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International Journal of Chronic Obstructive Pulmonary Disease Volume 16, 2021 - Issue
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Original Research

Impact of Lung Function and Exacerbations on Health-Related Quality of Life in COPD Patients Within One Year: Real-World Analysis Based on Claims Data

Alisa Stöber1 Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany;2 Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-University Munich (LMU), Munich, GermanyCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0001-6368-0662View further author information
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Johanna I Lutter1 Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany;3 Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, GermanyORCID Iconhttps://orcid.org/0000-0002-0159-4862View further author information
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Larissa Schwarzkopf1 Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany;3 Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany;4 Institute fuer Therapieforschung (IFT), Working Group Therapy and Health Services Research, Munich, GermanyORCID Iconhttps://orcid.org/0000-0002-9402-7700View further author information
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Florian Kirsch1 Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, GermanyView further author information
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Anja Schramm5 AOK Bayern, Service Center of Health Care Management, Regensburg, GermanyORCID Iconhttps://orcid.org/0000-0002-4703-2355View further author information
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Claus F Vogelmeier6 Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Member of the German Center for Lung Research (DZL), Marburg, GermanyView further author information
&
Reiner Leidl1 Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany;7 Munich Center of Health Sciences (MC-Health), Institute for Health Economics and Management, Ludwig-Maximilians-University Munich (LMU), Munich, GermanyORCID Iconhttps://orcid.org/0000-0002-7115-7510View further author information
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Pages 2637-2651 | Published online: 21 Sep 2021

Figures & data

Figure 1 Overview of the study population.

Abbreviations: DMP, disease management program; FEV1, forced expiratory volume in 1 second; BMI, body mass index; VAS, visual analog scale; CAT, COPD Assessment Test; mMRC, Modified Medical Research Council Questionnaire.
Figure 1 Overview of the study population.

Table 1 Baseline Characteristics of Participants Who Experienced a Minimal Important Difference Deterioration in VAS (≥-6.9) and CAT (≥+2)

Table 2 Change in FEV1, Exacerbations and HRQoL for 3016 Patients Who Completed Both Questionnaires

Figure 2 Proportion of HRQoL change with a Minimal Important Difference (MID).

Notes: MID-Deterioration in VAS ≥–6.9/MID-Improvement in VAS ≥6.9. MID-Deterioration in CAT ≥2/MID-Improvement in CAT ≥–2.
Figure 2 Proportion of HRQoL change with a Minimal Important Difference (MID).

Figure 3 Determinants of a clinically relevant deterioration in generic HRQoL VAS (A) and disease-specific HRQoL CAT (B).

Note: *Not significant.
Abbreviations: mMRC, Modified Medical Research Council Questionnaire; VAS, visual analog scale; CAT, COPD Assessment Test.
Figure 3 Determinants of a clinically relevant deterioration in generic HRQoL VAS (A) and disease-specific HRQoL CAT (B).

Table 3 Proportion of One-Year Changes in FEV1

Figure 4 Impact of clinical indicators on HRQoL: Linear relationship between change in FEV1 and VAS (A) and CAT (B).

Notes: The estimated smooth functions of the relationship between FEV1 and HRQoL are represented by the solid curves. The shaded areas indicate the 95% confidence intervals. Generalized additive models were adjusted for age, sex, smoking status, education, BMI, number of moderate and severe exacerbation, FEV1 liter change, Charlson Comorbidity index, mMRC, and VAS/CAT baseline.
Figure 4 Impact of clinical indicators on HRQoL: Linear relationship between change in FEV1 and VAS (A) and CAT (B).

Figure 5 Change score model: impact of FEV1 on HRQoL.

Notes: Absolute adjusted mean change in VAS (A) and CAT (B) after one year. ABCD groups at baseline. Error bars indicate 95% confidence intervals.
Figure 5 Change score model: impact of FEV1 on HRQoL.

Figure 6 Change score model: impact of exacerbations on HRQoL.

Notes: Absolute adjusted mean change in VAS (A) and CAT (B) after one year. ABCD groups at baseline. Error bars indicate 95% confidence intervals.
Figure 6 Change score model: impact of exacerbations on HRQoL.

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