Determinants of Health-Related Quality of Life Among COPD Patients From a Clinical Practice Setting in Nigeria

Background

Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous and multisystem disease with potential impact on health-related quality of life (HRQoL). Understanding the burden and determinants of poor HRQoL in COPD may highlight modifiable factors that could minimize disease impact among an already vulnerable population.

Objectives

To assess the HRQoL and its determinants among COPD patients attending a tertiary care hospital in Lagos, Nigeria.

Methods

This was a cross-sectional study conducted at the Lagos University Teaching Hospital, Lagos, Nigeria. Participants with stable COPD were recruited and sociodemographic and clinical characteristics, current medications, and comorbidities were obtained. The HRQoL was assessed using the St. Georges Respiratory Questionnaire COPD version (SGRQ-C), functional status was assessed by the 6-min walk test (6MWT) and mortality risk assessed using the BODE index.

Results

Eighty-three participants were recruited and 47 (56.6%) were male. COPD assessment test (CAT) score was ≥ 10 in 81 (97.6%) participants and 47 (56.6%) had Modified Medical Research Council Dyspnea (mMRC) grading ≥ 2. The median 6-min walk distance (6MWD) was 256.0 meters (IQR = 93.0) and median BODE index was 4.0 (IQR = 3.0). Most of the participants (72) had 6MWD of < 350 meters, 22 had a BODE index score of > 5 and only 1 participant scored > 7. The median total SGRQ score was 47.7 (39.6–52.8) and the symptoms domain had the worst score of 76.7 (65.9–88.3). Factors that independently worsened HRQoL are higher CAT and MRC scores.

Conclusion

HRQoL is substantially impaired in COPD in our practice setting. High symptoms burden and worsening dyspnea worsened HRQoL. Interventions that reduce the burden of dyspnea and other symptoms such as pulmonary rehabilitation is a potential high value intervention in our setting.