Assessment of quality of life in IPF Patients: a multicenter observational study

Main Article Content

Fatih Uzer
Aykut Cilli
Ismail Hanta
Funda Coskun
Can Sevinc
Ahmet Ursavaş
Asim Leblebici
Gozde Yilmaz
Gamze Yazici Celik
Ibrahim Kamel

Keywords

IPF, mood disorders, quality of life, sleep disturbance

Abstract

Aim: This study aimed to examine how dyspnea, cough, sleep disruption, anxiety, depression, and physiological factors affect the quality of life in newly diagnosed, untreated IPF patients. Methods: This study is a multicenter observational study. Patients not receiving antifibrotic treatment were included. To assess patients’ quality of life, Leicester Cough Questionnaire (LCQ), St. George’s Respiratory Questionnaire (SGRQ), Short Form-36 (SF-36), Hospital Anxiety and Depression Scale (HADS), Borg Dyspnea Index (BDI), Modified Medical Research Council Dyspnea Scale (MMRC) score, Composite Physiological Index (CPI), Gender Age and physiology (GAP) score, and Pittsburgh Sleep Quality Index (PSQI) were administered. Results: Among 88 patients (mean age: 67.6±8.5 years), 81.9% were diagnosed with IPF through HRCT, 14.8% through surgery, and 3.4% via cryobiopsy. The average disease duration was 2.2±2.9 years. Over 50% experienced moderate to severe depression, and 40% had moderate to severe anxiety. In the IPF group, 13.6% had possible usual interstitial pneumonia (UIP), and 81.8% had definite UIP pattern. No significant differences were found between UIP groups in various scores. Anxiety and depression correlated negatively with respiratory function and positively with MMRC score and BDI. Sleep quality scores had similar correlations. Patients with good sleep quality had better respiratory parameters (p=0.013), lower MMRC (p=0.004), BDI (p=0.026), and CPI (p=0.047). ­Conclusion: A notable number of IPF patients in follow-up show symptoms of anxiety and depression. Moreover, declining respiratory function not only diminishes sleep quality but also elevates dyspnea scores.


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References

1 Raghu G, Remy-Jardin M, Myers JL, et al. Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med. 2018 Sep;198(5):e44–68.
2 Patel AS, Siegert RJ, Brignall K, et al. The development and validation of the King’s Brief Interstitial Lung Disease (K-BILD) health status questionnaire. Thorax. 2012 Sep;67(9):804–10.
3 De Vries J, Kessels BL, Drent M. Quality of life of idiopathic pulmonary fibrosis patients. Eur Respir J. 2001 May;17(5):954–61.
4 Tzanakis N, Samiou M, Lambiri I, Antoniou K, Siafakas N, Bouros D. Evaluation of health-related quality-of-life and dyspnea scales in patients with idiopathic pulmonary fibrosis. Correlation with pulmonary function tests. Eur J Intern Med. 2005 Apr;16(2):105–12.
5 Yount SE, Beaumont JL, Chen S-Y, et al. Health-Related Quality of Life in Patients with Idiopathic Pulmonary Fibrosis. Lung. 2016 Apr;194(2):227–34.
6 Yorke J, Jones PW, Swigris JJ. Development and validity testing of an IPF-specific version of the St George’s Respiratory Questionnaire. Thorax. 2010 Oct;65(10):921–6.
7 Yorke J, Spencer LG, Duck A, et al. Cross-Atlantic modification and validation of the A Tool to Assess Quality of Life in Idiopathic Pulmonary Fibrosis (ATAQ-IPF-cA). BMJ Open Respir Res. 2014 May;1(1):e000024.
8 Lechtzin N, Hilliard ME, Horton MR. Validation of the Cough Quality-of-Life Questionnaire in Patients With Idiopathic Pulmonary Fibrosis. Chest. 2013 Jun;143(6):1745–9.
9 Koçyiğit H, Aydemir O, Fişek G, Ölmez N, Memiş A. Kısa Form-36 (SF-36)’nın Türkçe Versiyonunun Güvenilirliği ve Geçerliliği. Reliability and Validity of the Turkish Version of Short Form-36 (SF-36). İç Ve Tedavi Derg. 1999 Jan;12:102–6.
10 Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193–213.
11 My A. Pittsburgh Uyku Kalitesi indeksinin Gecerligi ve Guvenirligi. Turk Psikiyatri Derg. 1996;7:107–15.
12 Wells A, Desai S, Rubens M, et al. Idiopathic Pulmonary Fibrosis: A Composite Physiologic Index Derived from Disease Extent Observed by Computed Tomography. Am J Respir Crit Care Med. 2003 Apr;167:962–9.
13 Mura M, Porretta MA, Bargagli E, et al. Predicting survival in newly diagnosed idiopathic pulmonary fibrosis: a 3-year prospective study. Eur Respir J. 2012 Jul;40(1):101–9.
14 Martinez FJ, de Oca MM, Whyte RI, Stetz J, Gay SE, Celli BR. Lung-volume reduction improves dyspnea, dynamic hyperinflation, and respiratory muscle function. Am J Respir Crit Care Med. 1997 Jun;155(6):1984–90.
15 Janssens JP, Breitenstein E, Rochat T, Fitting JW. Does the “oxygen cost diagram” reflect changes in six minute walking distance in follow up studies? Respir Med. 1999 Nov;93(11):810–5.
16 Belkin A, Swigris JJ. Health-related quality of life in idiopathic pulmonary fibrosis: where are we now? Curr Opin Pulm Med. 2013 Sep;19(5):474–9.
17 Prior TS, Hoyer N, Shaker SB, et al. Validation of the IPF-specific version of St. George’s Respiratory Questionnaire. Respir Res. 2019 Aug;20(1):199.
18 Chang JA, Curtis JR, Patrick DL, Raghu G. Assessment of health-related quality of life in patients with interstitial lung disease. Chest. 1999 Nov;116(5):1175–82.
19 Lindell KO, Olshansky E, Song M-K, et al. Impact of a disease-management program on symptom burden and health-related quality of life in patients with idiopathic pulmonary fibrosis and their care partners. Heart Lung. 2010 Jul;39(4):304–13.