EuroQoL in assessment of the effect of pulmonary rehabilitation COPD patients

Thomas Ringbaek, Eva Brøndum, Gerd Martinez, Peter Lange
Respiratory Medicine 2008, 102 (11): 1563-7

BACKGROUND: The effect of pulmonary rehabilitation on EuroQol in COPD patients has not been investigated previously.

METHODS/MATERIALS: Two hundred and twenty nine consecutive COPD patients who had completed a 7-week pulmonary rehabilitation programme were assessed with EuroQol five-dimension questionnaire (EQ-5D), endurance shuttle walk test (ESWT), and the St George's Respiratory Questionnaire (SGRQ) before and after the programme, and at the 3-month follow-up visit.

RESULTS: Two hundred and two (88.4%) patients had FEV(1)<50% predicted and all but four (1.7%) had dyspnoea score at least 3 on MRC scale. At completion of the programme, statistical significant improvements were seen for ESWT 157.3s; p<0.001, EQ-5D utility score -0.019; p=0.03, EQ-5D VAS -2.1; p=0.056, SGRQ total score -2.8 units; p<0.001. The effects of rehabilitation on ESWT and SGRQ were maintained at 3-month follow-up (158.9s and -2.9 units), while the effect on EQ-5 utility decreased (0.013; p=0.18). At baseline, there was a maximum score ("ceiling effect") for EQ-5D utility and EQ VAS in 29 (12.7%) and five (2.2%) of the patients, respectively. After rehabilitation these number increased to 41 (17.9%) and seven (3.1%).

CONCLUSIONS: In COPD patients receiving rehabilitation, responsiveness of EQ-5D utility was poor. One explanation might be a "ceiling effect" of this instrument.

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