Comparison of respiratory health-related quality of life in patients with intractable breathlessness due to advanced cancer or advanced COPD
BMJ Supportive & Palliative Care
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Javadzadeh, S., Chowienczyk, S., Booth, S., & Farquhar, M. (2015). Comparison of respiratory health-related quality of life in patients with intractable breathlessness due to advanced cancer or advanced COPD. BMJ Supportive & Palliative Care, 6 105-108. https://doi.org/10.1136/bmjspcare-2015-000949
Objectives Breathlessness is common in patients with advanced cancer and almost universal in advanced chronic obstructive pulmonary disease (COPD), but studies suggest their experiences of breathlessness vary. This report builds on these studies by providing quantitative evidence of differences in respiratory health-related quality of life (HRQoL) between these groups. Further, it explores the validity of the Chronic Respiratory Questionnaire (CRQ) in patients with cancer. Methods The CRQ-Original was completed within baseline interviews for a randomised controlled trial of a palliative intervention for intractable breathlessness due to advanced disease. Independent samples Mann-Whitney U tests were performed to identify significant differences in median scores for the four CRQ domains (mastery, dyspnoea, emotional function, fatigue) in patients with advanced COPD (n=73) or advanced cancer (n=67). The Minimally Clinically Important Difference of 0.5 was applied to determine clinical significance. Results Patients with advanced COPD scored lower across all four CRQ domains. This was statistically significant for dyspnoea, mastery and emotional function (p<0.05), and clinically significant for the latter two, suggesting poorer respiratory HRQoL. Conclusions Patients with breathlessness due to advanced COPD have worse respiratory HRQoL than those with advanced cancer. This may result from greater burden of breathlessness in COPD due to condition longevity, lesser burden of breathlessness in cancer due to its episodic nature, or variance in palliative referral thresholds by disease group. Our results suggest that greater access to palliative care is needed in advanced COPD, and that formal psychometric testing of the CRQ may be warranted in cancer. Trial registration number NCT00678405.
dyspnoea, chronic obstructive pulmonary disease, cancer, quality of life
This paper presents independent research commissioned by the (NIHR under its Research for Patient Benefit (RfPB) programme (Grant Reference Number PB-PG-0107-11134). The views expressed are those of the author and not necessarily those of the NHS, the NIHR or the Department of Health. MF’s role in the Phase III RCT of CBIS was funded through a Macmillan Cancer Support post-doctoral fellowship.
External DOI: https://doi.org/10.1136/bmjspcare-2015-000949
This record's URL: https://www.repository.cam.ac.uk/handle/1810/253072