Measurement of activities of daily living in COPD. A systematic review.


PubMedID: 23681416

Janaudis-Ferreira T, Beauchamp MK, Robles PG, Goldstein RS, Brooks D. Measurement of activities of daily living in COPD. A systematic review. Chest. 2014;145(2):253-71.
ABSTRACT BACKGROUND: The objectives of this systematic review were to: synthesize the literature on measures of activities of daily living (ADL) that have been used in individuals with chronic obstructive pulmonary disease (COPD); provide an overview of the psychometric properties of the identified measures and describe the relationship of the disease-specific instruments with other relevant outcome measures for individuals with COPD and health-care utilization. METHODS: Studies that included a measure of ADL in individuals with COPD were identified using electronic and hand searches. Two investigators performed the literature search. One investigator reviewed the study title, abstract and full-text of the articles to determine study eligibility and performed the data extraction and tabulation. In case of uncertainty, a second reviewer was consulted. RESULTS: A total of 679 articles were identified. Of those, 116 met the inclusion criteria. Twenty-seven ADL instruments were identified, of which 11 instruments were respiratory disease-specific while 16 were generic. Most instruments combined Instrumental ADL (IADL) with Basic ADL (BADL). The majority of the instruments were self-reported; only 3 instruments were performance-based. Twenty-one studies assessed psychometric properties of 16 ADL instruments in patients with COPD. CONCLUSIONS: Although several ADL instruments were identified, psychometric properties have only been reported in a few. Selection of the most appropriate measure should focus on the target construct (BADL or IADL or both), type of test (disease-specific vs. generic and self-reported vs. performance-based), depth of information obtained and psychometric properties of the instruments. Given the relevance of ADL to the lives of patients with COPD its assessment should be more frequently incorporated as a clinical outcome in their management.