Symptom severity and its effect on health-related quality of life over time in patients with pulmonary hypertension: a multisite longitudinal cohort study
Symptom severity and its effect on health-related quality of life over time in patients with pulmonary hypertension: a multisite longitudinal cohort study
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DOI：
10.1136/bmjresp-2017-000263
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发表时间：
2018-01-01
影响因子：
4.1
通讯作者：
Armstrong, Iain
中科院分区：
文献类型：
--
作者：
Yorke, Janelle;Deaton, Christi;Armstrong, Iain
简介 本队列研究的目的是检查肺动脉高压 (PH) 患者的健康相关生活质量 (HRQoL) 和症状，并探索影响其随时间演变的因素。方法 一项前瞻性纵向多中心队列研究。参与者从英国专业 PH 中心招募，并在基线、6、12 和 18 个月时完成了一份问卷，以评估 HRQoL (emPHasis-10)、呼吸困难、疲劳、睡眠、焦虑和抑郁。结果 185 名患者在基线时进入研究，其中 126 名 (68%) 在第 18 个月完成。在基线时，患者的 HRQoL、焦虑、抑郁、呼吸困难和严重疲劳明显受损。 18 个月内，除了医院焦虑和抑郁量表焦虑评分降低（P=0.04）外，没有观察到显着变化。抑郁和呼吸困难是 HRQoL 的预测因素（分别为 P=0.002 和 P=0.03）。用氧还与 HRQoL 降低和症状严重程度增加相关。结论 PH 患者的症状严重程度较高，并且对 HRQoL 的负面影响随着时间的推移没有变化。尤其是氧疗的使用与 HRQoL 的显着影响相关。需要进一步研究影响 HRQoL 的因素以及针对 PH 患者的生理和心理社会后果的综合干预措施。
Introduction The aim of this cohort study was to examine health-related quality of life (HRQoL) and symptomatology in patients with pulmonary hypertension (PH) and explore factors that influence its evolution over time.Methods A prospective longitudinal multisite cohort study. Participants were recruited from specialist UK PH centres and completed a questionnaire pack at baseline, 6, 12 and 18 months to assess HRQoL (emPHasis-10), dyspnoea, fatigue, sleep, anxiety and depression.Results 185 patients entered the study at baseline and 126 (68%) completed month 18. At baseline, patients had significant impairment of HRQoL, anxiety, depression, dyspnoea and severe fatigue. No significant changes, apart from a reduction in the Hospital Anxiety and Depression Scale-Anxiety score (P=0.04), were observed over 18 months. Depression and dyspnoea were predictors of HRQoL (P=0.002 and P=0.03, respectively). Oxygen use was also associated with diminished HRQoL and increased symptom severity.Conclusion Patients with PH experience high levels of symptom severity and the negative impact on HRQoL was unchanged over time. The use of oxygen therapy, in particular, was associated with a significant impact on HRQoL. Further study of factors impacting HRQoL and interventions that target a combination of physiological and psychosocial consequences of living with PH are needed.