Quality of life assessment by SF-12 in COPD patients - in the follow-up of a population-based study (PLATINO 2003-2012) in three Latin American countries

Quality of life (QoL) assessment is an important tool in the care of patients with chronic obstructive pulmonary disease (COPD). Quality of life (QoL) questionnaires have been widely used in recent years to monitor the evolution of COPD and even to evaluate the effects of treatments (GOLD, 2017). Objective: to evaluate the impact of COPD on QoL in the follow-up of individuals from the population-based study PLATINO in São Paulo (Brazil), Santiago (Chile) and Montevideo (Uruguay), with the informations obtained in 2003-2005 and 2011-2012, in relation to individuals with normal spirometry. Methods: In both occasions the SF-12 questionnaire and pre and post bronchodilator spirometry were performed. Results: A total of 1913 individuals were recruited in the follow-up: 484 from São Paulo (48.4% of Basal; COPD: 52 and normal spirometry: 432), 788 from Santiago (65.2% of Basal; COPD: 130 and normal spirometry: 658) and 641 from Montevideo (67.9% of Basal; COPD: 189 and normal spirometry: 452). The total population in the Basal evaluation in the three countries, presented quality of life below the normal value both in the physical and mental domains (PCS and MCS) (<50); taking into account the clinically important minimum difference (PCS = 1.26 and MCS = 2.28), in followup evaluation MCS showed a significant improvement while PCS remained stable. In relation to COPD, about 45% of patients in each country worsened PCS, while 40% improved MCS. Taking into consideration the Basal evaluation during the follow up, the majority of COPD patients with HRQoL <50 worsened the PCS and those with ≥ 50 tended to improve or to be stable, whereas in the MSC HRQoL <50 there was a tendency to worsen and in those with HRQoL ≥50 a tendency to improve or to be stable. Conclusions: Overall, in relation to the evolution of the HRQoL in the total population of the three countries and taking into account the average value, the physical domain was good and worsened, whereas the mental domain was poor and tended to improve or to be stable. Participants with normal spirometry and COPD patients from the three countries in the follow-up, taking into account the DMCI, presented the same behavior in relation to the "improved and equal" vs "worse" groups: in the physical domain there was no relation with the value of the initial quality of life; in the mental domain there was worsening in those who had higher value.A avaliação da qualidade de vida relacionada à saúde (QVRS) é uma ferramenta importante no atendimento de qualidade de vida na doença pulmonar obstrutiva crônica (DPOC). Os questionários de qualidade de vida têm sido muito utilizados nos últimos anos para acompanhar a evolução da DPOC e até mesmo para avaliar os efeitos dos tratamentos (GOLD, 2007). Objetivo: avaliar o impacto da DPOC sobre a qualidade de vida no seguimento dos participantes do estudo de base populacional (PLATINO) em São Paulo (Brasil), Santiago (Chile) e Montevideo (Uruguai) (PLATINO), em 2010-2012 e compará-lo com os valores obtidos em 2003-2005, em relação aos indivíduos com espirometria normal. Método: Foi aplicado o questionário de qualidade de vida SF-12 e realizada espirometria pré e pós-broncodilatador nos indivíduos do Estudo PLATINO Basal que puderam ser contatados e aceitaram ser avaliados. Resultados: Foram reavaliados no Seguimento 1913 indivíduos: 484 participantes em São Paulo, Brasil (48,4% do Basal; DPOC: 52 e espirometria normal: 432); 788 em Santiago, Chile (65,2% do Basal; DPOC: 130 e espirometria normal: 658); e 641 em Montevidéu, Uruguai (67,9% do Basal; DPOC: 189 e espirometria normal: 452). A população total, controle e DPOC, avaliada no período Basal, nos três países, apresentou no domínio físico (PCS) e no domínio mental (MCS) qualidade de vida abaixo do valor normal (<50); levando-se em conta a diferença mínima clinicamente importante (PCS= 1,26; e MCS= 2,28), no Seguimento o PCS manteve-se estável, enquanto que o MCS apresentou melhora importante. Em relação à DPOC, em torno de 45% dos pacientes de cada país pioraram o PCS, enquanto que 40% melhoraram o MCS. Gênero e gravidade da DPOC não influenciaram a evolução da QVRS nos três países. No PCS, a maioria dos pacientes com DPOC com QVRS <50 pioraram e os com ≥ 50 tenderam à melhora ou ficar estável; no MSC, nos com QVRS