Measurement of quality of life in patients with chronic obstructive pulmonary disease.

In measuring quality of life in chronic obstructive pulmonary disease (COPD) we have to make a distinction between using quality-of-life (QOL) instruments for research or for patient care purposes. For research purposes, these instruments have proven their value. However, for healthcare, the value of these instruments has not yet been established. It is clear that quality of life is important to both the patient and the physician. For the patient, experienced health is quite probably the most important aspect of healthcare. For the time being, however, it is difficult to include this aspect of the primary care of patients with COPD in a proper and well balanced way, because we do not know exactly what value we must attach to a changed quality of life and what consequences this has for medical care. Moreover, in COPD it might be possible that only severely obstructed patients have a detectably impaired quality of life as assessed by QOL instruments, which obviously makes these instruments less suitable for healthcare.