Iranian Journal of Public Health 2017. 46(8):1046-1053.

A Cross-sectional Assessment of Health-related Quality of Life among Patients with Chronic Obstructive Pulmonary Disease


Background: Chronic obstructive pulmonary disease (COPD) is a major cause of mortality characterized by progressive airflow obstruction and inflammation in the airways, which has an impact on health-related quality of life. The EQ-5D-5L is one of the most used preference-based, health-related quality of life questionnaire. The objective of this study was to provide normative values of EQ-5D-5L for Spanish people suffering from COPD.

Methods: Data were extracted from the Spanish National Health Survey (2011/2012). Overall, 1130 people with COPD participated in this survey. The utility index of EQ-5D-5L and the Visual Analog Scale (VAS) score were defined by gender, region, and age.

Results: Mean (SD) EQ-5D-5L utility index and VAS score for Spanish people with COPD were 0.742 (0.309) and 60.466 (21.934) respectively. In general, men reported better health status than women. Ceiling effect of the whole sample was 30.35%.

Conclusion: The current study provides normative values of EQ-5D-5L for Spanish people affected by COPD. Ceiling effect was high and better results were observed in men compared with women.




EQ-5D; Quality of life; COPD; Pulmonary disease; Normative values

Full Text:



Decramer M, Janssens W, Miravitlles M (2012). Chronic obstructive pulmonary disease. Lancet, 379:1341-51.

Miravitlles M, Soriano JB, Garcia-Rio F, et al (2009). Prevalence of COPD in Spain: impact of undiagnosed COPD on quality of life and daily life activities. Thorax, 64:863-8.

Janson C, Marks G, Buist S, et al (2013). The impact of COPD on health status: findings from the BOLD study. Eur Respir J, 42:1472-83.

Huber MB, Wacker ME, Vogelmeier CF, Leidl R (2015). Comorbid Influences on Generic Health-Related Quality of Life in COPD: A Systematic Review. PLoS One, 10:e0132670.

Huber MB, Wacker ME, Vogelmeier CF, Leidl R (2015). Excess costs of comorbidities in chronic obstructive pulmonary disease: a systematic review. PLoS One, 10:e0123292.

de Miguel Diez J, Carrasco Garrido P, Garcia Carballo M, et al (2008). Determinants and predictors of the cost of COPD in primary care: a Spanish perspective. Int J Chron Obstruct Pulmon Dis, 3:701-12.

Herdman M, Gudex C, Lloyd A, et al (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res, 20:1727-36.

Rabin R, de Charro F (2001). EQ-5D: a measure of health status from the EuroQol Group. Ann Med, 33:337-43.

Janssen MF, Pickard AS, Golicki D, et al (2013). Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: a multi-country study. Qual Life Res, 22:1717-27.

Miravitlles M, Huerta A, Valle M, et al (2015). Clinical variables impacting on the estimation of utilities in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 10:367-77.

Carrasco Garrido P, de Miguel Diez J, Rejas Gutierrez J, et al (2006). Negative impact of chronic obstructive pulmonary disease on the health-related quality of life of patients. Results of the EPIDEPOC study. Health Qual Life Outcomes, 4:31.

Areia M, Alves S, Brito D, Cadime AT, et al (2014). Health-related quality of life and utilities in gastric premalignant conditions and malignant lesions: a multicentre study in a high prevalence country. J Gastrointestin Liver Dis, 23:371-8.

Collado Mateo D, Garcia Gordillo MA, et al (2015). Normative Values of Eq-5d-5l for Diabetes Patients from Spain. Nutr Hosp, 32:1595-602.

Kim S, Love F, Quistberg DA, Shea JA (2004). Association of health literacy with self-management behavior in patients with diabetes. Diabetes Care, 27:2980-2.

Rani PK, Raman R, Subramani S, et al (2008). Knowledge of diabetes and diabetic retinopathy among rural populations in India, and the influence of knowledge of diabetic retinopathy on attitude and practice. Rural Remote Health, 8:838.

Lemes Dos Santos PF, Dos Santos PR, Ferrari GS, et al (2014). Knowledge of diabetes mellitus: does gender make a difference? Osong Public Health Res Perspect, 5:199-203.

Miravitlles M, Huerta A, Fernandez-Villar JA, et al (2014). Generic utilities in chronic obstructive pulmonary disease patients stratified according to different staging systems. Health Qual Life Outcomes, 12:120.

Berg B (2012). Sf‐6d Population Norms. Health Econ, 21:1508-12.

Hawthorne G, Osborne R (2005). Population norms and meaningful differences for the Assessment of Quality of Life (AQoL) measure. Aust N Z J Public Health, 29:136-42.

Kendall PC, Marrs-Garcia A, Nath SR, Sheldrick RC (1999). Normative comparisons for the evaluation of clinical significance. J Consult Clin Psychol, 67:285-99.

Kendall PC, Grove WM (1988). Normative comparisons in therapy outcome. Behav Assess, 10: 147-158.

Snyder CF, Aaronson NK, Choucair AK, et al (2012). Implementing patient-reported outcomes assessment in clinical practice: a review of the options and considerations. Qual Life Res, 21:1305-14.


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.