title: Exacerbations worsen the quality of life of chronic obstructive pulmonary disease patients in primary healthcare.
abstract: OBJECTIVE
  To investigate the evolution of the quality of life of patients with chronic obstructive pulmonary disease (COPD) and quantify the impact of exacerbations on the deterioration of quality of life over 2 years.
  
  
  METHODS
  Multicentre, observational, prospective 2-year study carried out in primary care. Patients with COPD were seen every 6 months. All the exacerbations developing during the study period were recorded and the quality of life of these patients was measured with the St. George's Respiratory Questionnaire (SGRQ).
  
  
  RESULTS
  Twenty-seven physicians participated and collected information on 136 patients with a mean age of 70 years (SD: 9.7) and a mean forced expiratory volume in 1 s (FEV(1)) of 48.7% predicted (SD: 14.5%). The mean global score of the SGRQ was 39.6 at the beginning of the study and 37.9 at the end. Patients without exacerbations improved an average of -5.32 units compared with a worsening of +0.2 among patients with exacerbations (p = 0.023). Among the latter, patients with only one exacerbation improved -3.8 units (p = 0.012) compared with a worsening of +2.4 in those with two or more exacerbations (p = 0.134). The impact of exacerbations was greater in patients with more preserved pulmonary function, with a change in the SGRQ among patients with or without exacerbations of +0.23 and -6.17 (p = 0.017), respectively in patients with a FEV(1) > 50%, vs. +0.18 and -4.39 (p = 0.32) in patients with a FEV(1) </= 50%.
  
  
  CONCLUSIONS
  Exacerbations are associated with a significant worsening in the quality of life of patients with COPD measured with the SGRQ. The degree of impairment depends on the number of exacerbations, being greater in patients with more preserved pulmonary function.
authors.affiliation: Primary Healthcare Centre Jaume I, University Rovira i Virgili, Tarragona, Spain. carles.llor@urv.cat
authors.forename: C
authors.initials: C
authors.lastname: Llor
authors.forename: J
authors.initials: J
authors.lastname: Molina
authors.forename: K
authors.initials: K
authors.lastname: Naberan
authors.forename: J M
authors.initials: JM
authors.lastname: Cots
authors.forename: F
authors.initials: F
authors.lastname: Ros
authors.forename: M
authors.initials: M
authors.lastname: Miravitlles
mesh_terms: D000208:Acute Disease; D000368:Aged; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000523:psychology*; D011788:Quality of Life; D014797:Vital Capacity / Q000502:physiology