Quality of Life Changes With Duration of Chronic Breathlessness: A Random Sample of Community-Dwelling People

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

doi:10.1016/j.jpainsymman.2020.05.015

Quality of Life Changes With Duration of Chronic Breathlessness: A Random Sample of Community-Dwelling People

J Pain Symptom Manage. 2020 Oct;60(4):818-827.e4. doi: 10.1016/j.jpainsymman.2020.05.015. Epub 2020 May 20.

Authors

David C Currow¹, Sungwon Chang², Eleonora Dal Grande³, Diana H Ferreira⁴, Slavica Kochovska⁵, Irina Kinchin⁵, Miriam J Johnson⁶, Magnus Ekstrom⁷

Affiliations

¹ IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia; Wolfson Palliative Care Research Centre, University of Hull, Hull, England. Electronic address: david.currow@uts.edu.au.
² Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Sydney, New South Wales, Australia.
³ University of Adelaide, Adelaide, South Australia, Australia.
⁴ Discipline Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia.
⁵ IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
⁶ Wolfson Palliative Care Research Centre, University of Hull, Hull, England.
⁷ Division of Respiratory Medicine & Allergology, Department of Clinical Sciences, Lund University, Lund, Sweden.

PMID: 32442480
DOI: 10.1016/j.jpainsymman.2020.05.015

Abstract

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

Methods: This cross-sectional, population-based, and randomized survey of adults (n = 2977) in South Australia collected data on demographics, modified Medical Research Council (mMRC) breathlessness, and QoL (EuroQoL five-dimension five-level [EQ-5D-5L] measure; Short Form 12 quality-of-life measure). Data weighted to the census were analyzed for relationships between EQ-5D-5L and its dimensions with mMRC. Regression models controlled for age, sex, education, rurality, and body mass index.

Results: About 2883 responses were analyzed: 49% were males; mean age was 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 QoL scores. People who attributed their breathlessness to cardiac failure had poorer QoL. 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.

Keywords: Chronic breathlessness; population survey; prevalence study; quality of life.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cross-Sectional Studies
Dyspnea / epidemiology
Female
Health Status
Humans
Independent Living*
Male
Middle Aged
Quality of Life*
Surveys and Questionnaires