Key result
Health-related quality of life was worse in COPD patients with the frequent exacerbator phenotype compared to asthma-COPD overlap and non-exacerbator phenotypes.
Why the study?
The study sought to compare patients' health-related quality of life according to Spanish guideline COPD phenotypes based on exacerbation frequency and subtypes.
Cross-Sectional (n=185)
Yes
In a rural Malaysian cohort, COPD patients with a frequent exacerbator phenotype experienced significantly worse health-related quality of life compared to those with asthma-COPD overlap or non-exacerbator phenotypes.
Answers are grounded in this paper and cite their sources.
AE phenotype tied to worst HRQoL; hypothesis-generating for phenotyping, should not yet change practice.
BACKGROUND: The Spanish chronic obstructive pulmonary disease (COPD) guideline phenotypes patients according to the exacerbation frequency and COPD subtypes. In this study, we compared the patients' health-related quality of life (HRQoL) according to their COPD phenotypes. METHODS: This was a cross-sectional study of COPD patients who attended the outpatient clinic of the Serian Divisional Hospital and Bau District Hospital from 23th January 2018 to 22th January 2019. The HRQoL was assessed using modified Medical Research Council (mMRC), COPD Assessment Test (CAT), and St George's Respiratory Questionnaire for COPD (SGRQ-c). RESULTS: Of 185 patients, 108 (58.4%) were non-exacerbators (NON-AE), 51 (27.6%) were frequent exacerbators (AE), and the remaining 26 (14.1%) had asthma-COPD overlap (ACO). Of AE patients, 42 (82.4%) had chronic bronchitis and only 9 (17.6%) had emphysema. Of the 185 COPD patients, 65.9% had exposure to biomass fuel and 69.1% were ex- or current smokers. The scores of mMRC, CAT, and SGRQ-c were significantly different between COPD phenotypes (p < 0.001). There were significantly more patients with mMRC 2-4 among AE (68.6%) (p < 0.001), compared to those with ACO (38.5%) and NON-AE (16.7%). AE patients had significantly higher total CAT (p = 0.003; p < 0.001) and SGRQ-c (both p < 0.001) scores than those with ACO and NON-AE. Patients with ACO had significantly higher total CAT and SGRQ-c (both p < 0.001) scores than those with NON-AE. AE patients had significantly higher score in each item of CAT and component of SGRQ-c compared to those with NON-AE (all p < 0.001), and ACO [(p = 0.003-0.016; p = < 0.001-0.005) except CAT 1, 2 and 7. ACO patients had significantly higher score in each item of CAT and component of SGRQ-c (p = < 0.001-0.040; p < 0.001) except CAT 2 and activity components of SGRQ-c. CONCLUSIONS: The HRQoL of COPD patients was significantly different across different COPD phenotypes. HRQoL was worst in AE, followed by ACO and NON-AE. This study supports phenotyping COPD patients based on their exacerbation frequency and COPD subtypes. The treatment of COPD should be personalised according to these two factors.
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Chai et al. (2020) conducted a cross-sectional in Chronic obstructive pulmonary disease (COPD) (n=185). COPD phenotypes (Frequent exacerbators vs Asthma-COPD overlap vs Non-exacerbators) vs. Non-exacerbators was evaluated on Health-related quality of life (mMRC, CAT, and SGRQ-c scores) (p=<0.001). Health-related quality of life was worse in COPD patients with the frequent exacerbator phenotype compared to asthma-COPD overlap and non-exacerbator phenotypes.
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