Accuracy of Expected Symptoms and Subsequent Quality of Life Measures Among Adults With COPD

作者：Joanna L. Hart, A. Summer, L. Ogunduyile, Folasade C. Lapite, David Hong, Casey Whitman, Bryan S. Blette, Michael O. Harhay, Scott D. Halpern · 发表于：JAMA Network Open · 年份：2023 · DOI：10.1001/jamanetworkopen.2023.44030 · 被引用次数：10 · 研究领域：Chronic Obstructive Pulmonary Disease (COPD) Research、Patient-Provider Communication in Healthcare、Optimism, Hope, and Well-being

Importance: Patients' expectations for future health guide their decisions and enable them to prepare, adapt, and cope. However, little is known about how inaccurate expectations may affect patients' illness outcomes. Objective: To assess the association between patients' expectation inaccuracies and health-related quality of life. Design, Setting, and Participants: This cohort study of patients with severe chronic obstructive pulmonary disease (COPD) was conducted from 2017 to 2021, which included a 24-month follow-up period. Eligible participants received outpatient primary care at pulmonary clinics of a single large US health system. Data were analyzed between 2021 and 2023. Exposure: Expectation accuracy, measured by comparing patients' self-reported expectations of their symptom burden with their actual physical and emotional symptoms 3, 12, and 24 months in the future. Main Outcome and Measure: Health-related quality of life, measured by the St George's Respiratory Questionnaire-COPD at 3, 12, and 24 months. Results: A total of 207 participants were included (median age, 65.5 years [range, 42.0-86.0 years]; 120 women [58.0%]; 118 Black [57.0%], 79 White [38.2%]). The consent rate among approached patients was 80.0%. Most patients reported no or only limited discussions of future health and symptom burdens with their clinicians. Across physical and emotional symptoms and all 3 time points, patients' expectations were more optimistic than their experiences. There were no ...