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Research article
Chee-Shee Chai
Universiti Malaysia Sarawak
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4277-6152
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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 23 th January 2018 to 22 th 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 COPD patients, 65.9% had exposure to biomass fuel.
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 also 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 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.
Keywords
Chronic obstructive pulmonary disease, clinical phenotypes, health-related quality of life, exacerbators, asthma overlap
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CURRENT STATUS: Published
View the published article at BMC Pulmonary Medicine.
Version 3
Posted 21 Sep, 2020
No community comments so far
Submission checks complete
On 19 Sep, 2020
Editorial decision: Accept
On 16 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 26 Jul, 2020
Editor assigned
On 20 Jul, 2020
Submission checks complete
On 19 Jul, 2020
Editor invited
On 19 Jul, 2020
No comments provided
Review #2 received
Received 14 Jul, 2020
Editorial decision: Minor revision
On 14 Jul, 2020
Review #1 received
Received 13 Jul, 2020
Reviewer #2 agreed
On 15 Jun, 2020
Reviewer #1 agreed
On 13 Jun, 2020
Editor assigned
On 12 Jun, 2020
Reviewers invited
Invitations sent on 12 Jun, 2020
Submission checks complete
On 11 Jun, 2020
Editor invited
On 11 Jun, 2020
First submitted
On 10 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pulmonology
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A new preprint design is coming!
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See the published version of this preprint at BMC Pulmonary Medicine.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Chee-Shee Chai
Universiti Malaysia Sarawak
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4277-6152
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pulmonary Medicine.
Version 3
Posted 21 Sep, 2020
No community comments so far
Submission checks complete
On 19 Sep, 2020
Editorial decision: Accept
On 16 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 26 Jul, 2020
Editor assigned
On 20 Jul, 2020
Submission checks complete
On 19 Jul, 2020
Editor invited
On 19 Jul, 2020
No comments provided
Review #2 received
Received 14 Jul, 2020
Editorial decision: Minor revision
On 14 Jul, 2020
Review #1 received
Received 13 Jul, 2020
Reviewer #2 agreed
On 15 Jun, 2020
Reviewer #1 agreed
On 13 Jun, 2020
Editor assigned
On 12 Jun, 2020
Reviewers invited
Invitations sent on 12 Jun, 2020
Submission checks complete
On 11 Jun, 2020
Editor invited
On 11 Jun, 2020
First submitted
On 10 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Pulmonology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Pulmonary Medicine.
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 23 th January 2018 to 22 th 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 COPD patients, 65.9% had exposure to biomass fuel.
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 also 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 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.
Figure 1
Figure 2
Figure 3
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