Measurement of health status in COPD in daily clinical practice

PhD ceremony: Ms I. Tsiligianni, 12.45 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Measurement of health status in COPD in daily clinical practice

Promotor(s): prof. T. van der Molen

Faculty: Medical Sciences

COPD patients often experience impairments in their quality of life (QoL) and/or other health status aspects. A major goal in COPD management is to ensure that patients reach the best possible quality of life and health status. This thesis emphasizes health status measurement in COPD patients in daily clinical practice and evaluates available health status tools to support clinicians in choosing the optimal tool. Lung function has been traditionally considered as crucial in disease classification and decision making in COPD management. This thesis revealed dyspnea, depression, anxiety and exercise tolerance, and not lung function, as the most important factors that influence QoL in COPD, indicating the need for their evaluation in daily clinical practice. Moreover, results from a combined database (from three European countries) confirmed that lung function does not reflect health status. A systematic review of the available tools for assessing health status in primary care showed that the Clinical COPD Questionnaire (CCQ) was the best tool, followed by the COPD Assessment Tool (CAT). Subsequently, a study comparing CCQ and CAT showed similar psychometric properties with a slight advantage for CCQ mainly in terms of patient preferences. In summary, the CCQ is a valuable tool in assessing COPD health status and should be included in daily clinical practice. Finally, a first attempt was made to incorporate a telehealth integrated COPD service in Greece. A study to evaluate the feasibility of an adapted version of the asthma and COPD service model from Groningen (the Netherlands) is proposed.