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Channick JE, Swigris J. Cough in Fibrotic Interstitial Lung Disease: Effects and Implications. Am J Respir Crit Care Med 2024. [PMID: 38691820 DOI: 10.1164/rccm.202404-0683ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/30/2024] [Indexed: 05/03/2024] Open
Affiliation(s)
- Jessica E Channick
- UCLA, 8783, Division of Pulmonary, Critical Care and Sleep Medicine, Los Angeles, California, United States
| | - Jeff Swigris
- National Jewish Health, 2930, Interstitial Lung Disease Program, Department of Medicine, Denver, Colorado, United States;
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Swigris J, Foster B, Johnson N. Determining and reporting minimal important change for patient-reported outcome instruments in pulmonary medicine. Eur Respir J 2022; 60:13993003.00717-2022. [PMID: 35926876 DOI: 10.1183/13993003.00717-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/25/2022] [Indexed: 11/05/2022]
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Wijsenbeek M, Molina-Molina M, Chassany O, Fox J, Galvin L, Geissler K, Hammitt KM, Kreuter M, Moua T, O'Brien EC, Slagle AF, Krasnow A, Reaney M, Baldwin M, Male N, Rohr KB, Swigris J, Antoniou K. Developing a conceptual model of symptoms and impacts in progressive fibrosing interstitial lung disease to evaluate patient-reported outcome measures. ERJ Open Res 2022; 8:00681-2021. [PMID: 35509443 PMCID: PMC9062300 DOI: 10.1183/23120541.00681-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/04/2022] [Indexed: 12/04/2022] Open
Abstract
Background An understanding of the experience of patients with progressive fibrosing interstitial lung disease (PF-ILD) is needed to select appropriate patient-reported outcome measures (PROMs) to evaluate treatment effect in clinical trials. Methods A systematic literature review was conducted to develop a preliminary conceptual model of the symptoms experienced by patients with PF-ILD and the impacts the disease has on them. An online survey and consensus meetings were then conducted with 12-14 stakeholders (patients, clinicians, regulatory and payer advisors) to refine the conceptual model and critically appraise how key concepts should be measured by PROMs. PROMs assessed included Living with Idiopathic Pulmonary Fibrosis, Living with Pulmonary Fibrosis, the King's Brief Interstitial Lung Disease questionnaire, Cough and Sputum Assessment Questionnaire, Evaluating Respiratory Symptoms, Leicester Cough Questionnaire, Functional Assessment of Chronic Illness Therapy (Dyspnoea/Fatigue) and St George's Respiratory Questionnaire for Idiopathic Pulmonary Fibrosis. Results The literature review identified 36 signs/symptoms and 43 impacts directly or indirectly related to pulmonary aspects of PF-ILD. The most relevant symptoms identified by participants included shortness of breath on exertion, fatigue and cough; relevant impacts included effects on physical functioning, activities of daily living and emotional wellbeing. These are presented in a conceptual model. Consensus opinion was that existing PROMs need further modification and validation before use in clinical trials. Conclusions The conceptual model improves understanding of the symptoms and impacts that living with PF-ILD has on patients' wellbeing. It can help to inform the choice of PROMs in clinical trials and highlight aspects to assess in the clinical care of patients with PF-ILD.
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Affiliation(s)
- Marlies Wijsenbeek
- Dept of Respiratory Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Maria Molina-Molina
- Dept of Pneumology, Unit of Interstitial Lung Diseases, University Hospital of Bellvitge, Institute for Biomedical Research (IDIBELL), Barcelona, Spain
| | - Olivier Chassany
- Patient-Reported Outcomes Research Unit, Université de Paris, Paris, France
- Health Economics Clinical Trial Unit (URC-ECO), Hotel-Dieu Hospital, AP-HP, Paris, France
| | - John Fox
- Foxworthy Healthcare Consulting, Ada, MI, USA
| | - Liam Galvin
- European Idiopathic Pulmonary Fibrosis and Related Disorders Federation, Overijse, Belgium
| | | | | | - Michael Kreuter
- Center for Interstitial and Rare Lung Diseases, Department of Pneumology, Thoraxklinik, University of Heidelberg, Member of the German Center for Lung Research, Heidelberg, Germany
| | - Teng Moua
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | - Michael Baldwin
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | - Natalia Male
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | - Klaus B. Rohr
- Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany
| | | | - Katerina Antoniou
- Laboratory of Cellular and Molecular Pneumonology, Dept of Respiratory Medicine, School of Medicine, University of Crete, Crete, Greece
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Guler SA, Lindell KO, Swigris J, Ryerson CJ. Nondrug Treatments for Idiopathic Pulmonary Fibrosis: IPF Part 3. Am J Respir Crit Care Med 2021; 203:P10-P11. [PMID: 33576729 DOI: 10.1164/rccm.2034p10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Affiliation(s)
- Jeff Swigris
- 1 Interstitial Lung Disease Program National Jewish Health Denver, Colorado
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Kreuter M, Swigris J, Pittrow D, Geier S, Klotsche J, Prasse A, Wirtz H, Koschel D, Andreas S, Claussen M, Grohé C, Wilkens H, Hagmeyer L, Skowasch D, Meyer JF, Kirschner J, Gläser S, Kahn N, Welte T, Neurohr C, Schwaiblmair M, Held M, Bahmer T, Oqueka T, Frankenberger M, Behr J. The clinical course of idiopathic pulmonary fibrosis and its association to quality of life over time: longitudinal data from the INSIGHTS-IPF registry. Respir Res 2019; 20:59. [PMID: 30876420 PMCID: PMC6420774 DOI: 10.1186/s12931-019-1020-3] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 02/27/2019] [Indexed: 02/06/2023] Open
Abstract
Background Quality of life (QoL) is profoundly impaired in patients with idiopathic pulmonary fibrosis (IPF). However, data is limited regarding the course of QoL. We therefore analysed longitudinal data from the German INSIGHTS-IPF registry. Methods Clinical status and QoL were assessed at enrollment and subsequently at 6- to 12-months intervals. A range of different QoL questionnaires including the St. George’s Respiratory Questionnaire (SGRQ) were used. Results Data from 424 patients were included; 76.9% male; mean age 68.7 ± 9.1 years, mean FVC% predicted 75.9 ± 19.4, mean DLCO% predicted 36.1 ± 15.9. QoL worsened significantly during follow-up with higher total SGRQ scores (increased by 1.47 per year; 95% CI: 1.17 to 1.76; p < 0.001) and higher UCSD-SOBQ scores and lower EQ-5D VAS and WHO-5 scores. An absolute decline in FVC% predicted of > 10% was associated with a significant deterioration in SGRQ (increasing by 9.08 units; 95% CI: 2.48 to 15.67; p = 0.007), while patients with stable or improved FVC had no significantly change in SGRQ. Patients with a > 10% decrease of DLCO % predicted also had a significant increase in SGRQ (+ 7.79 units; 95% CI: 0.85 to 14.73; p = 0.028), while SQRQ was almost stable in patients with stable or improved DLCO. Patients who died had a significant greater increase in SGRQ total scores (mean 11.8 ± 18.6) at their last follow-up visit prior to death compared to survivors (mean 4.2 ± 18.9; HR = 1.03; 95% CI: 1.01 to 1.04; p < 0.001). All QoL scores across the follow-up period were significantly worse in hospitalised patients compared to non-hospitalised patients, with the worst scores reported in those hospitalised for acute exacerbations. Conclusions QoL assessments in the INSIGHTS-IPF registry demonstrate a close relationship between QoL and clinically meaningful changes in lung function, comorbidities, disease duration and clinical course of IPF, including hospitalisation and mortality. Electronic supplementary material The online version of this article (10.1186/s12931-019-1020-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michael Kreuter
- Center for interstitial and rare lung diseases, Thoraxklinik, University of Heidelberg, Röntgenstr 1, D-69126, Heidelberg, Germany. .,German Center for Lung Research, gießen, Germany.
| | - Jeff Swigris
- Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA
| | - David Pittrow
- Institut für Klinische Pharmakologie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | - Silke Geier
- Department Market Access, Boehringer Ingelheim, Ingelheim am Rhein, Germany
| | - Jens Klotsche
- Epidemiologie, Deutsches Rheuma-Forschungsinstitut, Berlin, Germany
| | - Antje Prasse
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover, Germany.,Fraunhofer Institute ITEM, Hannover, Germany.,German Center for Lung Research, gießen, Germany
| | - Hubert Wirtz
- Abteilung für Pneumologie, Department Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig AöR, Leipzig, Germany
| | - Dirk Koschel
- Zentrum für Pneumologie und Bereich Pneumologie, Fachkrankenhaus Coswig und Uniklinikum Dresden, Coswig, Germany
| | - Stefan Andreas
- Lungenfachklinik Immenhausen and Universitätsmedizin Göttingen, Kardiologie und Pneumologie, Göttingen, Germany
| | - Martin Claussen
- Lungen Clinic Grosshansdorf, Grosshansdorf, Germany.,German Center for Lung Research, gießen, Germany
| | | | - Henrike Wilkens
- Klinik für Innere Medizin V, Pneumologie, Universitätsklinikum Universitätskliniken des Saarlandes, Homburg, Germany
| | | | - Dirk Skowasch
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany
| | - Joachim F Meyer
- Lungenzentrum München, LZM Bogenhausen-Harlaching, Städtisches Klinikum München GmbH, Munich, Germany
| | | | - Sven Gläser
- Klinik und Poliklinik für Innere Medizin B, Forschungsbereich Pneumologie und Pneumologische Epidemiologie, Universitätsmedizin Greifswald, Greifswald, Germany.,Vivantes Klinikum Spandau, Klinik für Innere Medizin, Berlin, Germany
| | - Nicolas Kahn
- Center for interstitial and rare lung diseases, Thoraxklinik, University of Heidelberg, Röntgenstr 1, D-69126, Heidelberg, Germany.,German Center for Lung Research, gießen, Germany
| | - Tobias Welte
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover, Germany.,German Center for Lung Research, gießen, Germany
| | - Claus Neurohr
- Medizinische Klinik und Poliklinik V, Klinikum der LMU, Munich, Germany.,Schillerhöhe, Robert Bosch Krankenhaus, Stuttgart, Germany
| | | | - Matthias Held
- Klinikum Würzburg Mitte, Standort Missioklinik, Abteilung Innere Medizin, Pneumologie, Würzburg, Germany
| | - Thomas Bahmer
- Lungen Clinic Grosshansdorf, Grosshansdorf, Germany.,German Center for Lung Research, gießen, Germany
| | - Tim Oqueka
- Universitätsklinikum Hamburg, Hamburg, Germany
| | - Marion Frankenberger
- Medizinische Klinik und Poliklinik V, Klinikum der LMU, Munich, Germany.,Asklepios Fachkliniken München-Gauting, Munich, Germany.,German Center for Lung Research, gießen, Germany
| | - Jürgen Behr
- Medizinische Klinik und Poliklinik V, Klinikum der LMU, Munich, Germany.,Asklepios Fachkliniken München-Gauting, Munich, Germany.,German Center for Lung Research, gießen, Germany
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Maier LA, Liu H, Patel D, Welch A, Wilson C, Mroz M, Li L, Rose C, VanDyke M, Swigris J, Hamzeh N. Response. Chest 2018; 150:1423-1424. [PMID: 27938764 DOI: 10.1016/j.chest.2016.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 10/05/2016] [Indexed: 11/27/2022] Open
Affiliation(s)
- Lisa A Maier
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO; Division of Pulmonary and Critical Care Sciences, School of Medicine, University of Colorado, Denver, CO; Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Denver, CO.
| | - Hongbo Liu
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO; Department of Epidemiology and Biostatistics, China Medical University, Shenyang, China
| | - Divya Patel
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL
| | - Alison Welch
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO
| | - Carla Wilson
- Department of Biostatistics, National Jewish Health, Denver, CO
| | - Margaret Mroz
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO
| | - Li Li
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO; Division of Pulmonary and Critical Care Sciences, School of Medicine, University of Colorado, Denver, CO
| | - Cecile Rose
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO; Division of Pulmonary and Critical Care Sciences, School of Medicine, University of Colorado, Denver, CO; Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Denver, CO
| | - Michael VanDyke
- Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Denver, CO
| | - Jeff Swigris
- Pulmonary Division, National Jewish Health, Denver, CO; Division of Pulmonary and Critical Care Sciences, School of Medicine, University of Colorado, Denver, CO
| | - Nabeel Hamzeh
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO; Division of Pulmonary and Critical Care Sciences, School of Medicine, University of Colorado, Denver, CO
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Kreuter M, Maher TM, Swigris J, Wijsenbeek MS, Axmann J, Ireland L, Nathan S. Differences in Patients and Physician Viewpoints of the Management of Idiopathic Pulmonary Fibrosis (IPF). Pneumologie 2018. [DOI: 10.1055/s-0037-1619185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M Kreuter
- Zentrum für Interstitielle und Seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Thoraxklinik; Universitätsklinikum Heidelberg und Translationales Zentrum für Lungenforschung Heidelberg (TLRC); Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | - TM Maher
- Royal Brompton Hospital; NIHR Biological Research Unit, London
| | - J Swigris
- National Jewish Health, Denver, Colorado, USA
| | | | - J Axmann
- F. Hoffmann-La Roche Ltd., Basel
| | | | - S Nathan
- Inova Fairfax Hospital, Falls Church, USA
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Kreuter M, Swigris J, Pittrow D, Geier S, Klotsche J, Prasse A, Wirtz H, Koschel D, Andreas S, Grohe C, Wilkens H, Hagmeyer L, Skowasch D, Meyer FJ, Kirschner J, Gläser S, Herth FJF, Welte T, Neurohr C, Schweiblmair M, Held M, Bahmer T, Frankenberger M, Behr J. Quality of life trajectory in patients with idiopathic pulmonary fibrosis (IPF): longitudinal QoL assessment of the INSIGHTS-IPF registry. Pneumologie 2018. [DOI: 10.1055/s-0037-1619192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M Kreuter
- Zentrum für Interstitielle und Seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Thoraxklinik; Universitätsklinikum Heidelberg und Translationales Zentrum für Lungenforschung Heidelberg (TLRC); Mitglied des Deutschen Zentrums für Lungenforschung (DZL)
| | - J Swigris
- Interstitial Lung Disease Program, National Jewish Health, Denver, Colorado, USA
| | - D Pittrow
- Institut für Klinische Pharmakologie, Medizinische Fakultät, Technische Universität Dresden
| | - S Geier
- Department Market Access, Boehringer Ingelheim
| | - J Klotsche
- Epidemiologie, Deutsches Rheuma-Forschungsinstitut, Berlin
| | - A Prasse
- Klinik für Pneumologie, Medizinische Hochschule, Hannover
| | - H Wirtz
- Pneumologie, Universitätsklinikum der Universität Leipzig
| | - D Koschel
- Zentrum für Pneumologie-, Thorax- und Gefäßchirurgie, Fachkrankenhaus Coswig
| | - S Andreas
- Kardiologie und Pneumologie, Lungenfachklinik Immenhausen und Universitätsmedizin Göttingen
| | - C Grohe
- Klinik für Pneumologie, ELK, Berlin Buch
| | - H Wilkens
- Pneumologie, Klinik für Innere Medizin V, Universitätsklinikum des Saarlandes, Homburg
| | | | - D Skowasch
- Medical Clinic II, University Hospital Bonn
| | - FJ Meyer
- Lungenzentrum München, LZM Bogenhausen-Harlaching, Städtisches Klinikum München GmbH
| | - J Kirschner
- Center for Internal Medical Studies Cims, Bamberg
| | - S Gläser
- Klinik und Poliklinik für Innere Medizin B, Forschungsbereich Pneumologie und Pneumologische Epidemiologie, Universitätsmedizin Greifswald; Klinik für Innere Medizin – Pneumologie, Greifswald and Vivantes Klinikum Spandau/Berlin
| | - FJF Herth
- Zentrum für Interstitielle und Seltene Lungenerkrankungen, Thoraxklinik, Uniklinikum Heidelberg
| | - T Welte
- Klinik für Pneumologie, Medizinische Hochschule Hannover
| | - C Neurohr
- Comprehensive Pneumology Center, Lungenforschungsambulanz, Klinikum der Universität München
| | | | - M Held
- Abteilung Innere Medizin, Pneumologie, Standort Missioklinik, Klinikum Würzburg Mitte
| | | | - M Frankenberger
- Comprehensive Pneumology Center, Lungenforschungsambulanz, Klinikum der Universität München
| | - J Behr
- Comprehensive Pneumology Center, Lungenforschungsambulanz, Klinikum der Universität München and Asklepios Fachkliniken München-Gauting; Member of the German Center for Lung Research (DZL)
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Kreuter M, Bendstrup E, Russell AM, Bajwah S, Lindell K, Adir Y, Brown CE, Calligaro G, Cassidy N, Corte TJ, Geissler K, Hassan AA, Johannson KA, Kairalla R, Kolb M, Kondoh Y, Quadrelli S, Swigris J, Udwadia Z, Wells A, Wijsenbeek M. Palliative care in interstitial lung disease: living well. Lancet Respir Med 2017; 5:968-980. [PMID: 29033267 DOI: 10.1016/s2213-2600(17)30383-1] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 09/28/2017] [Accepted: 09/28/2017] [Indexed: 12/25/2022]
Abstract
Progressive fibrotic interstitial lung diseases (ILDs) are characterised by major reductions in quality of life and survival and have similarities to certain malignancies. However, palliative care expertise is conspicuously inaccessible to many patients with ILD. Unmet patient and caregiver needs include effective pharmacological and psychosocial interventions to improve quality of life throughout the disease course, sensitive advanced care planning, and timely patient-centred end-of-life care. The incorrect perception that palliative care is synonymous with end-of-life care, with no role earlier in the course of ILD, has created a culture of neglect. Interventions that aim to improve life expectancy are often prioritised without rigorous assessment of the individual's health and psychosocial needs, thereby inadvertently reducing quality of life. As in malignant disorders, radical interventions to slow disease progression and palliative measures to improve quality of life should both be prioritised. Efficient patient-centred models of palliative care must be validated, taking into account religious and cultural differences, as well as variability of resources. Effective implementation of palliative care for ILD will require multidisciplinary participation from clinicians, specialist nurses, psychologists, social workers, and, in some countries, non-governmental faith and community-based organisations with access to palliative care expertise.
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Affiliation(s)
- Michael Kreuter
- Center for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
| | - Elisabeth Bendstrup
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - Anne-Marie Russell
- National Heart & Lung Institute, Royal Brompton Hospital and Imperial College London, London, UK
| | - Sabrina Bajwah
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, UK
| | - Kathleen Lindell
- Dorothy P & Richard P Simmons Center for Interstitial Lung Disease at UPMC, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yochai Adir
- Pulmonary Division, Lady Davis Carmel Medical Center, Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel
| | - Crystal E Brown
- Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, Seattle, WA, USA; University of Washington Medical Center, Seattle, WA, USA
| | - Greg Calligaro
- Division of Pulmonology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Tamera J Corte
- Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW, Australia
| | | | - Azza Adel Hassan
- Hamad Medical Corporation, Supportive and Palliative Section, Oncology Department, Doha, Qatar; Medical Research Institute, Clinical Oncology Department, Alexandria University, Alexandria, Egypt
| | | | - Ronaldo Kairalla
- Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Martin Kolb
- Firestone Institute for Respiratory Health, Department of Medicine, Pathology & Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Yasuhiro Kondoh
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, Nagoya University School of Medicine, Nagoya, Japan
| | | | - Jeff Swigris
- Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA
| | - Zarir Udwadia
- Department of Respiratory Medicine, P D Hinduja National Hospital and Medical Research Center, Mumbai, India
| | - Athol Wells
- NIHR Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, UK; Fibrosis Research Group, National Heart and Lung Institute, Imperial College London, London, UK
| | - Marlies Wijsenbeek
- Department of Respiratory Medicine, Erasmus University Medical Centre, Rotterdam, Netherlands
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Kreuter M, Swigris J, Pittrow D, Geier S, Klotsche J, Prasse A, Wirtz H, Koschel D, Andreas S, Claussen M, Grohé C, Wilkens H, Hagmeyer L, Skowasch D, Meyer JF, Kirschner J, Gläser S, Herth FJF, Welte T, Neurohr C, Schwaiblmair M, Held M, Bahmer T, Frankenberger M, Behr J. Health related quality of life in patients with idiopathic pulmonary fibrosis in clinical practice: insights-IPF registry. Respir Res 2017; 18:139. [PMID: 28709421 PMCID: PMC5512739 DOI: 10.1186/s12931-017-0621-y] [Citation(s) in RCA: 106] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 07/03/2017] [Indexed: 12/13/2022] Open
Abstract
Background The INSIGHTS-IPF registry provides one of the largest data sets of clinical data and self-reported patient related outcomes including health related quality of life (QoL) on patients with idiopathic pulmonary fibrosis (IPF). We aimed to describe associations of various QoL instruments between each other and with patient characteristics at baseline. Methods Six hundred twenty-three IPF patients with available QoL data (St George’s Respiratory Questionnaire SGRQ, UCSD Shortness-of-Breath Questionnaire SoB, EuroQol visual analogue scale and index EQ-5D, Well-being Index WHO-5) were analysed. Mean age was 69.6 ± 8.7 years, 77% were males, mean disease duration 2.0 ± 3.3 years, FVC pred was 67.5 ± 17.8%, DLCO pred 35.6 ± 17%. Results Mean points were SGRQ total 48.3, UCSD SoB 47.8, EQ-5D VAS 66.8, and WHO-5 13.9. These instruments had a high or very high correlation (exception WHO-5 to EQ-5D VAS with moderate correlation). On bivariate analysis, QoL by SGRQ total was statistically significantly associated with clinical symptoms (NYHA; p < 0.001), number of comorbidities (p < 0.05), hospitalisation rate (p < 0.01) and disease severity (as measured by GAP score, CPI, FVC and 6-min walk test; p < 0.05 each). Multivariate analyses showed a significant association between QoL (by SGRQ total) and IPF duration, FVC, age, NYHA class and indication for long-term oxygen treatment. Conclusions Overall, IPF patients under real-life conditions have lower QoL compared to those in clinical studies. There is a meaningful relationship between QoL and various patient characteristics. Trial registration The INSIGHTS-IPF registry is registered at Clinicaltrials.gov (NCT01695408). Electronic supplementary material The online version of this article (doi:10.1186/s12931-017-0621-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michael Kreuter
- Center for interstitial and rare lung diseases, pneumology and respiratory critical care medicine, Thoraxklinik, University of Heidelberg, Röntgenstr. 1, D-69126, Heidelberg, Germany. .,German center for Lung Research, Aulweg 130, 35392, Gießen, Germany.
| | - Jeff Swigris
- Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA
| | - David Pittrow
- Institut für Klinische Pharmakologie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | - Silke Geier
- Department Market Access, Boehringer Ingelheim, Ingelheim am Rhein, Germany
| | - Jens Klotsche
- Epidemiologie, Deutsches Rheuma-Forschungsinstitut, Berlin, Germany
| | - Antje Prasse
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover, Germany.,Fraunhofer Institute ITEM, Hannover, Germany.,German center for Lung Research, Aulweg 130, 35392, Gießen, Germany
| | - Hubert Wirtz
- Abteilung für Pneumologie, Department Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig AöR, Leipzig, Germany
| | - Dirk Koschel
- Zentrum für Pneumologie, Fachkrankenhaus Coswig, Coswig, Germany
| | - Stefan Andreas
- Lungenfachklinik Immenhausen and Universitätsmedizin Göttingen, Kardiologie und Pneumologie, Göttingen, Germany
| | - Martin Claussen
- LungenClinic Grosshansdorf, Grosshansdorf, Germany.,German center for Lung Research, Aulweg 130, 35392, Gießen, Germany
| | | | - Henrike Wilkens
- Klinik für Innere Medizin V, Pneumologie, Universitätsklinikum Universitätskliniken des Saarlandes, Homburg, Germany
| | | | - Dirk Skowasch
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany
| | - Joachim F Meyer
- Lungenzentrum München, LZM Bogenhausen-Harlaching, Städtisches Klinikum München GmbH, München, Germany
| | | | - Sven Gläser
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Innere Medizin B, Forschungsbereich Pneumologie und Pneumologische Epidemiologie, Greifswald, Germany.,Vivantes Klinikum Spandau, Klinik für Innere Medizin, Berlin, Germany
| | - Felix J F Herth
- Center for interstitial and rare lung diseases, pneumology and respiratory critical care medicine, Thoraxklinik, University of Heidelberg, Röntgenstr. 1, D-69126, Heidelberg, Germany.,German center for Lung Research, Aulweg 130, 35392, Gießen, Germany
| | - Tobias Welte
- Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover, Germany.,German center for Lung Research, Aulweg 130, 35392, Gießen, Germany
| | - Claus Neurohr
- Comprehensive Pneumology Center, Lungenforschungsambulanz, Klinikum der Universität München, München, Germany.,German center for Lung Research, Aulweg 130, 35392, Gießen, Germany
| | | | - Matthias Held
- Klinikum Würzburg Mitte, Standort Missioklinik, Abteilung Innere Medizin, Pneumologie, Würzburg, Germany
| | - Thomas Bahmer
- LungenClinic Grosshansdorf, Grosshansdorf, Germany.,German center for Lung Research, Aulweg 130, 35392, Gießen, Germany
| | - Marion Frankenberger
- Comprehensive Pneumology Center, Lungenforschungsambulanz, Klinikum der Universität München, München, Germany.,Asklepios Fachkliniken München-Gauting, München, Germany.,German center for Lung Research, Aulweg 130, 35392, Gießen, Germany
| | - Jürgen Behr
- Comprehensive Pneumology Center, Lungenforschungsambulanz, Klinikum der Universität München, München, Germany.,Asklepios Fachkliniken München-Gauting, München, Germany.,German center for Lung Research, Aulweg 130, 35392, Gießen, Germany
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14
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Abstract
BACKGROUND Sarcoidosis patients suffer from fatigue and exercise limitation. The aim of this study was to establish whether a physical training program improves these and other outcomes important to sarcoidosis patients. METHODS From 11/2012 to 9/2014, 201 sarcoidosis patients were referred to the ild care expertise team, Ede, the Netherlands. In our center, all patients are routinely recommended to undergo testing at baseline to determine their physical functioning and encouraged to complete a 12-week, supervised physical training program. Ninety patients underwent baseline testing and returned for repeat testing at 3 months in the interim, 49 completed the training program (Group I) and 41 chose not to participate (Group II). Change over time (from baseline to 3 months) in fatigue, exercise capacity, and skeletal muscle strength were assessed between the two groups. RESULTS At baseline, there were no between-group differences for fatigue, DLCO%, FVC%, or exercise capacity [assessed by percent predicted six-minute walk distance (6MWD%) and Steep Ramp Test (SRT)]. The 6MWD for Group I improved between baseline and 3 months, while the 6MWD remained the same in Group II (F = 72.2, p < 0.001). Group I showed a significantly larger decrease of fatigue compared with Group II (F = 6.27, p = 0.014). Lung function tests did not change in either group. CONCLUSION A supervised physical training program improves exercise capacity and fatigue among sarcoidosis patients and should be included in their management regimen.
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Affiliation(s)
- Bert Strookappe
- Department of Physical Therapy, Hospital Gelderse Vallei (ZGV), Ede, The Netherlands
- ild care foundation research team, PO Box 18, 6720 AA, Bennekom, The Netherlands
| | - Jeff Swigris
- Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA
| | - Jolanda De Vries
- ild care foundation research team, PO Box 18, 6720 AA, Bennekom, The Netherlands
- Department of Medical Psychology, St. Elisabeth Hospital Tilburg and Department of Medical and Clinical Psychology, CoRPS, Tilburg University, Tilburg, The Netherlands
| | - Marjon Elfferich
- ild care foundation research team, PO Box 18, 6720 AA, Bennekom, The Netherlands
| | - Ton Knevel
- Department of Physical Therapy, Hospital Gelderse Vallei (ZGV), Ede, The Netherlands
| | - Marjolein Drent
- ild care foundation research team, PO Box 18, 6720 AA, Bennekom, The Netherlands.
- Center of Interstitial Lung Diseases, St. Antonius Hospital, Nieuwegein, The Netherlands.
- Department of Pharmacology and Toxicology, Faculty of Health, Medicine and Life Science, Maastricht University, Maastricht, The Netherlands.
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15
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Strookappe B, Elfferich M, Swigris J, Verschoof A, Veschakelen J, Knevel T, Drent M. Benefits of physical training in patients with idiopathic or end-stage sarcoidosis-related pulmonary fibrosis: a pilot study. Sarcoidosis Vasc Diffuse Lung Dis 2015; 32:43-52. [PMID: 26237355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 09/30/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND The natural history of disease in patients with stage IV (fibrotic) sarcoidosis may mirror that of patients with idiopathic pulmonary fibrosis (IPF). Both are bothered by progressive dyspnea, exercise limitation and fatigue. OBJECTIVE To establish whether patients suffering from pulmonary fibrosis might benefit from a physical training program. STUDY DESIGN Twenty-four eligible patients referred to the out-patient clinic of the ild care expertise team of Hospital Gelderse Vallei, Ede, The Netherlands between November 2012 and November 2013 were included in this observational pilot study of a 12-week physical training program. Outcomes, including exercise capacity, skeletal muscle strength, lung function and fatigue were assessed at two time points: 1) baseline; and 2) after completion of a 12-week physical training program. RESULTS At baseline, the percentage predicted DLCO, FVC, FEV1 and exercise capacity (assessed by six-minute walking distance (6MWD) or maximal oxygen uptake) was reduced in both groups. After program completion, exercise capacity improved (>10% improvement 6MWD) in 13 subjects (54.2%): 7 with IPF and 6 with sarcoidosis subjects. Other secondary endpoints, including pulmonary function tests and patient-reported outcome measures improved in some subjects. CONCLUSION A 12-week physical training program improved or maintained exercise capacity in patients with IPF (despite disease progression) or fibrotic sarcoidosis. The results from this pilot study could be used to design prospective studies aimed at answering lingering questions about exercise training in patients with these progressive, incurable conditions.
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Affiliation(s)
- Bert Strookappe
- Dept. of Physical Therapy Hospital Gelderse Vallei (ZGV) Ede; ild care expertise team, Dept. of Respiratory Medicine, ZGV, Ede.
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16
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Abstract
Objective We aimed to evaluate the relationship between cognitive dysfunction and lung function, exercise endurance, and self-reported activity levels in patients with systemic lupus erythematosus (SLE). Background Cognitive dysfunction is present in 20%–60% of SLE patients. No studies to date have investigated the inter-relationships between cardiopulmonary factors and cognition in this population. Methods Thirty-seven SLE patients without overt neuropsychiatric histories and 16 healthy controls completed neuropsychological testing, measures of lung function, exercise capacity (distance walked during a timed walk test,1 maximal oxygen uptake2), and exercise questionnaires. Results Thirty-two percent of SLE patients demonstrated cognitive impairment. Cognitive impairment was correlated with Six-Minute Walk Distance (6MWD) ( r = 0.37, p = 0.02) and certain measures of lung function. Also, in SLE patients, self-reported physical activity was correlated with 6MWD ( p = 0.012), but none of the more complex measures of physical activity (VO2max). Conclusions Patients with mild SLE disease activity have cognitive dysfunction associated with certain objective markers of exercise capacity and activity levels. The lack of associations between self-report activity and VO2max suggests the possibility that multiple factors mediate the relationships between perceived and actual physical ability. Additional studies are needed to better understand the relationship between cognition and physical activity in patients with SLE.
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Affiliation(s)
- E Kozora
- National Jewish Health, Denver, CO, USA
- Department of Neurology, University of Colorado Medical School, Denver, CO, USA
- Department of Psychiatry, University of Colorado Medical School, Denver, CO, USA
| | - J Zell
- National Jewish Health, Denver, CO, USA
| | - J Swigris
- National Jewish Health, Denver, CO, USA
| | - M Strand
- National Jewish Health, Denver, CO, USA
| | - E C Duggan
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | | | - B Make
- National Jewish Health, Denver, CO, USA
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17
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Mittoo S, Saketkoo L, Swigris J, LeSage D, Fischer A, Frankel S. AB0815 Living with connective tissue disease related interstitial lung disease: Patient experiences of the disease over time. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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18
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Pillai M, Lee-Chiong T, Hanna P, Swigris J. Obstructive Sleep Apnea (OSA) and Gastroesophageal Reflux Disease (GERD) Are Common in Patients With Fibrotic Interstitial Lung Disease (Fild). Chest 2011. [DOI: 10.1378/chest.1119880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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19
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Yorke J, Russell AM, Swigris J, Shuldham C, Haigh C, Rochnia N, Hoyle J, Jones PW. Assessment of dyspnea in asthma: validation of The Dyspnea-12. J Asthma 2011; 48:602-8. [PMID: 21635136 DOI: 10.3109/02770903.2011.585412] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Dyspnea is a prominent symptom in asthma. The Dyspnea-12 (D-12), an instrument that quantifies breathlessness using 12 descriptors that tap the physical and affective aspects, has shown promise for the measurement of dyspnea in cardiorespiratory disease. OBJECTIVE We report the results of a study designed to test the validity and reliability of the D-12 in a population of patients with asthma. METHODS This cross-sectional study included 102 patients with asthma. Subjects completed the D-12, Hospital Anxiety and Depression scale, St. George's Respiratory Questionnaire (SGRQ), and Medical Research Council scale. Confirmatory factor analysis confirmed the two-component structure of the D-12 (i.e., seven items that tap the physical aspects of breathlessness and five items that tap the affective aspects). RESULTS The D-12 subscales had excellent internal reliability (Cronbach's alpha for the "physical" score was 0.94 and the affective score was 0.95). The D-12 physical component was more strongly correlated with SGRQ Symptoms (r = 0.648), SGRQ Activities (r = 0.635) and Medical Research Council grade (r = 0.636), while the affective component was more strongly correlated with SGRQ Impacts (r = 0.765) and Hospital Anxiety and Depression scale scores (anxiety r = 0.641 and depression r = 0.602). CONCLUSION This study supports validity of the D-12 for use in the assessment of dyspnea of patients with asthma. It assesses one of the most pertinent symptoms of asthma from two viewpoints-physical and affective.
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Affiliation(s)
- Janelle Yorke
- School of Nursing and Midwifery, College of Health & Social Care, University of Salford, Greater Manchester, UK.
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21
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Raghu G, King TE, Behr J, Brown KK, du Bois RM, Leconte I, Roux S, Swigris J. Quality of life and dyspnoea in patients treated with bosentan for idiopathic pulmonary fibrosis (BUILD-1). Eur Respir J 2009; 35:118-23. [PMID: 19679600 DOI: 10.1183/09031936.00188108] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
No therapy is known to improve health-related quality of life (HRQoL) or dyspnoea in patients with idiopathic pulmonary fibrosis. The present study investigated longitudinal changes in HRQoL and dyspnoea and explored the effects of bosentan on these end-points during the Bosentan Use in Interstitial Lung Disease (BUILD)-1 trial. In total, 154 subjects received oral bosentan (n = 71) or placebo (n = 83). Changes in HRQoL and dyspnoea from baseline to month (M) 6 and up to M12 were measured using the St George's Respiratory Questionnaire (SGRQ), 36-item short-form health survey (SF-36), Transition Dyspnoea Index and Borg dyspnoea index. Overall, minimal changes occurred in measures of HRQoL and dyspnoea among placebo-treated subjects during the study. The effects of bosentan treatment on HRQoL and dyspnoea in the all-treated population were minimal. However, in the subset of subjects who had undergone surgical lung biopsy for diagnosis of idiopathic pulmonary fibrosis, treatment effects were observed up to M12 in the impact domain of the SGRQ and the physical functioning, general health and role emotional domains of the SF-36. HRQoL and dyspnoea changed minimally during the course of the present study. Observations from exploratory analyses suggested benefits of bosentan on HRQoL among patients who had undergone surgical lung biopsy for diagnosis, and they merit further investigation.
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Affiliation(s)
- G Raghu
- Division of Pulmonary and Critical Care Medicine, University of Washington School of Medicine, Seattle, WA 98195-6522, USA.
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22
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Swigris J, Behr J, Brown K, duBois R, King T, Raghu G. LONGITUDINAL TRENDS IN DYSPNEA IN PATIENTS WITH IDIOPATHIC PULMONARY FIBROSIS (IPF): THE BUILD 1 STUDY. Chest 2006. [DOI: 10.1378/chest.130.4_meetingabstracts.282s-a] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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