Pneumologie 2020; 74(S 01): 84
DOI: 10.1055/s-0039-3403248
Freie Vorträge (FV12) – Sektion Klinische Pneumologie
Hot Topics der klinischen Pneumologie
Georg Thieme Verlag KG Stuttgart · New York

determinants of health-related quality of life deterioration in interstitial lung disease patients

P Maqhuzu
1   Institute of Health Economics and Healthcare Management, Helmholtz Centre Munich GmbH, German Research Centre for Environmental Health, Member of the German Centre for Lung Research (Dzl), Comprehensive Pneumology Centre Munich (Cpc-M)
,
B Szentes
2   Helmholtz Zentrum München-Deutsches Foschungszentrum für Gesundheit und Umwelt (GmbH), Helmholtz Zentrum München, Neuherberg
,
M Kreuter
3   Zentrum für Interstitielle und Seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Thoraxklinik, Universitätsklinikum Heidelberg und Translationales Zentrum für Lungenforschung Heidelberg (Tlrc); Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
,
T bahmer
4   Lungenclinic Grosshansdorf GmbH Pneumology; Member of the Airway Research Center North (Arcn), German Center for Lung Research (Dzl)
,
M Claussen
5   Zentrum für Pneumologie und Thoraxchirurgie, Lungenclinic Grosshansdorf
,
L Schwarzkopf
6   Helmholtz Tenrtum München GmbH, Institut für Gesundheitsökonomie und Management Im Gesundheitswesen, Neuherberg, Comprehensive Pneumonology Center Munich (Cpc-M), Deutsches Zentrum für Lungenforschung
› Author Affiliations
Further Information

Publication History

Publication Date:
28 February 2020 (online)

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Background: Health-related quality of life (HRQL) in patients with interstitial lung disease (ILD) is known to be poor, however, predictors for HRQL decline over time are sparsely investigated. We aimed to identify predictors for HRQL decline in ILD-patients within a 12-month observation period.

Methods: We used longitudinal data of 194 ILD patients recruited at two large German ILD centers in the observational HILDA study. We used the generic HRQL measure, EQ-5D Visual Analog Scale (VAS), and the disease-specific Kingʼs Brief Interstitial Lung Disease questionnaire (KBILD) with the subdomains ‘psychological impact’, ‘chest symptomsʼ and ’breathlessness and activitiesʼ. Scores for both measures range between zero (worst HRQL) and 100 (best HRQL). We used the minimal clinically important differences (MCID) of VAS (6.9) and K-BILD (8) to analyze the proportion of patients who experienced a clinically meaningful decline in HRQL. Subsequently we investigated sociodemographic factors, lung function, baseline HRQL and medical history, as potential predictors of HRQL deterioration.

Results: Within the study population (34.0% male, Ø age 61.7) mean HRQL scores hardly changed between baseline and 12-months follow up (K-BILD: 52.8 vs. 52.5 | VAS: 60.0 vs. 57.3). On the intra-individual level according to prespecified MCIDs, 35.1% of patients experienced a clinically relevant deterioration in ‘breathlessness and activitiesʼ, 30.7% in ’chest symptomsʼ, 28.4% in ‘psychological impact’, 29.9% in KBILD total score and 29.4% in VAS. Baseline DLCO% pred. was associated with deterioration in ‘breathlessness and activitiesʼ (β-coef.-0.04, p = 0.003) and ’chest symptomsʼ (β-coef. − 0.04, p = 0.002) and baseline FVC% pred. with deterioration in ‘psychological impact’ (β-coef. − 0.02, p = 0.021), KBILD total score (β-coef. − 0.02, p = 0.007) and VAS (β-coef. − 0.04, p < 0.0001). On the contrary, increasing age positively influenced ‘psychological impact’ (β-coef. 0.06, p < 0,0001). Other factors had no significant impact.

Conclusion: Around a third of ILD patients experienced a clinically relevant HRQL deterioration in a 12-months period, which is mainly predicted by lung function baseline value. Thus, measures of lung function are important clinical assessment tools to predict the consequences of the disease for everyday life.