Dyspnea Associates With a Widely Impaired Quality of Life in Idiopathic Pulmonary Fibrosis Patients: A Longitudinal Study Using 15D

Abstract

<b><i>Background:</i></b> Research on health-related quality of life (HRQoL) is crucial for developing comprehensive palliative care in idiopathic pulmonary fibrosis (IPF). <b><i>Objectives:</i></b> To study IPF patients' HRQoL compared with general population and its association with dyspnea in a longitudinal follow-up. <b><i>Design:</i></b> Assessment of IPF patients' HRQoL by a generic tool. Comparison of baseline data with the general population and a 30-month follow-up with 6 months intervals. <b><i>Setting/Subjects:</i></b> In total, 246 IPF patients were recruited from the Finnish nationwide real-life study, FinnishIPF. <b><i>Measurements:</i></b> Modified Medical Research Council (MMRC) dyspnea scale for dyspnea and the generic HRQoL tool 15D for the total and dimensional HRQoL were used. <b><i>Results:</i></b> At baseline, the mean 15D total score was lower (0.786, standard deviation [SD] 0.116) in IPF patients than in the general population (0.871, SD 0.043) (<i>p</i> < 0.001) and among the IPF patients with MMRC ≥2 compared with those with MMRC <2 (<i>p</i> < 0.001). In patients with MMRC ≥2, significant impairment compared with general population existed in 11 dimensions of HRQoL, such as breathing, usual activities, and sexual activity, whereas this was true in only 4 dimensions in MMRC <2 category. Mental function was not impaired in either group. During the follow-up, 15D total score decreased in both MMRC categories (<i>p</i> < 0.001) but stayed constantly worse in the MMRC ≥2 group. Seven and two dimensions of HRQoL significantly declined in the categories of MMRC <2 and MMRC ≥2, respectively. <b><i>Conclusions:</i></b> Patients with IPF, especially if dyspnea limits everyday life, suffer from widely impaired HRQoL, although self-assessed mental capability is preserved. Integrated palliative care is supported to face the multiple needs of IPF patients.