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Vol. 40. Issue 10.
Pages 431-437 (October 2004)
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Vol. 40. Issue 10.
Pages 431-437 (October 2004)
Original Articles
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Quality of Life With Chronic Obstructive Pulmonary Disease: the Influence of Level of Patient Care
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4647
J. de Miguel Díeza, J.L. Izquierdo Alonsob,
Corresponding author
jlizquierdo@sescam.org

Correspondence: Dr. J.L. Izquierdo Alonso. Servicio de Neumología. Hospital General Universitario de Guadalajara. C/Donantes de Sangre, s/n. 19002 Guadalajara. España
, J.M. Rodríguez González-Moroa, P. de Lucas Ramosa, J.M. Bellón Canoc, J. Molina Parísd
a Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
b Sección de Neumología. Hospital General Universitario, Guadalajara, Spain
c Unidad de Investigación, Hospital General Universitario Gregorio Marañón, Madrid, Spain
d Centro de Salud Francia, Fuenlabrada, Madrid, Spain
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Objective

The aim of the study was to determine the factors related to the health-related quality of life (HRQL) of patients with stable chronic obstructive pulmonary disease (COPD) and to assess the degree of influence of level of patient care (primary or specialized).

Material And Method

An observational descriptive, cross-sectional, multicenter study was carried out. The study sample was a randomized selection taken from a stratified sample of patients treated by primary care physicians and pneumologists from each Spanish region. Only those patients whose level of health care was indicated and whose diagnosis of COPD was confirmed by spirometry were enrolled in the study.

Results

Five hundred sixty patients were assessed, 100 from primary health care and 460 from pneumology practices. No significant differences between the 2 levels of care were found in the scores on the HRQL questionnaire (Spanish version of the St George's Respiratory Questionnaire). There was a weak correlation between patients' perception of health and lung function parameters. Factors related to HRQL in the multivariate analysis were dyspnea, the presence of COPD exacerbations in the previous year, consequent visits to the emergency department, age, and degree of airflow restriction, but not level of patient care.

Conclusions

Stable COPD patients' HRQL is not related to their level of care, be it primary or specialized, but is related to other factors such as dyspnea, presence of exacerbations or consequent visits to the emergency department, age, and degree of airflow restriction.

Key Words:
COPD
Quality of life
Level of care
Primary health care
Pneumology
Objetivo

El estudio se realizó con el propósito de determinar los factores que se relacionan con la calidad de vida relacionada con la salud (CVRS) de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) estable y evaluar si existen diferencias según el nivel de asistencia de los pacientes (neumología o atención primaria).

Material Y Método

Se trata de un estudio observacional, descriptivo, transversal y multicéntrico. La selección de la muestra se realizó mediante un muestreo aleatorizado estratificado por población regional entre médicos de familia y neumólogos de todo el territorio nacional. Para este trabajo se seleccionó a aquellos en los que se registró el nivel de asistencia y en los que el diagnóstico de EPOC se confirmó por espirometría.

Resultados

Se evaluó a 560 pacientes, 100 en atención primaria y 460 en neumología. No se detectaron diferencias significativas en las puntuaciones obtenidas en el cuestionario de calidad de vida (versión española del Cuestionario Respiratorio St. George) en ambos niveles asistenciales. La correlación entre el estado de salud percibido por los pacientes y los parámetros de función pulmonar fue débil. Los factores que se relacionaron con la CVRS en el análisis multivariante fueron la disnea, la existencia de reagudizaciones de la EPOC en el año previo, las visitas a urgencias por este motivo, la edad y el grado de limitación al flujo respiratorio, pero no el ámbito de asistencia de los pacientes.

Conclusiones

La CVRS de los pacientes con EPOC estable no se relaciona con el nivel de atención, ya sea asistencia primaria o neumología, pero sí con otros factores como la disnea, la existencia de agudizaciones o visitas a urgencias por este motivo, la edad y el grado de obstrucción al flujo respiratorio.

Palabras clave:
EPOC
Calidad de vida
Nivel de asistencia
Atención primaria
Neumología
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