 2014 and 2018. Disease severity was assessed using the Gender-Age-Lung Physiology (GAP) index, the Composite Physiologic Index (CPI), and measures like forced vital capacity (FVC) % predicted, diffusing capacity for carbon monoxide (DLCO) % predicted, and oxygen use. QOL was evaluated using the St. George’s Respiratory Questionnaire (SGRQ), among other metrics.<br /><br />Key findings include that patients with IPF report significant impairments in QOL, particularly in physical domains. Disease severity, measured objectively, is strongly associated with diminished QOL, with notable impairments linked to supplemental oxygen use. The study reveals that oxygen use during activity or rest significantly worsens QOL, exceeding associations with composite severity scores or physiological measures like FVC or DLCO % predicted.<br /><br />The study highlights the moderate correlation between GAP and CPI, suggesting that these indexes may capture different aspects of disease severity. However, it is noted that not all domains of QOL are affected equally; for example, while physical functioning correlates with perceived QOL impacts, mental health aspects are less affected. The research emphasizes the importance of patient-centered approaches in managing IPF, advocating for consideration of QOL alongside purely clinical measures to guide treatment decisions.<br /><br />Limitations include the cross-sectional design, restricting conclusions about causality, and potential biases inherent in self-reported data. Future research should focus on temporal changes in QOL relative to disease progression and the development of patient-centered interventions to address QOL in severe IPF cases.

Keywords

idiopathic pulmonary fibrosis

quality of life

IPF-PRO Registry

disease severity

GAP index

Composite Physiologic Index

forced vital capacity

oxygen use

St. George’s Respiratory Questionnaire

patient-centered approaches