Quality of life changes with duration of chronic breathlessness: a random sample of community-dwelling people.

Currow, David C.; Chang, Sungwon; Grande, Eleonora Dal; Ferreira, Diana H; Kochovska, Slavica; Kinchin PhD, Irina; Johnson, Miriam J.; Ekstrom, Magnus

Abstract

Introduction
Chronic breathlessness is associated with poorer quality of life. This population study aimed to define dimensions of quality of life (QoL), and duration and dominant causes of breathlessness that most diminished QoL.

Methods
This cross-sectional, population-based, randomised survey of adults (n=2,977) in South Australia collected data on demographics, modified Medical Research Council (mMRC) breathlessness and QoL (EQ-5D-5L; SF-12). Data weighted to the census were analysed for relationships between EQ-5D-5L and its dimensions with mMRC. Regression models controlled for age, sex, education, rurality and body mass index.

Results
2,883 responses were analysed: 49% were male; mean age 48 years (SD 19). As mMRC worsened, EQ-5D-5L and its dimensions worsened. More severe chronic breathlessness was iteratively associated with lower mobility, daily activities and worse pain/discomfort. For self-care and anxiety/depression, impairment was only with the most severe breathlessness. Respondents who had chronic breathlessness for two to six years had the worst quality of life scores. People who attributed their breathlessness to cardiac failure had poorer quality of life. Respondents who reported a cardiac cause for their breathlessness had worse mobility, poorer usual activities and more pain than the other causes.
The regression analyses showed that worse chronic breathlessness was associated with worsening QoL in each dimension of EQ-5D-5L, with the exception of the self-care, which only worsened with the most severe breathlessness.

Conclusions
This is the first study to report on chronic breathlessness and impairment across dimensions of QoL and differences by its duration. Mobility, usual activity and pain drive these reductions.

Citation

Currow, D. C., Chang, S., Grande, E. D., Ferreira, D. H., Kochovska, S., Kinchin PhD, I., Johnson, M. J., & Ekstrom, M. (2020). Quality of life changes with duration of chronic breathlessness: a random sample of community-dwelling people. Journal of pain and symptom management, https://doi.org/10.1016/j.jpainsymman.2020.05.015

• Journal Article Type: Article
• Acceptance Date: May 11, 2020
• Online Publication Date: May 20, 2020
• Publication Date: 2020-10
• Deposit Date: Jul 2, 2020
• Publicly Available Date: May 21, 2021
• Journal: Journal of Pain and Symptom Management
• Print ISSN: 0885-3924
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1016/j.jpainsymman.2020.05.015
• Keywords: Chronic breathlessness; Quality of life; Population survey; Prevalence study
• Public URL: https://hull-repository.worktribe.com/output/3532836
• Publisher URL: https://www.sciencedirect.com/science/article/abs/pii/S088539242030395X