A pharmacotherapeutic approach to improving health-related quality of life for patients with chronic obstructive pulmonary disease: A narrative review

Chronic obstructive pulmonary disease (COPD) represents a growing social and economic burden in the United States and is currently the fourth leading cause of death. In addition to declining physiologic function, patients with symptomatic COPD often experience substantially worsened psychologic side effects, such as loss of sleep, anxiety, and depression-all of which may cause serious detriment to their health-related quality of life (HRQoL). Improving patients' HRQoL is essential to achieving optimal treatment outcomes and is now recognized as a clinically important assessment of medical treatment. Currently, COPD guidelines recommend regular pharmacologic treatment to achieve improvements in overall health status and lung function parameters. Studies have shown that pharmacologic treatments, particularly inhaled anticholinergics, β2-adrenergic receptor agonists, and bronchodilator combination therapies not only improve and maintain lung function but also substantially improve HRQoL. In addition, data demonstrate that achieving and maintaining an appreciable improvement in HRQoL is often more important to patients than are improvements in pulmonary function. Therefore, patient-reported outcomes, psychologic symptoms, patient satisfaction with treatment, and other essential components of HRQoL should be considered when prescribing pharmacologic therapy for patients with COPD. When considering therapeutic options for COPD, physicians should consult with their patients to determine which factors are of particular importance to them, as this will optimize treatment adherence and disease management.