Generic utilities in chronic obstructive pulmonary disease patients stratified according to different staging systems.
Health Qual Life Outcomes
; 12: 120, 2014 Sep 05.
Article
en En
| MEDLINE
| ID: mdl-25189786
ABSTRACT
BACKGROUND:
To determine generic utilities for Spanish chronic obstructive pulmonary disease (COPD) patients stratified by different classifications GOLD 2007, GOLD 2013, GesEPOC 2012 and BODEx index.METHODS:
Multicentre, observational, cross-sectional study. Patients were aged ≥40 years, with spirometrically confirmed COPD. Utility values were derived from EQ-5D-3 L. Means, standard deviations (SD), medians and interquartile ranges (IQR) were computed based on the different classifications. Differences in median utilities between groups were assessed by non-parametric tests.RESULTS:
346 patients were included, of which 85.5% were male with a mean age of 67.9 (SD = 9.7) years and a mean duration of COPD of 7.6 (SD = 5.8) years; 80.3% were ex-smokers and the mean smoking history was 54.2 (SD = 33.2) pack-years. Median utilities (IQR) by GOLD 2007 were 0.87 (0.22) for moderate; 0.80 (0.26) for severe and 0.67 (0.42) for very-severe patients (p < 0.001 for all comparisons). Median utilities by GOLD 2013 were group A 1.0 (0.09); group B 0.87 (0.13); group C 1.0 (0.16); group D 0.74 (0.29); comparisons were statistically significant (p < 0.001) except A vs C. Median utilities by GesEPOC phenotypes were 0.84 (0.33) for non exacerbator; 0.80 (0.26) for COPD-asthma overlap; 0.71 (0.62) for exacerbator with emphysema; 0.72 (0.57) for exacerbator with chronic bronchitis (p < 0.001). Comparisons between patients with or without exacerbations and between patients with COPD-asthma overlap and exacerbator with chronic bronchitis were statistically-significant (p < 0.001). Median utilities by BODEx index were group 0-2 0.89 (0.20); group 3-4 0.80 (0.27); group 5-6 0.67 (0.29); group 7-9 0.41 (0.31). All comparisons were significant (p < 0.001) except between groups 3-4 and 5-6.CONCLUSION:
Irrespective of the classification used utilities were associated to disease severity. Some clinical phenotypes were associated with worse utilities, probably related to a higher frequency of exacerbations. GOLD 2007 guidelines and BODEx index better discriminated patients with a worse health status than GOLD 2013 guidelines, while GOLD 2013 guidelines were better able to identify a smaller group of patients with the best health.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Ansiedad
/
Dolor
/
Calidad de Vida
/
Actividades Cotidianas
/
Enfermedad Pulmonar Obstructiva Crónica
/
Limitación de la Movilidad
Tipo de estudio:
Guideline
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Health Qual Life Outcomes
Asunto de la revista:
SAUDE PUBLICA
Año:
2014
Tipo del documento:
Article