Improving health-related quality of life in chronic obstructive pulmonary disease

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Abstract
Most current treatments for chronic obstructive pulmonary disease (COPD) have been unable to improve survival or arrest decline in lung function. This reality highlights the importance of patient-focused outcomes that address symptom relief, functional status, and overall health-related quality ov life (HRQOL). Measures of HRQOL can complement established physiologic outcomes that have been traditionally used. There are several generic and disease-specific instruments that can be used to measure HRQOL, each incorporating various aspects of physical, psychological, and social function. Basic concepts regarding these instruments are presented. Recent studies suggest that HRQOL is an important measure of prognosis and healthcare resource utilization in COPD patients. An increasing number of studies now incorporate HRQOL as an outcome measure. Interventions that have shown a positive effect on some or all components of HRQOL, including inhaled corticosteroids, inhaled bronchodilators, opioids, oxygen therapy, pulmonary rehabilitation, implementation of a disease-specific self-management program, and lung volume reduction surgery are discussed in this review.