Measuring patient and clinician perspectives to evaluate change in health-related quality of life among patients with chronic obstructive pulmonary disease

Kathleen W. Wyrwich, Stacie M. Metz, Kurt Kroenke, William M. Tierney, Ajit N. Babu, Fredric D. Wolinsky

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

CONTEXT: Many treatments aim to improve patients' health-related quality of life (HRQoL), and many care guidelines suggest assessing symptoms and their impact on HRQoL. However, there is a lack of consensus regarding which HRQoL outcome measures are appropriate to assess, and how much change on those measures depict significant HRQoL improvement. OBJECTIVE: We used triangulation methods to identify and understand clinically important differences (CIDs) for the amount of change in HRQoL that reflects both health professionals and patients' values, among patients with chronic obstructive pulmonary disease (COPD). DESIGN, SETTING, AND PARTICIPANTS: We incorporated three perspectives: (1) an expert panel of physicians familiar with the measurement of HRQoL in COPD patients; (2) 610 primary care COPD outpatients who completed baseline and bimonthly follow-up HRQoL interviews over the 12-month study; and (3) the primary care physicians (PCPs; n=43) of these outpatients who assessed their patients' disease at baseline and at subsequent PCP visits during the year long study. MEASUREMENTS: The Chronic Respiratory Disease Questionnaire (CRQ), the Medical Outcomes Study Short Form 36-item survey (SF-36, version 2.0), and global assessments of change from each of the three perspectives for all HRQoL domains. RESULTS: With few exceptions, the CRQ was able to detect small changes at levels reported by the patients (1-2 points) and their PCPs (1-5 points). These results confirm minimal important difference standards developed in 1989 by Jaeschke et al. anchored on patient-perceived changes in HRQoL. In general, the expert panel and PCP CIDs were larger than the patient CIDs. CONCLUSION: This triangulation methodology yielded improved interpretation, understanding, and insights on stakeholder perspectives of CIDs for patient-reported outcomes.

Original languageEnglish
Pages (from-to)161-170
Number of pages10
JournalJournal of General Internal Medicine
Volume22
Issue number2
DOIs
StatePublished - Feb 2007

Fingerprint

Chronic Obstructive Pulmonary Disease
Quality of Life
Chronic Disease
Outpatients
Outcome Assessment (Health Care)
Primary Care Physicians
Quality Improvement
Primary Health Care
Guidelines
Interviews
Physicians
Health
Surveys and Questionnaires

Keywords

  • Chronic obstructive pulmonary disease
  • Health-related quality of life
  • Minimal important difference

ASJC Scopus subject areas

  • Internal Medicine
  • Medicine(all)

Cite this

Measuring patient and clinician perspectives to evaluate change in health-related quality of life among patients with chronic obstructive pulmonary disease. / Wyrwich, Kathleen W.; Metz, Stacie M.; Kroenke, Kurt; Tierney, William M.; Babu, Ajit N.; Wolinsky, Fredric D.

In: Journal of General Internal Medicine, Vol. 22, No. 2, 02.2007, p. 161-170.

Research output: Contribution to journalArticle

Wyrwich, Kathleen W. ; Metz, Stacie M. ; Kroenke, Kurt ; Tierney, William M. ; Babu, Ajit N. ; Wolinsky, Fredric D. / Measuring patient and clinician perspectives to evaluate change in health-related quality of life among patients with chronic obstructive pulmonary disease. In: Journal of General Internal Medicine. 2007 ; Vol. 22, No. 2. pp. 161-170.
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