Analysis of two questionnaires on quality of life of Chronic Obstructive Pulmonary Disease patients

Calidad de vida del paciente con enfermedad pulmonar obstructiva crónica

Introducción: los pacientes que padecen de patologías crónicas, como la enfermedad pulmonar obstructiva, experimentan diversos cambios en su estado de salud, que los lleva a modificar su percepción de bienestar. Por ello, la evaluación de la calidad de vida se hace necesaria. Objetivo: describir, de forma global y por dimensiones, la calidad de vida de sujetos que padecen de Enfermedad Pulmonar Obstructiva Crónica (EPOC), que acudieron a la consulta externa de una institución hospitalaria en el primer semestre de 2018 en Bogotá. Método: las características sociodemográficas y la calidad de vida relacionada con salud se midieron en un estudio descriptivo transversal. La muestra estuvo conformada por 80 pacientes. El análisis se fundamentó en la aplicación de frecuencias y porcentajes para las variables sociodemográficas, y de medidas de tendencia central para la variable principal de la investigación. Resultados: los pacientes con EPOC reportaron una edad media de 73 años, fueron predominantemente mujeres, casadas, con bajo nivel de escolaridad y con una media en la calidad de vida de 36,67. La subescala más afectada fue la de actividad y la menos comprometida fue la dimensión de impacto. Conclusiones: la calidad de vida relacionada con la salud es un indicador de las consecuencias que tiene la EPOC sobre la ejecución de las diferentes actividades físicas y sociales de los pacientes, por ello, su evaluación se convierte en un aspecto fundamental en la valoración e intervención de dicha población.

Spiritual Health and Stress in Pregnant Women During the Covid-19 Pandemic

Stress is one of the effective factors in the occurrence of negative effects during pregnancy that can cause adverse outcomes such as preterm delivery and reduced intrauterine growth of the fetus in pregnant women. Therefore, one of the serious concerns during the COVID-19 pandemic is the physical health and mental health of pregnant women. This study aimed to evaluate the physical health status with the spiritual and mental health of pregnant women during the COVID-19 pandemic. The study is a descriptive study in 2019-2020 and the samples were randomly selected from all pregnant women who referred to hospitals and private maternity centers before and during the COVID-19 pandemic and performed all pregnancy and fetal health tests. It was performed on 560 pregnant female samples. The mental status of pregnant women was assessed using the DASS Spiritual Health and Stress Questionnaire. Data analysis was performed using SPSS statistical software (version 24). The results of this study showed that preterm birth, height, weight, and head circumference of babies and lungs and respiratory status of children with mental health and stress levels of pregnant women during the corona are significant compared with the previous of corona (p < 0.05). Increasing stress and decreasing the mental health of pregnant women during COVID-19 pandemic can increase the influencing factors in preterm delivery and unhealthy birth.

Early Clinically Important Improvement (ECII) and Exacerbation Outcomes in COPD Patients

Background

Chronic obstructive pulmonary disease (COPD) exacerbations are difficult outcomes to measure in clinical trials. It would be valuable to be able to predict which patients are likely to benefit in terms of exacerbation prevention based on their early response in lung function and symptoms.

Methods

This was a post-hoc analysis from the 52-week, randomized, double-blind, double-dummy, non-inferiority FLAME trial. Early clinically important improvement (ECII) was defined as achievement of minimal clinically important difference in trough forced expiratory volume in 1 second (FEV1; ≥100 mL increase) and one patient-reported outcome (PRO): either St. George's Respiratory Questionnaire for COPD (≥4-unit reduction; D1), or COPD assessment test (≥2-point reduction; D2) at Week 4 or 12.

Results

Approximately 18-20% of patients achieved ECII at Week 4 or 12 post-randomization according to any of the two definitions. The rate of subsequent exacerbations was lower in patients who achieved ECII at Week 4 (D1: ratio of rates [95% CI], 0.85 [0.74 to 0.98]; D2, 0.88 [0.77 to 1.00]) or at Week 12 (D1, 0.85 [0.74 to 0.98]; D2, 0.86 [0.75 to 1.00]) versus patients not achieving ECII. Patients who achieved ECII experienced longer time-to-first exacerbation between Week 4 or 12 to end of study. More patients achieved ECII with indacaterol/glycopyrronium versus salmeterol/fluticasone according to both definitions at Week 4 (D1, odds ratio [95% CI], 1.69 [1.40 to 2.04]; D2, 1.61 [1.34 to 1.93]), and 12 (D1, 2.01 [1.66 to 2.44]; D2, 1.80 [1.48 to 2.18]).

Conclusion

ECII is a novel composite endpoint, based on clinically relevant improvement in lung function and PROs in the early phase of treatment intervention that may predict subsequent exacerbation risk and may be used in clinical trials.