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Racial differences in quality of life in patients with COPD.

ABSTRACT: Although COPD is associated with significant health-related quality-of-life (HRQL) impairment, factors influencing HRQL in patients with COPD are not well understood, particularly in African Americans. We hypothesized that HRQL in COPD differs by race and sought to identify factors associated with those differences.We analyzed 224 African American and 1,049 Caucasian subjects with COPD enrolled in the COPDGene (Genetic Epidemiology of COPD) Study whose conditions were classified as GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages I to IV. HRQL and symptoms were compared using the St. George Respiratory Questionnaire (SGRQ) and the modified Medical Research Council Dyspnea (MMRC) scale. We constructed a mixed-effects linear regression model for SGRQ score.African Americans were younger and reported fewer pack-years of smoking, more current smoking, and less attained education than Caucasians; MMRC scores were higher (P = .02) as were SGRQ scores (mean score difference, 8.4; P < .001). In a general linear model of SGRQ total score after adjusting for factors such as age, sex, and pack-years of smoking, SGRQ total score was similar for African Americans and Caucasians who reported no COPD exacerbations in the prior year. However, for subjects with exacerbations, SGRQ total score was increased to a greater relative extent for African Americans than for Caucasians (1.89 points for each exacerbation, P = .006). For hospitalized exacerbations, the effect on SGRQ total score also was greater for African Americans (4.19 points, P = .04). Furthermore, a larger percentage of African Americans reported having had at least one exacerbation that required hospitalization in the prior year (32% vs 16%, P < .001).In analyses that account for other variables that affect quality of life, HRQL is similar for African Americans and Caucasians with COPD without exacerbations but worse for African Americans who experience exacerbations, particularly hospitalized exacerbations.

SUBMITTER: Han MK

PROVIDER: S-EPMC3205846 | biostudies-literature | 2011 Nov

REPOSITORIES: biostudies-literature

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Racial differences in quality of life in patients with COPD.

Han MeiLan K MK Curran-Everett Douglas D Dransfield Mark T MT Criner Gerard J GJ Zhang Lening L Murphy James R JR Hansel Nadia N NN DeMeo Dawn L DL Hanania Nicola A NA Regan Elizabeth A EA Make Barry J BJ Martinez Fernando J FJ Westney Gloria E GE Foreman Marilyn G MG

Chest 20110602 5

<h4>Background</h4>Although COPD is associated with significant health-related quality-of-life (HRQL) impairment, factors influencing HRQL in patients with COPD are not well understood, particularly in African Americans. We hypothesized that HRQL in COPD differs by race and sought to identify factors associated with those differences.<h4>Methods</h4>We analyzed 224 African American and 1,049 Caucasian subjects with COPD enrolled in the COPDGene (Genetic Epidemiology of COPD) Study whose conditio ...[more]

PMID: 21636665

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Project description:BackgroundThere are limited data about the racial difference in the characteristics of chronic obstructive pulmonary disease (COPD) patients who are treated at clinics. We aimed to compare sociodemographic and clinical characteristics between US and Korean COPD patients using large-scale nationwide COPD cohorts.MethodsWe used the baseline demographic and clinical data of COPD patients aged 45 years or older with at least a 10 pack-per year smoking history from the Korean COPD Subtype Study (KOCOSS, n = 1686) cohort (2012-2018) and phase I (2008-2011) of the US Genetic Epidemiology of COPD (COPDGene) study (n = 4477, 3461 were non-Hispanic whites [NHW], and 1016 were African Americans [AA]).ResultsCompared to NHW, AA had a significantly lower adjusted prevalence ratio (aPR) of cough >3 months (aPR: 0.67; 95% CI [confidence interval]: 0.60-0.75) and phlegm >3 months (aPR: 0.78, 95% CI: 0.70-0.86), but higher aPR of dyspnea (modified Medical Round Council scale ⩾2) (aPR: 1.22; 95% CI: 1.15-1.29), short six-minute walk distance (<350 m) (aPR: 1.98; 95% CI: 1.81-2.14), and poor quality of life (aPR: 1.10; 95% CI: 1.05-1.15). Compared to NHW, Koreans had a significantly lower aPR of cough >3 months (aPR: 0.53; 95% CI: 0.47-0.59), phlegm >3 months (aPR: 0.75; 95% CI: 0.67-0.82), dyspnea (aPR: 0.72; 95% CI: 0.66-0.79), and moderate-to-severe acute exacerbation in the previous year (aPR: 0.73; 95% CI: 0.65-0.82). NHW had the highest burden related to chronic bronchitis symptoms and cardiovascular diseases related to comorbidities.ConclusionThere are substantial differences in sociodemographic characteristics, clinical presentation, and comorbidities between COPD patients from the KOCOSS and COPDGene, which might be caused by interactions between various intrapersonal, interpersonal, and environmental factors of the ecological model. Thus, a broader and more comprehensive approach would be necessary to understand the racial differences of COPD patients.

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Racial differences in quality of life in patients with COPD.

Publications

Racial differences in quality of life in patients with COPD.

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