Why measure Health-Related Quality of Life in COPD?
Specific outcomes, such as spirometric measurements, may have greater appeal because of their relative simplicity and apparent link with pathophysiology. Besides, the combined effect of different treatments presumed to improve a particular physiologic parameter may not necessarily lead to better patient comfort and quality of life. Miravitlles et al. observed worse HRQoL in patients who received three or more drugs for COPD despite adjustment for severity of disease and comorbidities. Though the possibility of confounding by indication exists, this can also be due to unwanted side effects of overzealous treatment. Even from a physiologic standpoint, a single parameter such as the FEV1 may be a good indicator for airflow obstruction, but may not be a good indicator of dynamic hyperinflation causing dyspnea. (Belman MJ et al 1996) Perhaps the most important, though often overlooked, reason to consider HRQoL as an outcome is the patient’s perspective. COPD patients come to physicians seek
