Impact of adherence to GOLD guidelines on 6-minute walk distance, MRC dyspnea scale score, lung function decline, quality of life, and quality-adjusted life years in a Shanghai suburb

Y Q Jiang; Y X Zhu; X L Chen; X Xu; F Li; H J Fu; C Y Shen; Y Y Lu; Q J Zhuang; G Xu; Y Y Cai; Y Zhang; S S Liu; M Y Zhu; S H Li

doi:10.4238/2015.August.3.9

Impact of adherence to GOLD guidelines on 6-minute walk distance, MRC dyspnea scale score, lung function decline, quality of life, and quality-adjusted life years in a Shanghai suburb

Genet Mol Res. 2015 Aug 3;14(3):8861-70. doi: 10.4238/2015.August.3.9.

Authors

Y Q Jiang¹, Y X Zhu², X L Chen², X Xu², F Li², H J Fu³, C Y Shen³, Y Y Lu³, Q J Zhuang⁴, G Xu⁵, Y Y Cai⁶, Y Zhang⁷, S S Liu⁸, M Y Zhu⁸, S H Li²

Affiliations

¹ Shanghai Municipal First People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China.
² Songjiang Branch of Shanghai Municipal First People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China.
³ Xiaokunshan Town Primary Care of Songjiang District, Shanghai, China.
⁴ Xinbang Town Primary Care of Songjiang District, Shanghai, China.
⁵ School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
⁶ Institute of Respiratory Disease, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China.
⁷ Shanghai Songjiang District Public Health Bureau, Shanghai, China.
⁸ Shanghai Songjiang District Center for Diseases Control and Prevention, Shanghai, China.

PMID: 26345817
DOI: 10.4238/2015.August.3.9

Abstract

We performed a 1-year cluster-randomized field trial to assess the effect of standardized management of chronic obstructive pulmonary disease (COPD) on lung function and quality of life (QOL) measures in patients in China. We used the Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment guidelines and assessed indexes including pulmonary function, QOL, quality-adjusted life years (QALY), Medical Research Council (MRC) dyspnea scale, 6-min walk distance (6-MWD), number of emergency visits, and frequency of hospitalization. Of a total of 711 patients with chronic cough and asthma, 132 were diagnosed as having COPD and 102 participated in this study [intervention group (N = 47); control group (N = 55)]. We found that adherence to GOLD guidelines had a perceivable impact on 6-MWD, MRC dyspnea scale score, and QOL. The average QALY increased by 1.42/person/year in the intervention group, but declined by 0.95/person/year in the control group. We conclude that standardized management improves disease severity, QOL, and QALY in COPD patients when treatment protocols adhere to GOLD guidelines.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Case-Control Studies
China
Cost-Benefit Analysis
Dyspnea / diagnosis
Dyspnea / physiopathology
Female
Guideline Adherence
Humans
Male
Middle Aged
Patient Compliance
Pulmonary Disease, Chronic Obstructive / diagnosis*
Pulmonary Disease, Chronic Obstructive / physiopathology
Pulmonary Disease, Chronic Obstructive / prevention & control
Pulmonary Disease, Chronic Obstructive / therapy*
Quality of Life
Quality-Adjusted Life Years
Respiratory Function Tests
Walking / physiology*