Marked deterioration in the quality of life of patients with idiopathic pulmonary fibrosis during the last two years of life
Abstract Background Idiopathic pulmonary fibrosis (IPF) is a chronic disease with a high symptom burden and poor survival that influences patients’ health-related quality of life (HRQOL). We aimed to evaluate IPF patients’ symptoms and HRQOL in a well-documented clinical cohort during their last two...
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| Format: | Article |
| Language: | English |
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BMC
2018-11-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | http://link.springer.com/article/10.1186/s12890-018-0738-x |
| _version_ | 1818896770117140480 |
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| author | K. Rajala J. T. Lehto E. Sutinen H. Kautiainen M. Myllärniemi T. Saarto |
| author_facet | K. Rajala J. T. Lehto E. Sutinen H. Kautiainen M. Myllärniemi T. Saarto |
| author_sort | K. Rajala |
| collection | DOAJ |
| description | Abstract Background Idiopathic pulmonary fibrosis (IPF) is a chronic disease with a high symptom burden and poor survival that influences patients’ health-related quality of life (HRQOL). We aimed to evaluate IPF patients’ symptoms and HRQOL in a well-documented clinical cohort during their last two years of life. Methods In April 2015, we sent the Modified Medical Research Council Dyspnea Scale (MMRC), the modified Edmonton Symptom Assessment Scale (ESAS) and a self-rating HRQOL questionnaire (RAND-36) to 300 IPF patients, of which 247 (82%) responded. Thereafter, follow-up questionnaires were sent every six months for two years. Results Ninety-two patients died by August 2017. Among these patients, HRQOL was found to be considerably low already two years before death. The most prominent declines in HRQOL occurred in physical function, vitality, emotional role and social functioning (p < 0.001). The proportion of patients with MMRC scores ≥3 increased near death. Breathlessness and fatigue were the most severe symptoms. Symptom severity for the following symptoms increased significantly and reached the highest mean scores during the last six months of life (numeric rating scale/standard deviation): breathlessness (7.1/2.8), tiredness (7.0/2.3), dry mouth (6.0/3.0), cough (5.8/2.9), and pain with movement (5.0/3.5). Conclusions To our knowledge this is the first study demonstrating, that IPF patients experience remarkably low HRQOL already two years before death, especially regarding physical role. In addition, they suffer from severe breathlessness and fatigue. Furthermore, physical, social and emotional wellbeing deteriorate, and symptom burden increases near death. Regular symptom and HRQOL measurements are essential to assess palliative care needs in patients with IPF. |
| first_indexed | 2024-12-19T19:05:33Z |
| format | Article |
| id | doaj.art-91f62539bb744b36b62a5fd4355ad1a2 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-19T19:05:33Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-91f62539bb744b36b62a5fd4355ad1a22022-12-21T20:09:27ZengBMCBMC Pulmonary Medicine1471-24662018-11-011811910.1186/s12890-018-0738-xMarked deterioration in the quality of life of patients with idiopathic pulmonary fibrosis during the last two years of lifeK. Rajala0J. T. Lehto1E. Sutinen2H. Kautiainen3M. Myllärniemi4T. Saarto5Department of Palliative Care, Comprehensive Cancer Center,, Helsinki University HospitalDepartment of Oncology, Palliative Care Unit, Tampere University Hospital and Faculty of Medicine and Life Sciences, University of TampereFaculty of Medicine, University of HelsinkiPrimary Health Care Unit, Kuopio University Hospital, Finland and Folkhälsan Research CenterUniversity of Helsinki and Helsinki University Hospital, Heart and Lung Center, Department of Pulmonary MedicineHelsinki University Hospital, Comprehensive Cancer Center, Department of Palliative Care and Faculty of Medicine, University of HelsinkiAbstract Background Idiopathic pulmonary fibrosis (IPF) is a chronic disease with a high symptom burden and poor survival that influences patients’ health-related quality of life (HRQOL). We aimed to evaluate IPF patients’ symptoms and HRQOL in a well-documented clinical cohort during their last two years of life. Methods In April 2015, we sent the Modified Medical Research Council Dyspnea Scale (MMRC), the modified Edmonton Symptom Assessment Scale (ESAS) and a self-rating HRQOL questionnaire (RAND-36) to 300 IPF patients, of which 247 (82%) responded. Thereafter, follow-up questionnaires were sent every six months for two years. Results Ninety-two patients died by August 2017. Among these patients, HRQOL was found to be considerably low already two years before death. The most prominent declines in HRQOL occurred in physical function, vitality, emotional role and social functioning (p < 0.001). The proportion of patients with MMRC scores ≥3 increased near death. Breathlessness and fatigue were the most severe symptoms. Symptom severity for the following symptoms increased significantly and reached the highest mean scores during the last six months of life (numeric rating scale/standard deviation): breathlessness (7.1/2.8), tiredness (7.0/2.3), dry mouth (6.0/3.0), cough (5.8/2.9), and pain with movement (5.0/3.5). Conclusions To our knowledge this is the first study demonstrating, that IPF patients experience remarkably low HRQOL already two years before death, especially regarding physical role. In addition, they suffer from severe breathlessness and fatigue. Furthermore, physical, social and emotional wellbeing deteriorate, and symptom burden increases near death. Regular symptom and HRQOL measurements are essential to assess palliative care needs in patients with IPF.http://link.springer.com/article/10.1186/s12890-018-0738-xIdiopathic pulmonary fibrosisPalliative careHealth related quality of lifeSymptoms |
| spellingShingle | K. Rajala J. T. Lehto E. Sutinen H. Kautiainen M. Myllärniemi T. Saarto Marked deterioration in the quality of life of patients with idiopathic pulmonary fibrosis during the last two years of life BMC Pulmonary Medicine Idiopathic pulmonary fibrosis Palliative care Health related quality of life Symptoms |
| title | Marked deterioration in the quality of life of patients with idiopathic pulmonary fibrosis during the last two years of life |
| title_full | Marked deterioration in the quality of life of patients with idiopathic pulmonary fibrosis during the last two years of life |
| title_fullStr | Marked deterioration in the quality of life of patients with idiopathic pulmonary fibrosis during the last two years of life |
| title_full_unstemmed | Marked deterioration in the quality of life of patients with idiopathic pulmonary fibrosis during the last two years of life |
| title_short | Marked deterioration in the quality of life of patients with idiopathic pulmonary fibrosis during the last two years of life |
| title_sort | marked deterioration in the quality of life of patients with idiopathic pulmonary fibrosis during the last two years of life |
| topic | Idiopathic pulmonary fibrosis Palliative care Health related quality of life Symptoms |
| url | http://link.springer.com/article/10.1186/s12890-018-0738-x |
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