Background: Patients with COPD experience a consistent disability
which leads to a deterioration in their Health related quality of life
(HRQL). In Tunisia, this topic wasn’t yet studied.
Objective: This study aims to assess the HRQL of patients with COPD in
Tunisia and to identify possible predictors of HRQL.
Methods: A cross-sectional study was carried out in the two main primary
care centers in Sousse over a period of three months. HRQL was assessed by
the Medical Outcomes Study Short form 36 (SF-36). Clinic and socio
demographic data were collected from patients’ records. The population was
divided into four subgroups, high and low components’ scores. Univariable
analysis and multivariable analysis were used to identify predictive factors
Results: A total of 335 patients have participated with a mean age of
66.70±11.60. Physical component’s median was 37.08 and that of mental
component was 40.70. compared to age 40-49, the age groups associated
independently to impaired PQL and MQL were 70-79 (OR=19; 95% CI: 4-89 and
OR=6; 95% CI: 1.20-17, respectively), and ≥80 (OR=19; 95% CI: 4-99 and
OR=6.04; 95% CI: 1.30-26, respectively). Age group 60-69 was associated only
to impaired PQL (OR=9; 95% CI: 2-40). Analysis of associations between PQL
and the severity of the disease showed that the ORs of severe stage of COPD
(OR= 3.70; 95% CI: 1.20-11) and very severe stage (OR=31.50; 95% CI: 9.20-90
and) were significant. While in MQL, ORs of moderate (OR=11.40; 95% CI:
1.40-90), severe (OR=44.50; 95% CI: 5-357), and very severe stages of COPD
(OR=233; 95% CI: 28-280) were significant.
The ORs of stages 4 and 5 of dyspnea were significant only in PQL (OR= 15;
95% CI: 1-135 and OR=17; 95% CI: 8-180, respectively).
In addition, compared to having no comorbidities, the OR of two
co-morbidities or more (OR=2.80; 95% CI: 1.30-5 and OR=3.40; 95% CI: 1.70-7)
was significantly higher (OR=1.18; 95% CI: 0.50-2 and OR=1.20; 95% CI:
0.60-2.40).. Dyspnea was independently associated only to PQL.
Conclusion: Patients with COPD had an impaired HRQL associated independently
with age, disease severity and co-morbidity. Health care professionals
should take into account these predictive factors in order to improve the
general health condition of COPD patients.