Original Article
Impact of Chronic Obstructive Pulmonary Disease on Activities of Daily Living: Results of the Multicenter EIME Study
Francisco Javier Álvarez-Gutiérreza,
, Marc Miravitllesb, Miriam Callec, Elena Gobarttd, Francisco Lópeze, Antonio Martínf, the EIME Study Group *
Corresponding author
fag01se@saludalia.com
Correspondence: Dr. F.J. Álvarez-Gutiérrez. Alcalde Manuel del Valle, Edificio Cónsul, portal 6, 1.°, A. 41008 Sevilla. España
Correspondence: Dr. F.J. Álvarez-Gutiérrez. Alcalde Manuel del Valle, Edificio Cónsul, portal 6, 1.°, A. 41008 Sevilla. España
a Servicio de Neumología, Red Respira RTIC 03/11 ISCIII, Hospital Virgen del Rocío, Sevilla. Spain
b Servei de Pneumologia, Institut Clínic del Tòrax (IDIBAPS), Red Respira RTIC 03/11 ISCIII, Hospital Clínic, Barcelona, Spain
c Servicio de Neumología. Red Respira RTIC 03/11 ISCIII, Hospital Clínico San Carlos, Madrid, Spain
d R&D Department, Boehringer Ingelheim, Barcelona, Spain
e Nufarm 21, Madrid, Spain
f R&D Department, Pfizer, Madrid, Spain
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Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servei de Pneumologia, Institut Clínic del Tòrax (IDIBAPS), Red Respira RTIC 03/11 ISCIII, Hospital Clínic, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servicio de Neumología. Red Respira RTIC 03/11 ISCIII, Hospital Clínico San Carlos, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] 3 => array:3 [ "entidad" => "R&D Department, Boehringer Ingelheim, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] 4 => array:3 [ "entidad" => "Nufarm 21, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff5" ] 5 => array:3 [ "entidad" => "R&D Department, Pfizer, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff6" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. F.J. Álvarez-Gutiérrez. Alcalde Manuel del Valle, Edificio Cónsul, portal 6, 1.°, A. 41008 Sevilla. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-11-29" "fechaAceptado" => "2006-04-04" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154746" "palabras" => array:4 [ 0 => "Chronic obstructive pulmonary disease" 1 => "COPD" 2 => "Health-related quality of life" 3 => "Fragile patient" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154747" "palabras" => array:3 [ 0 => "EPOC" 1 => "Calidad de vida relacionada con la salud" 2 => "Paciente frágil" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to determine the impact of chronic obstructive pulmonary disease (COPD) on activities of daily living in a large group of patients in Spain who responded to a specific questionnaire. A second aim was to explore the practical utility of the questionnaire and determine which variables could be used to identify “fragile” patients or patients in greater need of attention. To do this, we examined the relationship between questionnaire results and clinical variables, lung function measurements, socioeconomic status, and validated quality of life questionnaires.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">We conducted an observational, descriptive, multicenter, cross-sectional study in which 227 respiratory specialists from all over Spain collected data from 1057 patients with COPD. Each patient was given a specific questionnaire containing 7 items that measured the extent to which COPD affected different aspects of their lives. The patients rated each item on a scale of 0 to 2, depending on the level of impact. Total possible scores, thus, ranged from 0 to 14, and patients with a score of 9 or higher were classified as fragile. We then explored the relationship between questionnaire results and clinical variables, socioeconomic status, spirometric values, and quality of life as measured by the St George's Respiratory Questionnaire (SGRQ).</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">We studied 1057 patients (95.2% male) with a mean (SD) age of 67 (9) years and a mean predicted forced expiratory volume in 1 second (FEV<span class="elsevierStyleInf">1</span>) of 41.8% (13.3%). The mean questionnaire score was 6.3 (3.1). The activities that were affected most were sport and leisure, habitual physical activity, and sex life (major impact reported by 52.5%, 30.3%, and 20.2% of patients, respectively). We found a correlation between questionnaire scores and known disease severity markers such as SGRQ scores, dyspnea, number of exacerbations, and FEV<span class="elsevierStyleInf">1</span> in liters. Patients included in the fragile category were older and had a lower socioeconomic status.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">COPD impact questionnaire scores correlated well with SGRQ scores and the usual clinical variables and lung function measurements for evaluating disease severity (dyspnea, FEV<span class="elsevierStyleInf">1</span>, and exacerbations). The questionnaire could, therefore, be a useful tool for identifying fragile patients who, in addition to having poorer clinical status and lung function measurements, have a lower socioeconomic status.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Realizamos el estudio con el propósito de conocer, a través de un cuestionario específico, el impacto de la enfermedad pulmonar obstructiva crónica (EPOC) sobre las actividades de la vida diaria en un grupo amplio de pacientes en España. Asimismo estudiamos su relación con parámetros clínicos, funcionales y socioeconómicos, y con escalas validadas de calidad de vida, para evaluar su utilidad en la práctica habitual y determinar qué variables pueden definir a los pacientes “frágiles” o que requieren una mayor atención.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio observacional, descriptivo, multicéntrico y transversal, con la participación de 227 neumólogos de toda España, que incluyó a pacientes con el diagnóstico de EPOC. A todos éstos se les pasó un cuestionario específico con 7 preguntas que medían el impacto de la enfermedad sobre aspectos de la vida diaria Las respuestas se valoraron de 0 a 2, según el grado de afectación, lo que supone un intervalo entre 0 y 14 unidades. Definimos al paciente como “frágil” si presentaba valores iguales o mayores de 9 en el cuestionario de impacto. Se evaluó la relación entre la escala de impacto y variables clínicas, situación socioeconómica, espirometría y calidad de vida medida con el cuestionario específico St. George's Respiratory Questionnaire (SGRQ).</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Estudiamos a 1.057 pacientes (un 95,2% varones), con una edad media (± desviación estándar) de 67 ± 9 años y volumen espiratorio forzado en el primer segundo (FEV<span class="elsevierStyleInf">1</span>), expresado en porcentaje, del 41,8 ± 13,3%. La puntuación media del cuestionario de impacto fue de 6,3 ± 3,1. Las actividades con mayor afectación fueron deporte y ocio, actividad física habitual y vida sexual (mucha afectación en el 52,5, el 30,3 y el 20,2% de los pacientes, respectivamente). Encontramos relación entre la puntuación del cuestionario y parámetros conocidos de gravedad (SGRQ, disnea, número de agudizaciones y FEV<span class="elsevierStyleInf">1</span> expresado en litros). Los pacientes definidos como frágiles tenían mayor edad y menor nivel tanto cultural como económico.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El cuestionario de impacto de la EPOC se correlaciona bien con los clásicos parámetros clínicos y funcionales de valoración de la gravedad de la enfermedad (disnea, FEV<span class="elsevierStyleInf">1</span> y exacerbaciones) y con el cuestionario de calidad de vida relacionada con la salud SGRQ. Así pues, podría ser un instrumento útil para identificar un perfil de paciente frágil, que presenta, además de una peor situación clínica y funcional, una situación socioeconómica más desfavorecida.</p>" ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara">The researchers that formed part of the EIME Study Group are listed at the end of the article.</p>" ] 1 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">The EIME study was funded by Boehringer Ingelheim and Pfizer.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Geographical variations in prevalence and underdiagnosis of COPD. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 1 | 5 | 6 |
| 2024 October | 28 | 36 | 64 |
| 2024 September | 34 | 18 | 52 |
| 2024 August | 71 | 49 | 120 |
| 2024 July | 30 | 20 | 50 |
| 2024 June | 40 | 31 | 71 |
| 2024 May | 37 | 28 | 65 |
| 2024 April | 18 | 24 | 42 |
| 2024 March | 27 | 16 | 43 |
| 2024 February | 18 | 19 | 37 |
| 2023 March | 3 | 3 | 6 |
| 2023 February | 15 | 17 | 32 |
| 2023 January | 13 | 25 | 38 |
| 2022 December | 14 | 23 | 37 |
| 2022 November | 32 | 25 | 57 |
| 2022 October | 23 | 32 | 55 |
| 2022 September | 17 | 21 | 38 |
| 2022 August | 23 | 35 | 58 |
| 2022 July | 25 | 44 | 69 |
| 2022 June | 21 | 28 | 49 |
| 2022 May | 25 | 36 | 61 |
| 2022 April | 26 | 35 | 61 |
| 2022 March | 20 | 41 | 61 |
| 2022 February | 29 | 34 | 63 |
| 2022 January | 15 | 37 | 52 |
| 2021 December | 15 | 54 | 69 |
| 2021 November | 15 | 47 | 62 |
| 2021 October | 18 | 45 | 63 |
| 2021 September | 18 | 60 | 78 |
| 2021 August | 13 | 23 | 36 |
| 2021 July | 18 | 26 | 44 |
| 2021 June | 6 | 33 | 39 |
| 2021 May | 8 | 20 | 28 |
| 2021 April | 31 | 60 | 91 |
| 2021 March | 20 | 13 | 33 |
| 2021 February | 10 | 12 | 22 |
| 2021 January | 14 | 11 | 25 |
| 2020 December | 7 | 12 | 19 |
| 2020 November | 7 | 13 | 20 |
| 2020 October | 6 | 4 | 10 |
| 2020 September | 3 | 3 | 6 |
| 2020 August | 1 | 8 | 9 |
| 2020 July | 8 | 10 | 18 |
| 2020 June | 2 | 4 | 6 |
| 2020 May | 6 | 13 | 19 |
| 2020 April | 8 | 19 | 27 |
| 2020 March | 6 | 8 | 14 |
| 2020 February | 6 | 14 | 20 |
| 2020 January | 23 | 20 | 43 |
| 2019 December | 6 | 11 | 17 |
| 2019 November | 7 | 6 | 13 |
| 2019 October | 7 | 5 | 12 |
| 2019 September | 7 | 7 | 14 |
| 2019 August | 6 | 9 | 15 |
| 2019 July | 32 | 18 | 50 |
| 2019 June | 47 | 7 | 54 |
| 2019 May | 42 | 12 | 54 |
| 2019 April | 11 | 26 | 37 |
| 2019 March | 10 | 10 | 20 |
| 2019 February | 7 | 10 | 17 |
| 2019 January | 4 | 11 | 15 |
| 2018 December | 3 | 11 | 14 |
| 2018 November | 23 | 10 | 33 |
| 2018 October | 27 | 12 | 39 |
| 2018 September | 24 | 13 | 37 |
| 2018 May | 4 | 0 | 4 |
| 2018 April | 7 | 7 | 14 |
| 2018 March | 6 | 3 | 9 |
| 2018 February | 3 | 7 | 10 |
| 2018 January | 3 | 5 | 8 |
| 2017 December | 3 | 6 | 9 |
| 2017 November | 2 | 6 | 8 |
| 2017 October | 4 | 11 | 15 |
| 2017 September | 5 | 9 | 14 |
| 2017 August | 8 | 11 | 19 |
| 2017 July | 5 | 7 | 12 |
| 2017 June | 11 | 15 | 26 |
| 2017 May | 5 | 12 | 17 |
| 2017 April | 2 | 5 | 7 |
| 2017 March | 2 | 2 | 4 |
| 2017 February | 3 | 7 | 10 |
| 2017 January | 1 | 3 | 4 |
| 2016 December | 9 | 6 | 15 |
| 2016 November | 10 | 6 | 16 |
| 2016 October | 11 | 11 | 22 |
| 2016 September | 12 | 5 | 17 |
| 2016 August | 7 | 6 | 13 |
| 2016 July | 2 | 4 | 6 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 201 | 16 | 217 |
| 2015 September | 220 | 13 | 233 |
| 2015 August | 189 | 11 | 200 |
| 2015 July | 179 | 8 | 187 |
| 2015 June | 153 | 12 | 165 |
| 2015 May | 194 | 17 | 211 |
| 2015 April | 187 | 12 | 199 |
| 2015 March | 221 | 11 | 232 |
| 2015 February | 161 | 7 | 168 |
| 2015 January | 141 | 6 | 147 |
| 2014 December | 159 | 9 | 168 |
| 2014 November | 215 | 13 | 228 |
| 2014 October | 238 | 9 | 247 |
| 2014 September | 217 | 11 | 228 |
| 2014 August | 163 | 13 | 176 |
| 2014 July | 169 | 13 | 182 |
| 2014 June | 180 | 10 | 190 |
| 2014 May | 178 | 11 | 189 |
| 2014 April | 197 | 11 | 208 |
| 2014 March | 204 | 11 | 215 |
| 2014 February | 137 | 15 | 152 |
| 2014 January | 146 | 11 | 157 |
| 2013 December | 111 | 10 | 121 |
| 2013 November | 121 | 5 | 126 |
| 2013 October | 97 | 8 | 105 |
| 2013 September | 117 | 10 | 127 |
| 2013 August | 59 | 5 | 64 |
| 2013 July | 87 | 21 | 108 |
| 2013 June | 71 | 11 | 82 |
| 2013 May | 65 | 8 | 73 |
| 2013 April | 49 | 3 | 52 |
| 2013 March | 18 | 3 | 21 |
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