Study Highlights Effects of Shortness of Breath, Fatigue in PAH Patients’ Quality of Life

By Patricia Inacio, PhD

In a new study entitled “Symptom Interference Severity and Health-Related Quality of Life in Pulmonary Arterial Hypertension,” researchers determined which symptoms experienced by those with pulmonary arterial hypertension are the most self-limiting and interfering with patients daily quality of life. The study was published in the Journal of Pain and Symptom Management.

Pulmonary Arterial Hypertension (PAH) is a chronic disease and one form of pulmonary hypertension. It is characterized byincreased blood pressure in lung arteries due to their abnormal constriction. This increased pressure results in an extra effort for the heart to pump blood to the lungs, ultimately leading to right heart failure and eventual death.

People with PAH experience severe symptoms that limit their health-related quality of life (HRQOL, a comprehensive concept that includes self-reported measures of physical, mental, emotional, and social functioning). Beyond symptom severity, it is crucial to determine how symptoms interfere with daily life in order to understand how to better manage and cope with the disease daily.

In this new study, the authors proposed to evaluated PAH symptoms in a comprehensive manner, specifically to describe the symptoms that interfere with patients’ daily-life; the scale of its interference; sociodemographic and clinical characteristics and symptoms associated with perturbations of HRQOL in patients with PAH. To this end, the team of authors recruited 191 patients with PAH (mean age was 53 years and the majority of patients were female, 85%) who completed a sociodemographic form. HRQOL was assessed by the Pulmonary Arterial Hypertension Symptom Interference Scale (PAHSIS) and the Medical Outcomes Survey Short Form-36 (SF-36).

The team identified the following symptoms as those interfering the most with patients’ lives — shortness of breath on exertion (92%), followed by fatigue (90%) and then sleep difficulty (57%). Overall, general health, physical function, role physical, vitality, and the composite physical summary scores were diminished, when compared to the US normative population. Additionally, age, gender, functional class, oxygen use, fatigue, dizziness and Raynaud’s phenomenon symptoms (a common condition that affects the blood supply to certain parts of the body, typically the fingers and toes) associated with patients HRQOL physical health scores.

Despite the fact that there were limitations to the study, including that PAH was self-assessed without confirmation through health provider reporting or clinical records and lack of racial/ethnic groups diversity, this is the first study reporting PAH patients’ experience multiple symptoms, with significant impact on their HRQOL and ability to function in daily life. The new insights could help improve PAH patient care and quality of life in living with the disease.

Patricia holds her Ph.D. in Cell Biology from University Nova de Lisboa, and has served as an author on several research projects and fellowships, as well as major grant applications for European Agencies. She also served as a PhD student research assistant in the Laboratory of Doctor David A. Fidock, Department of Microbiology & Immunology, Columbia University, New York.

The article was originally published at Pulmonary Hypertension News

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