Background: Anti-fibrotic therapies slow down the
progression of idiopathic pulmonary fibrosis (IPF) by reducing lung function
decline. However, little is known about the impact of anti-fibrotic drugs on
health-related quality of life. This study was aimed to determine the influence
of anti-fibrotic treatment on patients’ reported symptoms, along with their
experiences and expectations of the therapy.
Method: A total of 52 patients with confirmed IPF
performed pulmonary function tests (spirometry, TLCO and 6MWT) and
surveys (SF-36, SGRQ, BDI, FAS, LCQ and patient's needs and expectations
authors’ survey) at baseline and after 12 months of pirfenidone treatment.
Results:
No significant changes of FVC, TLCO,
and distance in 6MWT were observed after 1 year of therapy. Patients’ needs and expectations in the course
of the study did not change, except for the right of deciding on disease
management, which was significantly more important after 12 months of treatment
as compared with the baseline (p = 0.014).
The most important needs for patients were access to novel therapy, fast and
easy access to health centres specializing in IPF treatment, and improvement of
the general condition or maintenance of its level. The least essential needs were
everyday social assistance, psychological support, and access to oxygen therapy
at home. Quality of life, measured by the SF-36, after 1 year of pirfenidone
treatment significantly improved in mean values of the physical cumulative
score (p = 0.004) and mental cumulative score (p = 0.003), namely in role-physical,
role-emotional, general health, and mental health. Whereas significant
deteriorations were observed in bodily pain and vitality. For the remaining
questionnaires (SGRQ, BDI, FAS and LCQ), no significant changes in the course
of the study were noticed. However, taking into account individual answers, the
majority of patients with IPF declared improvement or stabilization rather than
a deterioration in the quality of life, perception of dyspnoea, incidence of
cough and fatigue. Additionally, after 1 year of therapy, 12% of patients had simultaneous
improvements in the quality of life and reduced dyspnoea and cough intensity.
Conclusions: We conclude that 1 year of
anti-fibrotic treatment results in a general improvement in quality of life in
the SF-36 questionnaire. Patients’ expectations of disease management did not
change and access to novel therapies and easy access to health centres
specializing in IPF management remained their top needs.
