{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:06:03Z","timestamp":1792069563701,"version":"4.4.0"},"reference-count":34,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Individual and increasing numbers of comorbidities have been associated with worse outcomes in patients with fibrotic interstitial lung disease (f-ILD). The association and impact of medical comorbidities on patient-reported outcome measures (PROMs) in f-ILD have yet to be reported. Methods: Analysis was conducted using data from a single-center prospective cohort involving 199 patients with f-ILD. All f-ILD diagnoses and severities were screened and enrolled over a three-year study period. Baseline demographics, pulmonary function test (PFT) measures, and survival status were collected. PROMs, including the Chronic Respiratory Questionnaire (CRQ) and the Self-Management Ability Scale (SMAS-30), were assessed at baseline and serially. Thirteen medical comorbidities were evaluated for their prevalence and impact on PROMs and all-cause mortality. Results: Mean age was 69 years, with a female-to-male ratio of 61% vs. 39%. Dyslipidemia (74%) and gastroesophageal reflux disease (GERD) (71%) were the most prevalent comorbidities. Hypertension, diabetes, GERD, pulmonary hypertension (PH), depression, congestive heart failure (CHF), and obstructive sleep apnea (OSA), were independently associated with lower PROM scores along with increasing numbers of concomitant comorbidities. Increasing numbers of comorbidities, as well as specifically diabetes, PH, hypertension, CHF, and OSA, were associated with greater all-cause mortality. Conclusions: Medical comorbidities may independently impact respiratory-related PROMs in patients with f-ILD. These findings highlight the importance of comprehensive comorbidity management in improving quality of life and survival outcomes in patients with f-ILD.<\/jats:p>","DOI":"10.3390\/jcm15031051","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T15:04:46Z","timestamp":1769612686000},"page":"1051","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of Medical Comorbidities on Respiratory-Related Patient-Reported Outcome Measures in Fibrotic Interstitial Lung Disease"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9579-5805","authenticated-orcid":false,"given":"Joon Yong","family":"Moon","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison","family":"Beenken","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3329-5717","authenticated-orcid":false,"given":"Teng","family":"Moua","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E44","DOI":"10.1164\/rccm.201807-1255ST","article-title":"Diagnosis of Idiopathic Pulmonary Fibrosis An Official ATS\/ERS\/JRS\/ALAT Clinical Practice Guideline","volume":"198","author":"Raghu","year":"2018","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1164\/rccm.202202-0399ST","article-title":"Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS\/ERS\/JRS\/ALAT Clinical Practice Guideline","volume":"205","author":"Raghu","year":"2022","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1056\/NEJMoa1908681","article-title":"Nintedanib in Progressive Fibrosing Interstitial Lung Diseases","volume":"381","author":"Flaherty","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1056\/NEJMoa1402582","article-title":"A phase 3 trial of pirfenidone in patients with idiopathic pulmonary fibrosis","volume":"370","author":"King","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Swigris, J.J., Brown, K.K., Abdulqawi, R., Buch, K., Dilling, D.F., Koschel, D., Thavarajah, K., Tomic, R., and Inoue, Y. (2018). Patients\u2019 perceptions and patient-reported outcomes in progressive-fibrosing interstitial lung diseases. Eur. Respir. Rev., 27.","DOI":"10.1183\/16000617.0075-2018"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Kalluri, M., Luppi, F., Vancheri, A., Vancheri, C., Balestro, E., Varone, F., Mogulkoc, N., Cacopardo, G., Bargagli, E., and Renzoni, E. (2021). Patient-reported outcomes and patient-reported outcome measures in interstitial lung disease: Where to go from here?. Eur. Respir. Rev., 30.","DOI":"10.1183\/16000617.0026-2021"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1186\/s12931-017-0621-y","article-title":"Health related quality of life in patients with idiopathic pulmonary fibrosis in clinical practice: Insights-IPF registry","volume":"18","author":"Kreuter","year":"2017","journal-title":"Respir. Res."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Humphries, S.M., Chung, A., Swigris, J.J., Oh, A.S., Walsh, S.L.F., Lynch, D.A., Goldin, J.G., and Kim, G.H.J. (2025). Quantification of Interstitial Lung Diseases, from the AJR Special Series on Quantitative Imaging. Am. J. Roentgenol., 225.","DOI":"10.2214\/AJR.24.32053"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"U.S. Department of Health and Human Services FDA Center for Drug Evaluation and Research, U.S. Department of Health and Human Services FDA Center for Biologics Evaluation and Research, and U.S. Department of Health and Human Services FDA Center for Devices and Radiological Health (2006). Guidance for industry: Patient-reported outcome measures: Use in medical product development to support labeling claims: Draft guidance. Health Qual. Life Outcomes, 4, 79.","DOI":"10.1186\/1477-7525-4-79"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Cox, I.A., Borchers Arriagada, N., de Graaff, B., Corte, T.J., Glaspole, I., Lartey, S., Walters, E.H., and Palmer, A.J. (2020). Health-related quality of life of patients with idiopathic pulmonary fibrosis: A systematic review and meta-analysis. Eur. Respir. Rev., 29.","DOI":"10.1183\/16000617.0154-2020"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e3","DOI":"10.1164\/rccm.202105-1193ST","article-title":"Patient-centered Outcomes Research in Interstitial Lung Disease: An Official American Thoracic Society Research Statement","volume":"204","author":"Aronson","year":"2021","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.rmed.2012.10.002","article-title":"Impact of comorbidities on COPD-specific health-related quality of life","volume":"107","author":"Burgel","year":"2013","journal-title":"Respir. Med."},{"key":"ref_13","unstructured":"Holle, R., Wacker, M.E., Joerres, R.A., Schulz, H., Heinrich, J., Peters, A., Koch, A., Leidl, R., Vogelmeier, C.F., and Grp, C.S. (2015). Do Comorbidities Have A Specific Impact on Generic Health-Related Quality of Life (hrql) in COPD Patients Compared to Controls? First Results of The German Cosyconet Cohort Study. Am. J. Respir. Crit. Care Med., 191."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1111\/resp.13207_48","article-title":"Different Impact of Respiratory Symptoms and Comorbidities on Copd-Specific Health-Related Quality of Life by Copd Severity","volume":"22","author":"Park","year":"2017","journal-title":"Respirology"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Ozaltin, B., Chapman, R., Arfeen, M.Q.U., Fitzpatick, N., Hemingway, H., Direk, K., and Jacob, J. (2024). Delineating excess comorbidities in idiopathic pulmonary fibrosis: An observational study. Respir. Res., 25.","DOI":"10.1186\/s12931-024-02875-2"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Duke, J.D., Roy, M., Daley, S., Hoult, J., Benzo, R., and Moua, T. (2024). Association of patient-reported outcome measures with lung function and mortality in fibrotic interstitial lung disease: A prospective cohort study. ERJ Open Res., 10.","DOI":"10.1183\/23120541.00591-2023"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1136\/thx.49.5.465","article-title":"Reliability and Validity of the Chronic Respiratory Questionnaire (Crq)","volume":"49","author":"Wijkstra","year":"1994","journal-title":"Thorax"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1081\/COPD-200050651","article-title":"Measurement properties and interpretability of the Chronic respiratory disease questionnaire (CRQ)","volume":"2","author":"Schunemann","year":"2005","journal-title":"J. Chronic Obstr. Pulm. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Moua, T., Kubbara, A., Novotny, P., Ridgeway, J.L., Limper, A.H., Ryu, J.H., Clark, M.M., and Benzo, R. (2021). Patient-reported quality of life in fibrotic interstitial lung disease: Novel assessments of self-management ability and affect. ERJ Open Res., 7.","DOI":"10.1183\/23120541.00011-2021"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1808","DOI":"10.1513\/AnnalsATS.202203-214OC","article-title":"Promoting Chronic Obstructive Pulmonary Disease Wellness through Remote Monitoring and Health Coaching: A Clinical Trial","volume":"19","author":"Benzo","year":"2022","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1378\/chest.122.5.1701","article-title":"A randomized controlled trial to evaluate the effect of informing patients about their pretreatment responses to two respiratory questionnaires","volume":"122","author":"Schunemann","year":"2002","journal-title":"Chest"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2215","DOI":"10.1007\/s11136-005-8166-9","article-title":"How to measure self-management abilities in older people by self-report. The development of the SMAS-30","volume":"14","author":"Schuurmans","year":"2005","journal-title":"Qual. Life Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1477-7525-10-9","article-title":"Validation of the self-management ability scale (SMAS) and development and validation of a shorter scale (SMAS-S) among older patients shortly after hospitalisation","volume":"10","author":"Cramm","year":"2012","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/j.pec.2021.07.005","article-title":"Self-management for pulmonary fibrosis: Insights from people living with the disease and healthcare professionals","volume":"105","author":"Lee","year":"2021","journal-title":"Patient Educ. Couns."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s12931-022-01981-3","article-title":"Comorbidities in unclassifiable interstitial lung disease","volume":"23","author":"Prior","year":"2022","journal-title":"Resp. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"208","DOI":"10.4103\/atm.ATM_230_20","article-title":"Clinical characteristics, comorbidities, and outcomes in patients with idiopathic pulmonary fibrosis","volume":"15","author":"Alhamad","year":"2020","journal-title":"Ann. Thorac. Med."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Kreuter, M., Ehlers-Tenenbaum, S., Palmowski, K., Bruhwyler, J., Oltmanns, U., Muley, T., Heussel, C.P., Warth, A., Kolb, M., and Herth, F.J.F. (2016). Impact of Comorbidities on Mortality in Patients with Idiopathic Pulmonary Fibrosis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0151425"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1513\/AnnalsATS.201906-437OC","article-title":"Associations between Patient-reported Outcomes and Death or Lung Transplant in Idiopathic Pulmonary Fibrosis. Data from the Idiopathic Pulmonary Fibrosis Prospective Outcomes Registry","volume":"17","author":"Case","year":"2020","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3301","DOI":"10.2147\/COPD.S145910","article-title":"Different impacts of respiratory symptoms and comorbidities on COPD-specific health-related quality of life by COPD severity","volume":"12","author":"Lee","year":"2017","journal-title":"Int. J. Chronic Obstr. Pulm. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"194","DOI":"10.24171\/j.phrp.2020.11.4.08","article-title":"Health-Related Quality of Life Based on Comorbidities Among Patients with End-Stage Renal Disease","volume":"11","author":"Cha","year":"2020","journal-title":"Osong Public Health Res. Perspect."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Znegui, T., Nadia, M., Mahmoud, N., Amina, K., Nesrin, K., Rahma, G., Najla, B., Walid, F., Sameh, M., and Ilhem, Y. (2021). Associations between comorbidities and survival in patients with interstitial lung diseases. Eur. Respir. J., 58.","DOI":"10.1183\/13993003.congress-2021.PA2342"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1183\/13993003.02316-2014","article-title":"Comorbidities in idiopathic pulmonary fibrosis patients: A systematic literature review","volume":"46","author":"Raghu","year":"2015","journal-title":"Eur. Respir. J."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Torrisi, S.E., Ley, B., Kreuter, M., Wijsenbeek, M., Vittinghoff, E., Collard, H.R., and Vancheri, C. (2019). The added value of comorbidities in predicting survival in idiopathic pulmonary fibrosis: A multicentre observational study. Eur. Respir. J., 53.","DOI":"10.1183\/13993003.00615-2019"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/S2213-2600(20)30554-3","article-title":"Pirfenidone in patients with progressive fibrotic interstitial lung diseases other than idiopathic pulmonary fibrosis (RELIEF): A double-blind, randomised, placebo-controlled, phase 2b trial","volume":"20","author":"Behr","year":"2021","journal-title":"Lancet Respir. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/3\/1051\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T15:31:49Z","timestamp":1769614309000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/3\/1051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":34,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["jcm15031051"],"URL":"https:\/\/doi.org\/10.3390\/jcm15031051","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]}}}