TY - JOUR
T1 - Racial differences in quality of life in patients with COPD
AU - Han, Mei Lan K.
AU - Curran-Everett, Douglas
AU - Dransfield, Mark T.
AU - Criner, Gerard J.
AU - Zhang, Lening
AU - Murphy, James R.
AU - Hansel, Nadia N.
AU - DeMeo, Dawn L.
AU - Hanania, Nicola A.
AU - Regan, Elizabeth A.
AU - Make, Barry J.
AU - Martinez, Fernando J.
AU - Westney, Gloria E.
AU - Foreman, Marilyn G.
N1 - Funding Information:
Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: In the past 3 years, Dr Han has participated in advisory boards for Boehringer Ingelheim GmbH, Pfizer, GlaxoSmithKline, Genentech, Novartis, and Medimmune. She has participated on speaker's bureaus for Boehringer Ingelheim GmbH, Pfizer, GlaxoSmithKline, the National Association for Continuing Education, and WebMD. She has consulted for Novartis and Nycomed, and has received royalties from UpToDate and ePocrates, Inc. In the past 3 years, Dr Dransfield has consulted for GlaxoSmithKline and Boehringer Ingelheim GmbH. His institution has received funds to conduct clinical research trials for GlaxoSmithKline and Boehringer Ingelheim GmbH. Over the past 3 years, Dr Make has participated in advisory boards, speaker bureaus, consultations, and multicenter clinical trials with funding from the National Heart, Lung, and Blood Institute; Abbott Laboratories; Astellas Pharma Inc; AstraZeneca; Boehringer Ingelheim GmbH; Dey Pharma, LP; Embryon Inc; Forest Laboratories, Inc; GlaxoSmithKline; Nabi Biopharmaceuticals; Nycomed; Novartis Pharmaceuticals Corporation; Pfizer Inc; Respironics Inc; Merck/Schering-Plough; SeQual Technologies; and Talecris Biotherapeutics, Inc. Dr Martinez has served on advisory boards relating to COPD-related topics for GlaxoSmithKline; MedImmune, LLC; AstraZeneca; Merck & Co, Inc; Pearl Therapeutics Inc, Novartis Pharmaceuticals Corporation, United BioSource Corporation; Forest Laboratories, Inc; and Almirall, SA. He has consulted for Actelion Pharmaceuticals Ltd; Boehringer Ingelheim GmbH; Nycomed; Forest Laboratories; F. Hoffmann-La Roche Ltd; Bayer Corporation, Merck/Schering-Plough; Health Learning Systems; Talecris Biotherapeutics, Inc; Comgenex; fb Communications; BoomComm; and Actelion Pharmaceuticals Ltd. He has served on speaker's bureaus for GlaxoSmithKline; National Association for Continuing Education; Med-Ed; Potomac Center for Medical Education; Pfizer Inc; Boehringer Ingelheim GmbH; Merck/Schering-Plough; Vox Medica, Inc; American Lung Association; WebMD; ePocrates Inc; AstraZeneca; France Foundation; CME Incite; and Altana/Nycomed. His institution has received funds from Boehringer Ingelheim GmbH for a clinical trial. He has received royalties from Associates in Medical Marketing and Castle Connolly. He has developed educational materials for the France Foundation, HIT Global, and ePocrates Inc. He has served on steering committees for clinical trials supported by GlaxoSmithKline; Nycomed; Forest Laboratories, Inc; and Actelion Pharmaceuticals Ltd. Drs Curran-Everett, Criner, Zhang, Murphy, Hanzel, DeMeo, Regan, Westney, and Foreman have reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Funding Information:
Funding/Support: The project was supported by the National Heart, Lung, and Blood Institute [award numbers U01HL089897 and U01HL089856]. The COPDGene project also is supported by the COPD Foundation through contributions made to an industry advisory board comprising AstraZeneca, Boehringer Ingelheim GmbH, Novartis Pharmaceuticals Corporation, and Sepracor Inc. Dr Han is supported by funding from the National Heart, Lung and Blood Institute [Grant K23 HL093351].
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2011/11
Y1 - 2011/11
N2 - Background: Although COPD is associated with significant health-related quality-of-life (HRQL) impairment, factors influencing HRQL in patients with COPD are not well understood, particularly in African Americans. We hypothesized that HRQL in COPD differs by race and sought to identify factors associated with those differences. Methods: We analyzed 224 African American and 1,049 Caucasian subjects with COPD enrolled in the COPDGene (Genetic Epidemiology of COPD) Study whose conditions were classified as GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages I to IV. HRQL and symptoms were compared using the St. George Respiratory Questionnaire (SGRQ) and the modified Medical Research Council Dyspnea (MMRC) scale. We constructed a mixed-effects linear regression model for SGRQ score. Results: African Americans were younger and reported fewer pack-years of smoking, more current smoking, and less attained education than Caucasians; MMRC scores were higher(P = .02) as were SGRQ scores (mean score difference, 8.4; P < .001). In a general linear model of SGRQ total score after adjusting for factors such as age, sex, and pack-years of smoking, SGRQ total score was similar for African Americans and Caucasians who reported no COPD exacerbations in the prior year. However, for subjects with exacerbations, SGRQ total score was increased to a greater relative extent for African Americans than for Caucasians (1.89 points for each exacerbation, P = .006). For hospitalized exacerbations, the effect on SGRQ total score also was greater for African Americans (4.19 points, P = .04). Furthermore, a larger percentage of African Americans reported having had at least one exacerbation that required hospitalization in the prior year (32% vs 16%, P < .001). Conclusion: In analyses that account for other variables that affect quality of life, HRQL is similar for African Americans and Caucasians with COPD without exacerbations but worse for African Americans who experience exacerbations, particularly hospitalized exacerbations. Trial registry: ClinicalTrials.gov; No.: NCT00608764; URL: www.clinicaltrials.gov
AB - Background: Although COPD is associated with significant health-related quality-of-life (HRQL) impairment, factors influencing HRQL in patients with COPD are not well understood, particularly in African Americans. We hypothesized that HRQL in COPD differs by race and sought to identify factors associated with those differences. Methods: We analyzed 224 African American and 1,049 Caucasian subjects with COPD enrolled in the COPDGene (Genetic Epidemiology of COPD) Study whose conditions were classified as GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages I to IV. HRQL and symptoms were compared using the St. George Respiratory Questionnaire (SGRQ) and the modified Medical Research Council Dyspnea (MMRC) scale. We constructed a mixed-effects linear regression model for SGRQ score. Results: African Americans were younger and reported fewer pack-years of smoking, more current smoking, and less attained education than Caucasians; MMRC scores were higher(P = .02) as were SGRQ scores (mean score difference, 8.4; P < .001). In a general linear model of SGRQ total score after adjusting for factors such as age, sex, and pack-years of smoking, SGRQ total score was similar for African Americans and Caucasians who reported no COPD exacerbations in the prior year. However, for subjects with exacerbations, SGRQ total score was increased to a greater relative extent for African Americans than for Caucasians (1.89 points for each exacerbation, P = .006). For hospitalized exacerbations, the effect on SGRQ total score also was greater for African Americans (4.19 points, P = .04). Furthermore, a larger percentage of African Americans reported having had at least one exacerbation that required hospitalization in the prior year (32% vs 16%, P < .001). Conclusion: In analyses that account for other variables that affect quality of life, HRQL is similar for African Americans and Caucasians with COPD without exacerbations but worse for African Americans who experience exacerbations, particularly hospitalized exacerbations. Trial registry: ClinicalTrials.gov; No.: NCT00608764; URL: www.clinicaltrials.gov
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U2 - 10.1378/chest.10-2869
DO - 10.1378/chest.10-2869
M3 - Article
C2 - 21636665
AN - SCOPUS:81055141268
VL - 140
SP - 1169
EP - 1176
JO - Chest
JF - Chest
SN - 0012-3692
IS - 5
ER -