Impact of chronic obstructive pulmonary disease on quality of life: The role of dyspnea

Dyspnea is a common symptom that accompanies a diagnosis of chronic obstructive pulmonary disease (COPD). Dyspnea often interferes with the patient's health-related quality of life (HRQOL), yet it is often underreported by the patient and underrecognized by the clinician. Reductions in objective pulmonary function measurements, such as forced expiratory volume in 1 second, are not well correlated with the patient's perception of symptoms and HRQOL. The patient's self-reported or subjective assessment is therefore important when evaluating the intensity of dyspnea and its impact on HRQOL. This article describes several well-validated questionnaires and dyspnea assessment scales that can be effective for assessing the intensity and impact that dyspnea may have on patient-perceived HRQOL. In addition, it describes the integration of pulmonary rehabilitation and specific pharmacotherapies as well as how these interventions can positively influence and modify the severity and distress of dyspnea. Effective assessment and therapeutic management of dyspnea for the patient living with COPD are opportunities to improve the patient's overall HRQOL. (c) 2006 Elsevier Inc. All rights reserved.