Publication:
Generic utilities in chronic obstructive pulmonary disease patients stratified according to different staging systems.

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Abstract
BACKGROUND To determine generic utilities for Spanish chronic obstructive pulmonary disease (COPD) patients stratified by different classifications: GOLD 2007, GOLD 2013, GesEPOC 2012 and BODEx index. METHODS Multicentre, observational, cross-sectional study. Patients were aged ≥40 years, with spirometrically confirmed COPD. Utility values were derived from EQ-5D-3 L. Means, standard deviations (SD), medians and interquartile ranges (IQR) were computed based on the different classifications. Differences in median utilities between groups were assessed by non-parametric tests. RESULTS 346 patients were included, of which 85.5% were male with a mean age of 67.9 (SD = 9.7) years and a mean duration of COPD of 7.6 (SD = 5.8) years; 80.3% were ex-smokers and the mean smoking history was 54.2 (SD = 33.2) pack-years. Median utilities (IQR) by GOLD 2007 were 0.87 (0.22) for moderate; 0.80 (0.26) for severe and 0.67 (0.42) for very-severe patients (p < 0.001 for all comparisons). Median utilities by GOLD 2013 were group A: 1.0 (0.09); group B: 0.87 (0.13); group C: 1.0 (0.16); group D: 0.74 (0.29); comparisons were statistically significant (p < 0.001) except A vs C. Median utilities by GesEPOC phenotypes were 0.84 (0.33) for non exacerbator; 0.80 (0.26) for COPD-asthma overlap; 0.71 (0.62) for exacerbator with emphysema; 0.72 (0.57) for exacerbator with chronic bronchitis (p < 0.001). Comparisons between patients with or without exacerbations and between patients with COPD-asthma overlap and exacerbator with chronic bronchitis were statistically-significant (p < 0.001). Median utilities by BODEx index were: group 0-2: 0.89 (0.20); group 3-4: 0.80 (0.27); group 5-6: 0.67 (0.29); group 7-9: 0.41 (0.31). All comparisons were significant (p < 0.001) except between groups 3-4 and 5-6. CONCLUSION Irrespective of the classification used utilities were associated to disease severity. Some clinical phenotypes were associated with worse utilities, probably related to a higher frequency of exacerbations. GOLD 2007 guidelines and BODEx index better discriminated patients with a worse health status than GOLD 2013 guidelines, while GOLD 2013 guidelines were better able to identify a smaller group of patients with the best health.
Description
Journal Article; Observational Study; Research Support, Non-U.S. Gov't;
MeSH Terms
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Aged
Medical Subject Headings::Information Science::Information Science::Computing Methodologies::Algorithms
Medical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Emotions::Anxiety
Medical Subject Headings::Diseases::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Asthma
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cross-Sectional Studies
Medical Subject Headings::Anatomy::Urogenital System::Genitalia::Genitalia, Female
Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Epidemiologic Measurements::Demography::Health Status::Health Status Disparities
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Anatomy::Urogenital System::Genitalia::Genitalia, Male
Medical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Mobility Limitation
Medical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Motor Activity
Medical Subject Headings::Diseases::Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Pain
Medical Subject Headings::Diseases::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive
Medical Subject Headings::Disciplines and Occupations::Social Sciences::Quality of Life
Medical Subject Headings::Geographicals::Geographic Locations::Europe::Spain
Medical Subject Headings::Information Science::Information Science::Data Collection::Questionnaires
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Rehabilitation::Activities of Daily Living
DeCS Terms
CIE Terms
Keywords
Chronic obstructive pulmonary disease, Health utility, Health related quality of life, GOLD, GesEPOC, Enfermedad pulmonar obstructiva crónica, Calidad de vida, Salud, Asma, Ansiedad
Citation
Miravitlles M, Huerta A, Fernández-Villar JA, Alcázar B, Villa G, Forné C, et al. Generic utilities in chronic obstructive pulmonary disease patients stratified according to different staging systems. Health Qual Life Outcomes. 2014; 12:120