The influence of COPD on health-related quality of life independent of the influence of comorbidity

van Manen, Jeannette G; Bindels, Patrick J.E; Dekker, Friedo W; Bottema, Bernardus J.A.M; van der Zee, Jaring S; Ijzermans, C.Joris; Schadé, Egbert

doi:10.1016/S0895-4356(03)00208-7

« Previous Next »Journal of Clinical Epidemiology
Volume 56, Issue 12 , Pages 1177-1184, December 2003

The influence of COPD on health-related quality of life independent of the influence of comorbidity

Jeannette G van Manen
- Department of General Practice, Division of Public Health, Academic Medical Center–University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
- Corresponding author. Tel.: 31-0-71-526-6914; fax: 31-0-71-526-6994.
Patrick J.E Bindels
- Department of General Practice, Division of Public Health, Academic Medical Center–University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Center, P.O. Box 2300, 2300 RC, Leiden, The Netherlands
Bernardus J.A.M Bottema
- Department of General Practice and Social Medicine, University of Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
Jaring S van der Zee
- Department of Pulmonology, Academic Medical Center–University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
C.Joris Ijzermans
- Department of General Practice, Division of Public Health, Academic Medical Center–University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
Egbert Schadé
- Department of General Practice, Division of Public Health, Academic Medical Center–University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands

Accepted 26 May 2003.

Abstract

Background and objective

The goal of this study was to determine the influence of chronic obstructive pulmonary disease (COPD) on health-related quality of life (HRQL) independent of comorbidity.

Methods

Patients with COPD in general practice, ⩾40 years, were selected. To recruit controls, a random sample of persons without COPD and ⩾40 years, was taken. HRQL was assessed with the SF-36 and comorbidity was determined by questionnaire.

Results

The influence of COPD on HRQL independent of comorbidity (represented by adjusted regression coefficients) was significant for physical functioning (−27.6), role functioning due to physical problems (−21.6), vitality (−14.4), and general health (−25.7), and was minor and not significant for social functioning (−5.6), mental health (−1.3), role functioning due to emotional problems (−2.7), and bodily pain (−2.5). Comorbidity contributed significantly to the HRQL of all domains (−7.6 to −27.1).

Conclusion

COPD patients can be impaired in all domains of HRQL. However, impairments in physical functioning, vitality, and general health are related to COPD and to some extent to comorbidity, while impairments in social and emotional functioning do not seem to be related to COPD, but only to comorbidity.

Keywords: COPD, Quality of life, Comorbidity, General practice