Health-related quality of life in chronic obstructive pulmonary disease patients in Korea

BACKGROUND

There are few publications on quality measurement of COPD health state according to the severity level using EQ-5D in Korea. The present study aimed to evaluate the health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD) in terms of disease severity in Korea.

METHODS

Totally two hundred patients with COPD were consecutively recruited in one tertiary hospital of Korea. Each respondent was asked to fill out the questionnaire through a face-to-face interview after providing informed consent. The questionnaire included general and clinical characteristics as well as the EQ-5D and Clinical COPD Questionnaire (CCQ). HRQoL was evaluated according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria and severity of breathlessness.

RESULTS

The adjusted mean EQ-5D index scores were 0.83, 0.88, 0.81 and 0.60 in stage I, II, III and IV, respectively. The EQ-5D index tended to decrease with GOLD criteria. The adjusted mean EQ-Visual Analog Scale (VAS) scores ranged from 65.1 in stage IV to 73.9 in stage I. The CCQ total scores deteriorated with an increasing GOLD stage and severity of breathlessness (all P < 0.001). The correlation between CCQ total score and EQ-5D index was -0.69.

CONCLUSIONS

Our study shows that HRQoL in COPD measured by EQ-5D and CCQ worsens with the GOLD stage and severity of breathlessness. EQ-5D and CCQ could be useful instruments for an evaluation of HRQoL in COPD patients in Korea.

Craving predicts time to cocaine relapse: further validation of the Now and Brief versions of the cocaine craving questionnaire

BACKGROUND

The 10-item version of the cocaine craving questionnaire (CCQ-Brief) has not been validated in a mixed-gender sample, and predictive validity of the CCQ-Now and CCQ-Brief in terms of their relationship with cocaine relapse has not been demonstrated.

OBJECTIVE

To further validate the CCQ-Brief in a mixed gender sample and to determine the predictive validity of the CCQ-Now and CCQ-Brief.

METHOD

Seventy-two men and 51 women (Total N=123) seeking inpatient cocaine dependence treatment were administered assessments upon admission, and a prospective design was employed to assess cocaine relapse outcomes during a 90-day follow-up period after discharge from inpatient treatment. Data were analyzed using Pearson's correlation, Cox proportional hazards regression, and multiple regression.

FINDINGS

The CCQ-Brief demonstrated good internal consistency and construct and concurrent validity. Both the CCQ-Now and the CCQ-Brief summary scores predicted time to cocaine relapse. In addition, the anticipation of a positive outcome from cocaine use, and intent and planning to use cocaine subscales of the CCQ-Now also predicted time to cocaine relapse.

CONCLUSIONS

The CCQ-Brief was found to be a reliable and valid measure in a mixed gender sample, and both the CCQ-Now and CCQ-Brief were predictive of cocaine relapse risk. Craving assessments that go beyond desire and take into account intent and planning to use cocaine and the patient's anticipation of a positive outcome from using cocaine are likely to provide a sensitive index of cocaine relapse susceptibility. However, fear of social and clinical consequences could impact accurate reporting of cocaine craving and intent to use cocaine.