Josephine M Cranston

Survival on long-term oxygen therapy in chronic airflow limitation : from evidence to outcomes in the routine clinical setting

Abstract

The impact of anxiety, depression and living alone in chronic obstructive pulmonary disease

Objective: This prospective longitudinal study examined whether quality of life as measured by the disease specific chronic respiratory questionnaire (CRQ) and living alone, at the time of prescription of long-term oxygen therapy (LTOT), impacted on the mortality of patients with severe chronic obstructive pulmonary disease (COPD). Methods: One-hundred and fifty-seven patients, (male:female, 74:83) with severe COPD, aged under 80 years completed the CRQ at the time of prescription of LTOT. Demographic and physiological parameters were also collected. The patients were followed in outpatient clinics after commencing LTOT. Results: Kaplan–Meier analysis of the data demonstrated a relationship between the emotional function score of the CRQ at the commencement of LTOT and survival on LTOT for female patients. Living with a partner was associated with an additional 12 months of life. When known physiological predictors of survival, the CRQ dimensions and living alone were included in a Coxs proportional hazard model, emotional function, body mass index and forced vital capacity were independent prognostic indicators for females, and arterial partial pressure of oxygen for males. Conclusion: Our results suggest that poor emotional functioning of female patients with severe COPD at the time of prescription of LTOT is associated with increased mortality.

The MOS SF-36 health survey questionnaire in severe chronic airflow limitation: Comparison with the Nottingham health profile

This study documents the cross-sectional, health-related quality of life (HRQOL) measures obtained at baseline for patients with severe chronic airways limitation (CAL) being assessed for home oxygen therapy (HOT) at the Flinders Medical Centre, Adelaide, South Australia. Two generic quality of life instruments, the Nottingham Health Profile (NHP) and the Medical Outcomes Study (MOS) short form 36-item questionnaire (SF-36), were administered by interview to the same patients to permit comparisons to be made between the two instruments. SF-36 mean scores were also compared with scores obtained in separate studies of a South Australian elderly general population and of groups of Australian subjects with various medical and psychiatric conditions. NHP mean scores were compared with scores from an elderly group of Adelaide residents from a household survey. HRQOL measures were obtained for 60 patients, 32 males and 28 females. At assessment for HOT, patients with severe CAL were experiencing severe impairment in their quality of life in comparison to age-matched South Australian norms, with physical disability the major limitation. There were several significant correlations between the domains of the SF-36 and the NHP which were predominantly gender-specific. Only small decrements in mental health were found with the SF-36 questionnaire. The SF-36 and the NHP appear to provide discrepant information for severely disabled CAL patients for the subjective domains of emotional and mental health.

The relative survival of COPD patients on long-term oxygen therapy in Australia: A comparative study

Objective:  The survival of patients with COPD on long‐term oxygen therapy (LTOT) has been studied using both univariate and multivariate procedures. There has been only one previous report of relative survival. Relative survival takes into account the risk of death due to increasing age. The objective of this study was to determine the relative survival of a group of South Australian patients prescribed home oxygen therapy for COPD.

The changing prevalence of asthma‐like respiratory symptoms in South Australian rural schoolchildren

Objectives: To describe the changing prevalence of wheezy breathing and doctor‐diagnosed asthma, as obtained by questionnaire data, from the years 1984‐92 in a sample of South Australian rural schoolchildren.