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Bartoszko J, Miles S, Ansari S, Grewal D, Li M, Callum J, McCluskey SA, Lin Y, Karkouti K. Postoperative intravenous iron to treat iron-deficiency anaemia in patients undergoing cardiac surgery: a protocol for a pilot, multicentre, placebo-controlled randomized trial (the POAM trial). BJA OPEN 2024; 11:100303. [PMID: 39161801 PMCID: PMC11332809 DOI: 10.1016/j.bjao.2024.100303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/01/2024] [Indexed: 08/21/2024]
Abstract
Background Iron-deficiency anaemia, occurring in 30-40% of patients undergoing cardiac surgery, is an independent risk factor for adverse outcomes. Our long-term goal is to assess if postoperative i.v. iron therapy improves clinical outcomes in patients with preoperative iron-deficiency anaemia undergoing cardiac surgery. Before conducting a definitive RCT, we first propose a multicentre pilot trial to establish the feasibility of the definitive trial. Methods This internal pilot, double-blinded, RCT will include three centres. Sixty adults with preoperative iron-deficiency anaemia undergoing non-emergency cardiac surgery will be randomised on postoperative day 2 or 3 to receive either blinded i.v. iron (1000 mg ferric derisomaltose) or placebo. Six weeks after surgery, patients who remain iron deficient will receive a second blinded dose of i.v. iron according to their assigned treatment arm. Patients will be followed for 12 months. Clinical practice will not be otherwise modified. For the pilot study, feasibility will be assessed through rates of enrolment, protocol deviations, and loss to follow up. For the definitive study, the primary outcome will be the number of days alive and out of hospital at 90 days after surgery. Ethics and dissemination The trial has been approved by the University Health Network Research Ethics Board (REB # 22-5685; approved by Clinical Trials Ontario funding on 22 December 2023) and will be conducted in accordance with the Declaration of Helsinki, Good Clinical Practices guidelines, and regulatory requirements. Clinical trial registration NCT06287619.
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Affiliation(s)
- Justyna Bartoszko
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada
- Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada
- University of Toronto Quality in Utilization, Education and Safety in Transfusion Research Program, Toronto, ON, Canada
| | - Sarah Miles
- Department of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada
| | - Saba Ansari
- Department of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada
| | - Deep Grewal
- Department of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada
| | - Michelle Li
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada
| | - Jeannie Callum
- University of Toronto Quality in Utilization, Education and Safety in Transfusion Research Program, Toronto, ON, Canada
- Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre and Queen's University, Kingston, ON, Canada
| | - Stuart A. McCluskey
- Department of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada
- Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada
| | - Yulia Lin
- University of Toronto Quality in Utilization, Education and Safety in Transfusion Research Program, Toronto, ON, Canada
- Precision Diagnostics and Therapeutics Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Keyvan Karkouti
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada
- Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada
- University of Toronto Quality in Utilization, Education and Safety in Transfusion Research Program, Toronto, ON, Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Interdepartmental Division of Critical Care, Department of Medicine, University of Toronto, Toronto, ON, Canada
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Hutchinson C, Ratcliffe J, Cleland J, Milte R, Muller A, Ly M, Hannaford N, Khadka J. Further Evidence of Feasibility, Validity, and Reliability of Quality of Life-Aged Care Consumers: Evidence From Home-Based Care Settings. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:1206-1214. [PMID: 38795955 DOI: 10.1016/j.jval.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 04/22/2024] [Accepted: 05/10/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVES The Quality of Life-Aged Care Consumers (QOL-ACC) is an aged-care-specific preference-based instrument currently being rolled out in residential care across Australia as part of the aged care Quality Indicator program. This study aimed to provide a comprehensive assessment of the feasibility, reliability, and construct validity of the QOL-ACC in a large national sample of older adults receiving aged care services at home. METHODS Older adults receiving in-home aged care services completed a survey including the QOL-ACC, Quality of Care Experience-ACC, adult social care outcome tool, EQ-5D-5L, and 2 global single item measures of health and quality of life. Feasibility was assessed by missing responses (≤5%) and ceiling/floor effects (≤15%). Construct validity was assessed by exploring the relationship between the QOL-ACC and other instruments (convergent validity) and its ability to discriminate varying levels of self-rated health and quality of life (known-group validity). RESULTS A total of 802 respondents (mean age, 74.5 ± 6.3 years; 56.0% females) completed the survey. The QOL-ACC had no missing responses, no floor effects, and very low ceiling effect (3.5%) and demonstrated moderate correlation with adult social care outcome tool (r = 0.59, P < .001), EQ-5D-5L (r = 0.65, P < .001), EQ-VAS (r = 0.53, P < .001), and a lower correlation with the QCE-ACC (r = 0.41, P < .001). Respondents with poor self-rated health and quality of life had significantly lower preference-weighted scores on the QOL-ACC. CONCLUSIONS The QOL-ACC demonstrated adequate feasibility, reliability, and construct validity in a large population of older people accessing government-subsidized aged care services at home. Further studies will explore the responsiveness of the QOL-ACC to aged-care-specific interventions both in home and residential aged care settings.
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Affiliation(s)
- Claire Hutchinson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
| | - Julie Ratcliffe
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Jenny Cleland
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Rachel Milte
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Amanda Muller
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Marleesa Ly
- ECH, Adelaide, SA, Australia; School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | | | - Jyoti Khadka
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia; Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
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Graue M, Igland J, Oftedal BF, Haugstvedt A, Riise HKR, Zoffmann V, Jenum AK, Richards D, Kolltveit BCH. Interprofessional follow-up for people at risk of type 2 diabetes in primary healthcare - a randomized controlled trial with embedded qualitative interviews. Scand J Prim Health Care 2024; 42:450-462. [PMID: 38588447 PMCID: PMC11332301 DOI: 10.1080/02813432.2024.2337071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 03/26/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVE To examine the effects of an empowerment-based interprofessional lifestyle intervention program among people at risk of type 2 diabetes on knowledge, skills, and confidence in self-management, health, psychological well-being, and lifestyle characteristics, and to explore the participants' perceptions of participating in the intervention. DESIGN AND METHODS In line with the Medical Research Council complex interventions research methods framework, we conducted a randomized controlled trial with embedded qualitative interviews in primary healthcare clinics in Norway between 2019-2021. Of the patients at risk (The Finnish Diabetes Risk Score Calculator (FINDRISC) ≥15 or Body Mass Index (BMI) ≥30) 142 accepted the invitation, and 14 participants from the intervention group participated in individual interviews after the 12-month follow-up. Our primary outcome was the Patient Activation Measure (PAM-13). Secondary outcomes were EQ-5D-5L, EQ-VAS, WHO-Overall health, WHO-Overall QOL, weight, height, waist circumference, and regularity of physical activity. We used thematic analysis to analyse the qualitative data. RESULTS There was no clinically relevant differences of neither the primary nor the secondary endpoints between intervention and control group. As to the qualitative data, we identified two distinct features: 'Meaningful perspectives on lifestyle changes' and 'Lifestyle change is not a linear process due to challenges faced along the way' putting ownership of their choices in life into picture. CONCLUSION The negative results of the RCT stand in contrast to the findings given by the participants voices, perceiving the intervention as a key eye opener placing their health challenges in perspective. How to interpret these seemingly conflicting findings of participants being seen, heard, and understood, helping them to take more conscious ownership of their choices in life, and at the same time demonstrating no improvements in symptoms or measures, is a dilemma that needs further exploration. We should be careful to implement interventions that do not demonstrate any effects on the quantitative outcomes.
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Affiliation(s)
- Marit Graue
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Jannicke Igland
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | | | - Anne Haugstvedt
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Hilde Kristin Refvik Riise
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- Department of Internal Medicine, Haukeland University Hospital, Bergen, Norway
| | - Vibeke Zoffmann
- Julie Marie Centre, Rigshospitalet, Research unit for Women`s and Children`s Health, Copenhagen, Denmark
- Institute of Public Health Copenhagen University, Copenhagen, Denmark
| | - Anne Karen Jenum
- General Practice Research Unit, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - David Richards
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- Institute for Health Research, College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Beate-Christin Hope Kolltveit
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- Vossevangen medical center, Voss, Norway
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Roberts A, Benterud E, Santana MJ, Engbers J, Lorenz C, Verdin N, Pearson W, Edgar P, Adekanye J, Javaheri P, MacDonald CE, Simmons S, Zelinsky S, Caird J, Sawatzky R, Har B, Ghali WA, Norris CM, Graham MM, James MT, Wilton SB, Sajobi TT. APPROACH e-PROM system: a user-centered development and evaluation of an electronic patient-reported outcomes measurement system for management of coronary artery disease. J Patient Rep Outcomes 2024; 8:102. [PMID: 39196484 DOI: 10.1186/s41687-024-00779-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 08/13/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Coronary artery disease (CAD) confers increased risks of premature mortality, non-fatal morbidity, and significant impairment in functional status and health-related quality of life. Routine administration of electronic patient-reported outcome measures (PROMs) and its real time delivery to care providers is known to have the potential to inform routine cardiac care and to improve quality of care and patient outcomes. This study describes a user-centered development and evaluation of the Alberta Provincial Project for Outcomes Assessment (APPROACH) electronic Patient Reported Outcomes Measurement (e-PROM) system. This e-PROM system is an electronic system for the administration of PROMs to patients with CAD and the delivery of the summarized information to their care providers to facilitate patient-physician communication and shared decision-making. This electronic platform was designed to be accessible via web-based and hand-held devices. Heuristic and user acceptance evaluation were conducted with patients and attending care providers. RESULTS The APPROACH e-PROM system was co-developed with patients and care providers, research investigators, informaticians and information technology experts. Five PROMs were selected for inclusion in the online platform after consultations with patient partners, care providers, and PROMs experts: the Seattle Angina Questionnaire, Patient Health Questionnaire, EuroQOL, and Medical Outcomes Study Social Support Survey, and Self-Care of Coronary Heart Disease Inventory. The heuristic evaluation was completed by four design experts who examined the usability of the prototype interfaces. User acceptance testing was completed with 13 patients and 10 cardiologists who evaluated prototype user interfaces of the e-PROM system. CONCLUSION Both patients and physicians found the APPROACH e-PROM system to be easy to use, understandable, and acceptable. The APPROACH e-PROM system provides a user-informed electronic platform designed to incorporate PROMs into the delivery of individualized cardiac care for persons with CAD.
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Affiliation(s)
- Andrew Roberts
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Eleanor Benterud
- Department of Medicine, University of Calgary, Calgary, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada
| | - Maria J Santana
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW Calgary, Calgary, T4B 4B2, Canada
| | | | | | - Nancy Verdin
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW Calgary, Calgary, T4B 4B2, Canada
| | - Winnie Pearson
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW Calgary, Calgary, T4B 4B2, Canada
| | - Peter Edgar
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Joel Adekanye
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW Calgary, Calgary, T4B 4B2, Canada
| | - Pantea Javaheri
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada
| | | | - Sarah Simmons
- Ward of the 21st Century, University of Calgary, Calgary, Canada
| | - Sandra Zelinsky
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW Calgary, Calgary, T4B 4B2, Canada
| | - Jeff Caird
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW Calgary, Calgary, T4B 4B2, Canada
| | - Rick Sawatzky
- School of Nursing, Trinity Western University, Langley, BC, Canada
| | - Bryan Har
- Department of Cardiac Sciences, University of Calgary, Calgary, Canada
| | - William A Ghali
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW Calgary, Calgary, T4B 4B2, Canada
| | | | - Michelle M Graham
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Matthew T James
- Department of Medicine, University of Calgary, Calgary, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW Calgary, Calgary, T4B 4B2, Canada
| | - Stephen B Wilton
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada
- Department of Cardiac Sciences, University of Calgary, Calgary, Canada
| | - Tolulope T Sajobi
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Canada.
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW Calgary, Calgary, T4B 4B2, Canada.
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Ortega-Castillo M, Cuesta-Vargas A, Melloh M, Trinidad-Fernández M. Cross-Cultural Adaptation and Validation of the German Version of the Upper Limb Functional Index. J Sport Rehabil 2024:1-9. [PMID: 39187250 DOI: 10.1123/jsr.2023-0342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 04/25/2024] [Accepted: 06/29/2024] [Indexed: 08/28/2024]
Abstract
CONTEXT The Upper Limb Functional Index (ULFI) is a popular tool with valid psychometric properties to assess upper limb function in patients with musculoskeletal conditions. The aim of the study was to cross-culturally adapt and validate the German version of the ULFI. DESIGN Cross-cultural validation. METHODS A 2-stage cross-cultural adaptation of the ULFI was performed according to international guidelines through consecutive forward and backward translations. Psychometric properties of internal consistency, test-retest reliability, criterion, face and content validity, and factor structure were determined from the included German participants suffering from upper limb conditions (n = 100), who fulfilled the following inclusion criteria: (1) older than 18 years old, (2) German as native language, and (3) medical diagnosis of musculoskeletal upper limb condition. Participants completed the ULFI; Disabilities of the Arm, Shoulder, and Hand; EuroQol Health Questionnaire 5 Dimensions; and Short Form-12 questionnaires. RESULTS The ULFI-G showed good internal consistency (α = .88); excellent test-retest reliability (intraclass correlation coefficient2:1 = .98); directly strong correlation with Disabilities of the Arm, Shoulder, and Hand (r = .84); fair correlation with Disabilities of the Arm, Shoulder, and Hand-sport (r = .54); inversely fair correlation with EuroQol Health Questionnaire 5 Dimensions (r = -.62); and Short Form 12's physical health domain (r = -.7). A single-factor structure was revealed. CONCLUSIONS The ULFI-G showed adequate psychometric properties and proved to be a valid tool for upper limb functional assessment in German population.
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Affiliation(s)
- Miguel Ortega-Castillo
- Department of Physiotherapy, Universidad de Málaga, Málaga, Spain
- Clinimetria Research Group F-14, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Antonio Cuesta-Vargas
- Department of Physiotherapy, Universidad de Málaga, Málaga, Spain
- Clinimetria Research Group F-14, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- School of Clinical Science, Faculty of Health Science, Queensland University Technology, Brisbane, Australia
| | - Markus Melloh
- Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Manuel Trinidad-Fernández
- Department of Physiotherapy, Universidad de Málaga, Málaga, Spain
- Clinimetria Research Group F-14, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
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Darbyshire J, Greenhalgh T, Bakerly ND, Balasundaram K, Baley S, Ball M, Bullock E, Cooper R, Davies H, De Kock JH, Echevarria C, Elkin S, Evans R, Falope Z, Flynn C, Fraser E, Halpin S, Jones S, Lardner R, Lee C, Lovett A, Masey V, Master H, Mir G, Mosley A, Mullard J, O'Connor RJ, Parkin A, Pick A, Scott J, Smith N, Tucker E, Williams P, Winch D, Wood C, Sivan M. Improving Quality in Adult Long Covid Services: Findings from the LOCOMOTION Quality Improvement Collaborative. Clin Med (Lond) 2024:100237. [PMID: 39181334 DOI: 10.1016/j.clinme.2024.100237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 08/02/2024] [Accepted: 08/15/2024] [Indexed: 08/27/2024]
Abstract
The protracted form of COVID-19 known as 'long covid' was first described in 2020. Its symptoms, course and prognosis vary widely; some patients have a multi-system, disabling and prolonged illness. In 2021, ring-fenced funding was provided to establish 90 long covid clinics in England; some clinics were also established in Scotland and Wales. The NIHR-funded LOCOMOTION project implemented a UK-wide quality improvement collaborative involving ten of these clinics, which ran from 2021 to 2023. At regular online meetings held approximately 8-weekly, participants prioritized topics, discussed research evidence and guidelines, and presented exemplar case histories and clinic audits. A patient advisory group also held a priority-setting exercise, participated in quality meetings and undertook a service evaluation audit. The goal of successive quality improvement cycles aimed at changing practice to align with evidence was sometimes hard to achieve because definitive evidence did not yet exist in this new condition; many patients had comorbidities; and clinics were practically constrained in various ways. Nevertheless, much progress was made and a series of 'best practice' guides was produced, covering general assessment and management; breathing difficulties; orthostatic tachycardia and other autonomic symptoms; fatigue and cognitive impairment; and vocational rehabilitation. This paper summarises key findings with the front-line clinician in mind.
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Affiliation(s)
- Julie Darbyshire
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | | | | | - Sareeta Baley
- Person with lived experience of long COVID and Birmingham Community Health Care NHS Foundation Trust.
| | - Megan Ball
- Newcastle Upon Tyne Hospitals NHS Foundation Trust.
| | | | - Rowena Cooper
- Research, Development & Innovation Division, NHS Highland, Inverness, UK.
| | | | - Johannes H De Kock
- Research, Development & Innovation Division, NHS Highland, North West University, Potchefstroom, South Africa.
| | - Carlos Echevarria
- Research, Development & Innovation Division, NHS Highland, Inverness, UK.
| | | | | | - Zacc Falope
- Birmingham Community Health Care NHS Foundation Trust.
| | | | - Emily Fraser
- Birmingham Community Health Care NHS Foundation Trust.
| | | | | | | | - Cassie Lee
- Oxford University Hospitals NHS Foundation Trust.
| | | | | | | | | | - Adam Mosley
- University Hospitals of Leicester NHS Trust.
| | | | - Rory J O'Connor
- Research, Development & Innovation Division, NHS Highland Inverness, UK; and MRC-University of Glasgow Center for Virus Research, University of Glasgow, Glasgow, UK.
| | | | | | - Janet Scott
- Research, Development & Innovation Division, NHS Highland Inverness, UK; and MRC-University of Glasgow Center for Virus Research, University of Glasgow, Glasgow, UK.
| | - Nikki Smith
- Person with lived experience of long COVID and member of the LOCOMOTION Patient Advisory Group.
| | - Emma Tucker
- Person with lived experience of long COVID and member of the LOCOMOTION Patient Advisory Group.
| | | | | | | | - Manoj Sivan
- Person with lived experience of long COVID and member of the LOCOMOTION Patient Advisory Group.
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Swärd EM, Beckman J, Tabaroj F, Wilcke MK. Efficacy of denervation for osteoarthritis in the proximal interphalangeal joint (DOP): protocol of a randomized controlled trial. Trials 2024; 25:553. [PMID: 39169395 PMCID: PMC11340183 DOI: 10.1186/s13063-024-08399-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 08/12/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Osteoarthritis (OA) contributes increasingly to disability worldwide. There is ample high-quality research on the treatment of knee and hip OA, whereas research on surgical and non-surgical treatment in hand OA is sparse. Limited evidence suggests that education and exercise may improve pain, function, stiffness, and grip strength in hand OA. The established surgical options in hand OA have disadvantages. Prostheses preserve motion but have a high complication rate, whereas fusions decrease function due to limited movement. There is an unmet need for high-quality research on treatment options for hand OA and a need for the development of effective and safe movement-sparing therapies. This study aims to compare the effects of a motion-preserving surgical treatment (denervation of the proximal interphalangeal (PIP) joint) with a patient education and exercise program on patient-reported outcomes and objective function in painful PIP OA. METHODS In this parallel-group, two-armed, randomized, controlled superiority trial (RCT), 90 participants are assigned to surgical PIP joint denervation or education and exercise. Pain on load 1 year after intervention is the primary outcome measure. Secondary outcome measures include pain at rest, Patient-Rated Wrist and Hand Evaluation (PRWHE), HQ8 score, EQ5D-5L, objective physical function, complications, two-point discrimination, Mini Sollerman, consumption of analgesics, and the need for further surgery. Assessments are performed at baseline, 3 and 6 months, and 1 year after intervention. DISCUSSION There are no previous RCTs comparing surgical and non-surgical treatment in PIP OA. If patient education plus exercise or PIP denervation improve function, these treatments could be implemented as first-line treatment options in PIP OA. However, if denervation does not achieve better results than non-surgical treatment, it is not justified to use in PIP OA. TRIAL REGISTRATION Prospectively registered in ClinicalTrials.gov (NCT05980793) on 8 August 2023. URL https://classic. CLINICALTRIALS gov/ct2/show/NCT05980793 .
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Affiliation(s)
- Elin M Swärd
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, Stockholm, 11883, Sweden.
- Department for Hand Surgery, Södersjukhuset, Stockholm, Sweden.
- Handkirurgiska kliniken Södersjukhuset, Sjukhusbacken 10, Stockholm, 11883, Sweden.
| | - Jonas Beckman
- Department for Hand Surgery, Södersjukhuset, Stockholm, Sweden
| | | | - Maria K Wilcke
- Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, Stockholm, 11883, Sweden
- Department for Hand Surgery, Södersjukhuset, Stockholm, Sweden
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El-Toukhy S, Hegeman P, Zuckerman G, Das AR, Moses N, Troendle J, Powell-Wiley TM. Study of Postacute Sequelae of COVID-19 Using Digital Wearables: Protocol for a Prospective Longitudinal Observational Study. JMIR Res Protoc 2024; 13:e57382. [PMID: 39150750 DOI: 10.2196/57382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 05/03/2024] [Accepted: 06/14/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Postacute sequelae of COVID-19 (PASC) remain understudied in nonhospitalized patients. Digital wearables allow for a continuous collection of physiological parameters such as respiratory rate and oxygen saturation that have been predictive of disease trajectories in hospitalized patients. OBJECTIVE This protocol outlines the design and procedures of a prospective, longitudinal, observational study of PASC that aims to identify wearables-collected physiological parameters that are associated with PASC in patients with a positive diagnosis. METHODS This is a single-arm, prospective, observational study of a cohort of 550 patients, aged 18 to 65 years, male or female, who own a smartphone or a tablet that meets predetermined Bluetooth version and operating system requirements, speak English, and provide documentation of a positive COVID-19 test issued by a health care professional within 5 days before enrollment. The primary end point is long COVID-19, defined as ≥1 symptom at 3 weeks beyond the first symptom onset or positive diagnosis, whichever comes first. The secondary end point is chronic COVID-19, defined as ≥1 symptom at 12 weeks beyond the first symptom onset or positive diagnosis. Participants must be willing and able to consent to participate in the study and adhere to study procedures for 6 months. RESULTS The first patient was enrolled in October 2021. The estimated year for publishing the study results is 2025. CONCLUSIONS This is a fully decentralized study investigating PASC using wearable devices to collect physiological parameters and patient-reported outcomes. The study will shed light on the duration and symptom manifestation of PASC in nonhospitalized patient subgroups and is an exemplar of the use of wearables as population-level monitoring health tools for communicable diseases. TRIAL REGISTRATION ClinicalTrials.gov NCT04927442; https://clinicaltrials.gov/study/NCT04927442. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/57382.
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Affiliation(s)
- Sherine El-Toukhy
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, MD, United States
| | - Phillip Hegeman
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, MD, United States
| | - Gabrielle Zuckerman
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, MD, United States
| | | | - Nia Moses
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, MD, United States
| | - James Troendle
- Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Tiffany M Powell-Wiley
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Rockville, MD, United States
- Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
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9
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Janssen MF, Dewilde S, Wolfe GI, Muppidi S, Phillips G. Psychometric properties of MG-ADL items and MG-ADL score: An assessment of distributional characteristics, validity and factor structure in two large datasets. J Neurol Sci 2024; 463:123135. [PMID: 39068745 DOI: 10.1016/j.jns.2024.123135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 06/13/2024] [Accepted: 07/10/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND The Myasthenia Gravis-Activities of Daily Living scale (MG-ADL) is an 8-item outcome measure to assess symptoms and functional limitations in myasthenia gravis (MG) patients. The MG-ADL score is an equally weighted level sum score that is used as primary outcome measures in clinical trials, in clinical practice, and as an end-point in health economic evaluation. This data analysis aims to obtain detailed knowledge of measurement properties of MG-ADL items and the MG-ADL score. METHODS Cross-sectional data from a real-world prospective study (MRW) were combined with longitudinal data from the ADAPT trial. Outcome measures included were MG-ADL, Quantitative Myasthenia Gravis score (QMG), MG 15-item Quality of Life (MG-QOL15r) and EQ-5D-5L. Patients were categorized by their Myasthenia Gravis Foundation of America (MGFA) clinical classification. The following measurement properties were assessed: distributional characteristics, inter-item correlation, convergent, known groups and construct validity and internal factor structure. RESULTS Correlations of items within MG-ADL dimensions were moderate, while MG-ADL correlations between comparable MG-QOL15r and QMG items were mixed. Known groups validity for the MG-ADL score was demonstrated for MGFA class. Mean MG-ADL item level scores by MGFA class demonstrated construct validity. PCA, including all four outcome measures, resulted in a nine factor solution. DISCUSSION Psychometric properties of individual MG-ADL items were moderate to good. This study showed that the MG-ADL adequately captures the multidimensional heterogeneous nature of MG. This is, however, accompanied by mixed psychometric performance of the MG-ADL score, which may complicate health economic modelling. REGISTRATION MyRealWorld-MG was registered on November 25, 2019, with registration numberNCT04176211. The ADAPT randomized clinical trial is registered atClinicalTrials.gov(NCT03669588).
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Affiliation(s)
- Mathieu F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, the Netherlands.
| | - Sarah Dewilde
- Services in Health Economics (SHE), Brussels, Belgium
| | - Gil I Wolfe
- Dept. of Neurology, Jacobs School of Medicine and Biomedical Sciences, Univ. at Buffalo/SUNY, Buffalo, NY, USA
| | - Srikanth Muppidi
- Dept of Neurology, Stanford University School of Medicine, Stanford, CA, USA
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10
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Takasaki H, Kanayasu S. KOJI AWARENESS, a self-rating whole-body movement assessment system, has intersession reliability and comparability to external examiner rating. PLoS One 2024; 19:e0308973. [PMID: 39146306 PMCID: PMC11326541 DOI: 10.1371/journal.pone.0308973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 08/03/2024] [Indexed: 08/17/2024] Open
Abstract
KOJI AWARENESS is a newly developed self-rating whole-body movement assessment system that includes 11 domains and 22 tests. The primary aim of this study was to investigate the intersession reliability of KOJI AWARENESS, and the secondary aim was to determine whether a fixed bias existed between self-rating and external examiner rating. Fifty university students rated their movement ability in two separate sessions; an external examiner also rated the students' movement ability. Participants were blinded to their scores at the first session as well as the external examiner's rating scores. The primary analysis included examining the intersession reliability of the total score with intraclass correlation coefficients (ICCs). ICC values were interpreted as follows: insufficient, < .7 and sufficient, ≥ .7. To achieve the secondary aim, Bland-Altman analysis was performed. ICC for the intersession reliability was .86 with a 95% confidence interval (CI) of .77 to .92 and a minimum detectable change (MDC) of 5.15. Bland-Altman analysis revealed fixed bias as the 95% CIs of the mean difference between the two different rating scores (-3.49 to -2.43 and -3.94 to -2.98 in the first and second sessions, respectively) did not include 0 in the data of each session. However, no proportional bias was identified because no statistically significant Pearson's correlation (P > .05) was noted between the means of the two methods and the mean difference between the two different methods in each session. This study identified that KOJI AWARENESS has sufficient intersession reliability among relatively young and healthy participants. External examiner rating tended to have lower total scores than self-rating; however, the bias was below the MDC and seemed not to be clinically significant.
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Affiliation(s)
- Hiroshi Takasaki
- Department of Physical Therapy, Saitama Prefectural University, Koshigaya, Saitama, Japan
| | - Shunsuke Kanayasu
- Department of Physical Therapy, Saitama Prefectural University, Koshigaya, Saitama, Japan
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11
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Bell KJ, Brodie S, Couper JJ, Colman P, Davis E, Deed G, Hagopian W, Haynes A, Hendrieckx C, Henry A, Gordon A, Howard K, Huynh T, Kerr B, Mikler K, Nassar N, Norris S, Oram R, Pawlak D, Shand A, Sinnott RO, Wadling B, Wentworth JM, Craig ME. Protocol for the Australian Type 1 Diabetes National Screening Pilot: Assessing the feasibility and acceptability of three general population screening models in children. Diabet Med 2024:e15419. [PMID: 39129150 DOI: 10.1111/dme.15419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 07/18/2024] [Accepted: 07/23/2024] [Indexed: 08/13/2024]
Abstract
AIM One third of Australian children diagnosed with type 1 diabetes present with life-threatening diabetic ketoacidosis (DKA) at diagnosis. Screening for early-stage, presymptomatic type 1 diabetes, with ongoing follow-up, can substantially reduce this risk (<5% risk). Several screening models are being trialled internationally, without consensus on the optimal approach. This pilot study aims to assess three models for a routine, population-wide screening programme in Australia. METHODS An implementation science-guided pilot study to evaluate the feasibility, acceptability and costs of three screening models in children will be conducted between July 2022 and June 2024. These models are as follows: (1) Genetic risk-stratified screening using newborn heel prick dried bloodspots, followed by autoantibody testing from 11 months of age; (2) genetic risk-stratified screening of infant (6-12 months) saliva followed by autoantibody testing from 10 months of age; and (3) autoantibody screening using capillary dried bloodspots collected from children aged 2, 6 or 10 years. Cohorts for each model will be recruited from targeted geographic areas across Australia involving ≥2 states per cohort, with a recruitment target of up to 3000 children per cohort (total up to 9000 children). The primary outcome is screening uptake for each cohort. Secondary outcomes include programme feasibility, costs, parental anxiety, risk perception, satisfaction, well-being and quality of life, and health professional attitudes and satisfaction. CONCLUSIONS This pilot is the first direct comparison of three screening implementation models for general population screening. Findings will provide evidence to inform a potential national screening programme for Australian children. TRIAL REGISTRATION ACTRN12622000381785.
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Affiliation(s)
- Kirstine J Bell
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Shannon Brodie
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jennifer J Couper
- Diabetes and Endocrinology, Women's and Children's Hospital, Adelaide, South Australia, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Peter Colman
- Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Royal Melbourne Hospital, University of Melbourne Department of Medicine, Parkville, Victoria, Australia
| | - Elizabeth Davis
- Children's Diabetes Centre, Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
- Department of Endocrinology and Diabetes, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Gary Deed
- Monash University, Melbourne, Victoria, Australia
| | - William Hagopian
- University of Washington, Seattle, Washington, USA
- Indiana University, Indianapolis, Indiana, USA
| | - Aveni Haynes
- Children's Diabetes Centre, Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
- UWA Medical School, Paediatrics, the University of Western Australia, Nedlands, Western Australia, Australia
| | - Christel Hendrieckx
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - Amanda Henry
- Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Adrienne Gordon
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Institute for Women, Children and Families, Sydney Local Health District, Camperdown, New South Wales, Australia
| | - Kirsten Howard
- Menzies Centre for Health Policy and Economics, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Tony Huynh
- Department of Endocrinology and Diabetes, Queensland Children's Hospital, South Brisbane, Queensland, Australia
- Children's Health Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
- Department of Chemical Pathology, Mater Pathology, South Brisbane, Queensland, Australia
| | - Bernadette Kerr
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kara Mikler
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Natasha Nassar
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Norris
- Menzies Centre for Health Policy and Economics, School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Richard Oram
- University of Exeter College of Medicine and Health, Exeter, UK
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | | | - Antonia Shand
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Richard O Sinnott
- School of Computing and Information Systems, The University of Melbourne, Melbourne, Victoria, Australia
| | - Bethany Wadling
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - John M Wentworth
- Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Royal Melbourne Hospital, University of Melbourne Department of Medicine, Parkville, Victoria, Australia
- Population Health and Immunity Division, Walter and Eliza Hall Institute, Parkville, Victoria, Australia
| | - Maria E Craig
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
- Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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12
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Nørgaard JE, Andersen S, Ryg J, Andreasen J, Oliveira ADSC, Stevenson AJT, Danielsen MBB, Jorgensen MG. Perturbation-based balance training of older adults and effects on physiological, cognitive and sociopsychological factors: a secondary analysis from a randomised controlled trial with 12-month follow-up. BMJ Open 2024; 14:e080550. [PMID: 39117404 DOI: 10.1136/bmjopen-2023-080550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Perturbation-based balance training (PBT) has shown promising, although diverging, fall-preventive effects; however, the effects on important physical, cognitive and sociopsychological factors are currently unknown. The study aimed to evaluate these effects on PBT at three different time points (post-training, 6-months and 12-months) in community-dwelling older adults compared with regular treadmill walking. METHODS This was a preplanned secondary analysis from a randomised, controlled trial performed in Aalborg, Denmark, between March 2021 and November 2022. Community-dwelling older adults aged ≥65 were randomly assigned to participate in four sessions (lasting 20 min each) of either PBT (intervention) or regular treadmill walking (control). All participants were assigned to four testing sessions: pretraining, post-training, 6-month follow-up and 12-month follow-up. At these sessions, physical, cognitive and sociopsychological measures were assessed. RESULTS In total, 140 participants were randomly allocated to either the PBT or control group. Short-term (pretraining to post-training) between-group differences were seen for choice stepping reaction time (-49 ms, 95% CI -80 to -18), dual-task gait speed (0.05 m/s, 95% CI 0.01 to 0.09) favouring the PBT group. However, these improvements were not sustained at the 6-month and 12-month follow-up. No significant between-group differences were found in other physical, cognitive or sociopsychological factors. CONCLUSIONS This study showed that PBT, in the short term, improved choice stepping reaction time and dual-task gait speed among community-dwelling older adults. Yet, these improvements were not retained for 6- or 12-months. The healthy state of the study's population may have imposed a ceiling effect limiting the ability to show any clinically relevant effects of PBT. TRIAL REGISTRATION NUMBER NCT04733222.
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Affiliation(s)
- Jens Eg Nørgaard
- Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg Universitet, Aalborg, Denmark
| | - Stig Andersen
- Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg Universitet, Aalborg, Denmark
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jane Andreasen
- Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark
- Department of Health, Science and Technology, Aalborg University, Aalborg, Denmark
- Aalborg Health and Rehabilitation Center, Aalborg Municipality, Aalborg, Denmark
| | | | | | - Mathias Brix Brix Danielsen
- Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg Universitet, Aalborg, Denmark
| | - Martin Gronbech Jorgensen
- Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg Universitet, Aalborg, Denmark
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13
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Shava BK, Vhudzijena B, Kupenga-Maposa T, Musingwini T, Samudzi T, Muchemwa S, Chibanda D, Dambi JM. Perceived benefits and barriers to exercise and associated factors among Zimbabwean undergraduate students: a cross-sectional study. Front Sports Act Living 2024; 6:1205914. [PMID: 39170689 PMCID: PMC11335725 DOI: 10.3389/fspor.2024.1205914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/14/2024] [Indexed: 08/23/2024] Open
Abstract
Background Despite the well-documented benefits of regular physical activity (PA), many university students are physically inactive. Personal, socio-economic, and environmental factors predict PA engagement behaviours in university students. There is a need to understand context-specific perceived barriers and benefits to exercise engagement and physical activity levels amongst university students from low-income settings. This study primarily evaluated the barriers and facilitators to PA engagement in Zimbabwean undergraduate students. We also assessed the correlates of perceived barriers and benefits to PA engagement, risk of common mental disorders (CMDs) and health-related quality of life (HRQoL). Methods We used a cross-sectional study to recruit 465 university undergraduate students. The Exercise Benefits and Barriers Scale, International Physical Activity Questionnaire (IPAQ), Shona Symptoms Questionnaire (SSQ-8) and EuroQol 5 Dimension (EQ5D-5l) were used to measure barriers and facilitators, physical activity level, risk of depression and anxiety and HRQoL, respectively. Data were analysed through descriptive statistics and logistic regression. Results and conclusion Most participants were male (58.5%) with a mean age of 21.7 (SD 1.6) years. Majority of the participants were first year students (37.2%), consumed alcohol (66.5%), did not smoke (88.2%) and had a normal BMI (64.7%). The prevalence of low PA levels was 17.4%, with 33.5% of students at risk of CMDs. The most perceived benefits were in the physical performance (e.g., exercise improves my level of physical fitness) and life enhancement (e.g., exercise improves my self-concept) domains, while the most perceived barriers were lack of exercise infrastructure (e.g., exercise facilities do not have convenient schedules) and physical exertion (e.g., exercise tires me). Food insecurity (AOR 2.51: 95% CI 1.62-3.88) and the risk of CMDs (AOR 0.49: 95% CI 0.32-0.76) were associated with increased odds of experiencing barriers to exercise. Not using substances (AOR = 2.14: 95% CI 1.11-4.14) and a higher self-rated HRQoL (AOR 24.34: 95% CI 1.77-335.13) were associated with increased odds of a high perception of exercise benefits. Improving access to community and on-campus exercise facilities and campus-wide health promotional interventions is necessary to enhance PA amongst university students.
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Affiliation(s)
- Beatrice K. Shava
- Rehabilitation Sciences Unit—Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Blessed Vhudzijena
- Rehabilitation Sciences Unit—Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Tariro Kupenga-Maposa
- Rehabilitation Sciences Unit—Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Thelma Musingwini
- Rehabilitation Sciences Unit—Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Tanaka Samudzi
- Rehabilitation Sciences Unit—Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Sidney Muchemwa
- Rehabilitation Sciences Unit—Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Dixon Chibanda
- Mental Health Unit—Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Jermaine M. Dambi
- Rehabilitation Sciences Unit—Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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14
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Vu HM, Duong NN, Nguyen CD, Vu LG, Nguyen HT, Tran TH. Health-related quality of life among inpatients suffering from Traumatic brain injury in an urban setting in Vietnam. PLoS One 2024; 19:e0308372. [PMID: 39106245 DOI: 10.1371/journal.pone.0308372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/23/2024] [Indexed: 08/09/2024] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is a leading cause of mortality and morbidity globally. This study aimed to measure the health-related quality of life (HRQOL) of TBI patients in Vietnam and evaluate the associated factors. METHODS A longitudinal study was conducted in Thai Binh, Vietnam, from February to September 2020. The EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) and EQ-Visual Analog Scale (EQ-VAS) were used to measure HRQOL. Socio-demographic characteristics, including age, gender, education level, employment status, marital status, and income, as well as clinical characteristics such as injury severity, cause of injury, comorbidities, and functional status, were collected through patient interviews and medical records. Multivariate Tobit regression analysis was performed to identify variables associated with HRQOL. RESULTS The study included 212 TBI patients. The mean scores of the VAS and EQ-5D-5L scales were 82.4/100 (SD = 14.49) and 0.9/1.0 (SD = 0.2), respectively, indicating a relatively high HRQOL. However, certain factors significantly impacted HRQOL. Unemployed patients and those with depression or higher injury severity, as measured by the Injury Severity Score (ISS), had notably lower HRQOL scores. Poor sleep quality and severe functional impairments also adversely affected HRQOL, whereas patients discharged for a longer period had slightly better HRQOL scores. CONCLUSION This study highlights that while HRQOL is relatively high among TBI patients, mental health disorders, injury severity, and functional impairments are key factors negatively impacting their quality of life. High HRQOL was defined by mean scores on the VAS and EQ-5D-5L scales, with higher scores indicating better quality of life. Home-based interventions addressing these issues could improve HRQOL for TBI patients.
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Affiliation(s)
- Hai Minh Vu
- Department of Trauma, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Nam Nhu Duong
- Department of Trauma, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Cuong Duy Nguyen
- Department of Intensive Care Unit, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam
| | - Linh Gia Vu
- School for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Hien Thu Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Viet Nam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Tung Hoang Tran
- Institute of Orthopaedic and Trauma Surgery, Vietnam-Germany Hospital, Hanoi, Vietnam
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15
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Yıldız P, Keles E, Yıldız G, Birol İlter P, Temoçin RB, Kaya C, Mat E. Health-related quality of life following hysterectomy by vNOTES versus conventional laparoscopy. MINIM INVASIV THER 2024; 33:232-236. [PMID: 39084252 DOI: 10.1080/13645706.2024.2323100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 02/06/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVE To evaluate safety, efficacy, pre- and postoperative outcomes of vNOTES hysterectomy compared to conventional laparoscopic (CL) hysterectomy. MATERIAL AND METHODS This prospective study was conducted on patients who underwent CL or vNOTES hysterectomy for benign gynecological indications between January and July 2021. Sociodemographic, clinical, and surgical data were collected. Health-related quality of life (HRQoL) outcomes were evaluated using the EQ-5D-5L questionnaire. RESULTS A total of 228 patients (CL vs. vNOTES: 147 vs. 81) were included. No significant differences were observed between the two groups in terms of blood loss, uterine weight, complications, length of hospital stay, and readmission rate. Patients in the vNOTES group experienced significantly less postoperative pain and required less analgesia compared to those who underwent CL hysterectomy (p < 0.001). The CL group had a shorter operative time (p < 0.001). There was a significant difference between the two groups in the EQ-5D-5L pain/discomfort dimension (p = 0.047). CONCLUSION This research showed that vNOTES has various advantages, such as less postoperative pain, reduced analgesic usage, and better HRQoL outcomes three months after surgery.
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Affiliation(s)
- Pınar Yıldız
- Department of Perinatology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Esra Keles
- Department of Gynecologic Oncology, University of Health Sciences Turkey, Kartal Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - Gazi Yıldız
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Kartal Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - Pınar Birol İlter
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Kartal Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - Rezzan Berna Temoçin
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Kartal Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - Celal Kaya
- Department of Obstetrics and Gynecology, University of Health Sciences Turkey, Kartal Lütfi Kırdar City Hospital, Istanbul, Turkey
| | - Emre Mat
- Department of Gynecologic Oncology, University of Health Sciences Turkey, Kartal Lütfi Kırdar City Hospital, Istanbul, Turkey
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Fortelny RH, Hofmann A, Baumann P, Riedl S, Kewer JL, Hoelderle J, Shamiyeh A, Klugsberger B, Maier TD, Schumacher G, Köckerling F, Pession U, Schirren M, Albertsmeier M. Three-year follow-up analysis of the short-stitch versus long-stitch technique for elective midline abdominal closure randomized-controlled (ESTOIH) trial. Hernia 2024; 28:1283-1291. [PMID: 38536592 PMCID: PMC11297062 DOI: 10.1007/s10029-024-03025-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/08/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND Clinical trials have shown reduced incisional hernia rates 1 year after elective median laparotomy closure using a short-stitch technique. With hernia development continuing beyond the first postoperative year, we aimed to compare incisional hernias 3 years after midline closure using short or long stitches in patients from the ESTOIH trial. METHODS The ESTOIH trial was a prospective, multicenter, parallel-group, double-blind, randomized-controlled study of primary elective midline closure. Patients were randomized to fascia closure using a short- or long-stitch technique with a poly-4-hydroxybutyrate-based suture. A predefined 3-year follow-up analysis was performed with the radiological imaging-verified incisional hernia rate as the primary endpoint. RESULTS The 3-year intention-to-treat follow-up cohort consisted of 414 patients (210 short-stitch and 204 long-stitch technique) for analysis. Compared with 1 year postoperatively, incisional hernias increased from 4.83% (20/414 patients) to 9.02% (36/399 patients, p = 0.0183). The difference between the treatment groups at 3 years (short vs. long stitches, 15/198 patients (7.58%) vs. 21/201 (10.45%)) was not significant (OR, 1.4233; 95% CI [0.7112-2.8485]; p = 0.31). CONCLUSION Hernia rates increased significantly between one and 3 years postoperatively. The short-stitch technique using a poly-4-hydroxybutyrate-based suture is safe in the long term, while no significant advantage was found at 3 years postoperatively compared with the standard long-stitch technique. TRIAL REGISTRY NCT01965249, registered on 18 October 2013.
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Affiliation(s)
- R H Fortelny
- Allgemein-, Viszeral- und Tumorchirurgie, Wilhelminenspital Montleartstr. 37, 1160, Vienna, Austria.
- Med. Fakultät, Sigmund Freud Privatuniversität, Freudplatz 3, 1020, Vienna, Austria.
| | - A Hofmann
- Department of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-Universität (LMU) Munich, LMU University Hospital, 81377, Munich, Germany
| | - P Baumann
- Department of Medical Scientific Affairs, Aesculap AG, Am Aesculap Platz, 78532, Tuttlingen, Germany
| | - S Riedl
- Alb Fils Klinik GmbH, Klinik am Eichert, Allgemeinchirurgie, Eichertstr. 3, 73035, Göppingen, Germany
| | - J L Kewer
- Klinikum Landkreis Tuttlingen, Viszeral- und Gefäßchirurgie, Klinik für Allgemein, Zeppelinstr. 21, 78532, Tuttlingen, Germany
| | - J Hoelderle
- Klinikum Landkreis Tuttlingen, Viszeral- und Gefäßchirurgie, Klinik für Allgemein, Zeppelinstr. 21, 78532, Tuttlingen, Germany
| | - A Shamiyeh
- Kepler Universitätsklinikum GmbH, Klinik für Allgemein- und Viszeralchirurgie, Krankenhausstr. 9, 4021, Linz, Austria
| | - B Klugsberger
- Kepler Universitätsklinikum GmbH, Klinik für Allgemein- und Viszeralchirurgie, Krankenhausstr. 9, 4021, Linz, Austria
| | - T D Maier
- Robert-Bosch-Krankenhaus, Allgemein- und Viszeralchirurgie, Auerbachstr. 110, 70376, Stuttgart, Germany
| | - G Schumacher
- Städtisches Klinikum Braunschweig, Chirurgische Klinik, Salzdahlumer Str. 90, 38126, Brunswick, Germany
| | - F Köckerling
- Vivantes Humboldt-Hospital, Hernia Center, Am Nordgraben 2, 13509, Berlin, Germany
| | - Ursula Pession
- Zentrum der Chirurgie, Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Frankfurt, Theodor-Stern-Kai, 60590, Frankfurt am Main, Germany
| | - M Schirren
- Department of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-Universität (LMU) Munich, LMU University Hospital, 81377, Munich, Germany
| | - M Albertsmeier
- Department of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-Universität (LMU) Munich, LMU University Hospital, 81377, Munich, Germany
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Jolliffe L, Andrew NE, Srikanth V, Beare R, Noeske KE, Snowdon DA. Development of an implementation strategy for routine collection of generic patient reported outcome measures: a qualitative study in multidisciplinary community rehabilitation. Disabil Rehabil 2024; 46:3895-3904. [PMID: 37735798 DOI: 10.1080/09638288.2023.2258334] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE To explore staff perceptions of barriers and enablers towards implementing the EQ-5D-5L in community rehabilitation, and develop a theory-informed implementation approach for routine administration of generic patient-reported outcome measures (PROMs) using implementation science frameworks. MATERIALS AND METHODS A qualitative study was conducted at three sites. Multidisciplinary rehabilitation staff completed individual semi-structured interviews, which were transcribed and coded against the Theoretical Domains Framework (TDF). We identified and selected potentially effective behaviour change techniques using the Behavior Change Wheel. Hypothetical strategies were operationalised. RESULTS Twenty-one interviews were conducted, and four themes emerged: (1) The Impact of PROMs on patient centered-care; (2) Considerations for validity of PROMs; (3) Service-level impact of embedding PROMs; (4) Practical issues of embedding PROMs within the service. Barriers and enablers were mapped to seven of the TDF domains; relating most to clinicians' "belief about consequences", "reinforcement", and "environmental context and resources". Five hypothetical strategies were developed to overcome identified barriers and strengthen enablers. Key behaviour change techniques underpinning the strategies include: restructuring the physical environment, incentivisation, persuasion and education, enablement, and, social support. CONCLUSIONS Our implementation approach highlights the importance of automating processes, engaging site champions, routinely reporting, and using PROM data to inform service provision.
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Affiliation(s)
- Laura Jolliffe
- National Centre for Healthy Ageing (NCHA), Melbourne, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia
- Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
- Peninsula Health, Melbourne, Australia
| | - Nadine E Andrew
- National Centre for Healthy Ageing (NCHA), Melbourne, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia
- Peninsula Health, Melbourne, Australia
| | - Velandai Srikanth
- National Centre for Healthy Ageing (NCHA), Melbourne, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia
- Peninsula Health, Melbourne, Australia
| | - Richard Beare
- National Centre for Healthy Ageing (NCHA), Melbourne, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia
- Peninsula Health, Melbourne, Australia
| | - Kate E Noeske
- National Centre for Healthy Ageing (NCHA), Melbourne, Australia
- Peninsula Health, Melbourne, Australia
| | - David A Snowdon
- National Centre for Healthy Ageing (NCHA), Melbourne, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Australia
- Peninsula Health, Melbourne, Australia
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18
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Tan YJ, Ong SC, Yong VS, Khor WW, Pang LJ, Choong YY, Zameram AM, Tan LY, Voo JYH, Lam KK, Yen CH, Wahab MJA, Abdulla ZB. Examining health-related quality of life in ambulatory adult patients with chronic heart failure: insights from Malaysia using EQ-5D-5L. Qual Life Res 2024; 33:2181-2195. [PMID: 38839679 DOI: 10.1007/s11136-024-03674-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE Health-related quality-of-life (HRQoL) data for the chronic heart failure (HF) population in Malaysia are lacking. Using EQ-5D-5L, this study intended to describe their HRQoL, identify predictors of worse HRQoL, and derive EQ-5D-5L index scores for use in economic evaluations. METHODS A cross-sectional survey was conducted between April and September 2023 to collect EQ-5D-5L, sociodemographic, and clinical data from outpatients with HF across seven public specialist hospitals in Malaysia. Multivariable logistic and linear regression models were used to identify independent predictors of reported problems in the EQ-5D-5L dimensions, and predictors of index scores and EQ-VAS, respectively. RESULTS EQ-5D-5L data from 424 outpatients of multi-ethnic background (mean age: 57.1 years, 23.8% female, mean left ventricular ejection fraction: 35.7%, 89.7% NYHA class I-II) were collected using either Malay, English, or Chinese, achieving a 99.8% completion rate. Nearly half of the respondents reported issues in the Mobility, Usual Activities, and Pain/Discomfort dimensions. Mean EQ-5D-5L index was 0.820, lower than the general population, and significantly lower with NYHA class III-IV (0.747) versus NYHA class I (0.846) and NYHA class II (0.805). Besides NYHA class, independent predictors of worse HRQoL included Indian ethnicity, living alone, lower education, unemployment due to ill-health, and proxy-reported HRQoL, largely aligning with existing literature. CONCLUSION Community-dwelling Malaysians with HF reported poorer HRQoL compared to the general population. The observed disparities in HRQoL among HF patients may be linked to specific patient characteristics, suggesting potential areas for targeted interventions. HRQoL assessment using EQ-5D-5L proves feasible and should be considered for routine implementation in local clinics.
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Affiliation(s)
- Yi Jing Tan
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Gelugor, Penang, Malaysia
- Seri Manjung Hospital, Ministry of Health Malaysia, 32040 Seri Manjung, Perak, Malaysia
| | - Siew Chin Ong
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Gelugor, Penang, Malaysia.
| | - Vee Sim Yong
- Clinical Research Centre, Institute for Clinical Research, Hospital Queen Elizabeth II, National Institute of Health, Ministry of Health Malaysia, 88300, Kota Kinabalu, Sabah, Malaysia
| | - Wei Wern Khor
- Sarawak General Hospital, Ministry of Health Malaysia, 93586, Kuching, Sarawak, Malaysia
| | - Lie Jin Pang
- Sarawak General Hospital, Ministry of Health Malaysia, 93586, Kuching, Sarawak, Malaysia
| | - Yong Ying Choong
- Seri Manjung Hospital, Ministry of Health Malaysia, 32040 Seri Manjung, Perak, Malaysia
| | | | - Lin Yuing Tan
- Teluk Intan Hospital, Ministry of Health Malaysia, 36000, Teluk Intan, Perak, Malaysia
| | - James Yau Hon Voo
- Duchess of Kent Hospital, Ministry of Health Malaysia, 90000, Sandakan, Sabah, Malaysia
| | - Kar Kei Lam
- Duchess of Kent Hospital, Ministry of Health Malaysia, 90000, Sandakan, Sabah, Malaysia
| | - Chia How Yen
- Clinical Research Centre, Institute for Clinical Research, Hospital Queen Elizabeth II, National Institute of Health, Ministry of Health Malaysia, 88300, Kota Kinabalu, Sabah, Malaysia
| | | | - Zarina Banu Abdulla
- Penang General Hospital, Ministry of Health Malaysia, 10990, Georgetown, Penang, Malaysia
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Vieira RJ, Leemann L, Schünemann HJ, Azevedo LF, Fonseca JA, Bousquet J, Sousa-Pinto B. Impact of Uncontrolled Symptoms on the Health-Related Quality of Life (EQ-5D-5L) of Patients With Allergic Rhinitis: A MASK-air Study. Clin Exp Allergy 2024; 54:634-637. [PMID: 39031606 DOI: 10.1111/cea.14516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/14/2024] [Accepted: 05/26/2024] [Indexed: 07/22/2024]
Affiliation(s)
- Rafael José Vieira
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Lucas Leemann
- Department of Political Science, University of Zurich, Zurich, Switzerland
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Luís Filipe Azevedo
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - João A Fonseca
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jean Bousquet
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology, Berlin, Germany
- MASK-Air SAS, Montpellier, France
| | - Bernardo Sousa-Pinto
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
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Hertel E, Arendt-Nielsen L, Olesen AE, Andersen MS, Petersen KKS. Quantitative sensory testing, psychological factors, and quality of life as predictors of current and future pain in patients with knee osteoarthritis. Pain 2024; 165:1719-1726. [PMID: 38381930 DOI: 10.1097/j.pain.0000000000003194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/08/2024] [Indexed: 02/23/2024]
Abstract
ABSTRACT Substantial interindividual variability characterizes osteoarthritis (OA) pain. Previous findings identify quantitative sensory testing (QST), psychological factors, and health-related quality of life as contributors to OA pain and predictors of treatment outcomes. This exploratory study aimed to explain baseline OA pain intensity and predict OA pain after administration of a nonsteroidal anti-inflammatory drug in combination with paracetamol for 3 weeks. The Knee Injury and Osteoarthritis Outcome Score (KOOS) pain score was used to estimate OA pain presentation. One hundred one patients were assessed at baseline and follow-up using QST (pressure pain thresholds and temporal summation of pain [TSP]), symptoms of depression and anxiety, pain catastrophizing scales (PCSs), and health-related quality of life. Linear regression with backward selection identified that PCS significantly explained 34.2% of the variability in baseline KOOS pain, with nonsignificant contributions from TSP. Pain catastrophizing score and TSP predicted 29.3% of follow-up KOOS pain, with nonsignificant contributions from symptoms of anxiety. When assessed separately, PCS was the strongest predictor (32.2% of baseline and 24.1% of follow-up pain), but QST, symptoms of anxiety and depression, PCS, and quality of life also explained some variability in baseline and follow-up knee OA pain. Further analyses revealed that only TSP and PCS were not mediated by any other included variables, highlighting their role as unique contributors to OA pain presentation. This study emphasizes the importance of embracing a multimodal approach to OA pain and highlights PCS and TSP as major contributors to the baseline OA pain experience and the OA pain experience after OA treatment.
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Affiliation(s)
- Emma Hertel
- Center for Mathematical Modeling of Knee Osteoarthritis (MathKOA), Department of Materials and Production, Aalborg University, Aalborg, Denmark
| | - Lars Arendt-Nielsen
- Center for Mathematical Modeling of Knee Osteoarthritis (MathKOA), Department of Materials and Production, Aalborg University, Aalborg, Denmark
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
- Steno Diabetes Center North Denmark, Clinical Institute, Aalborg University Hospital, Aalborg, Denmark
| | - Anne Estrup Olesen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Clinical Pharmacology, Aalborg University Hospital, Aalborg, Denmark
| | - Michael Skipper Andersen
- Center for Mathematical Modeling of Knee Osteoarthritis (MathKOA), Department of Materials and Production, Aalborg University, Aalborg, Denmark
| | - Kristian Kjær-Staal Petersen
- Center for Mathematical Modeling of Knee Osteoarthritis (MathKOA), Department of Materials and Production, Aalborg University, Aalborg, Denmark
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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Woods TJ, Kaambwa B. An empirical comparison of sleep-specific versus generic quality of life instruments among Australians with sleep disorders. Qual Life Res 2024; 33:2261-2274. [PMID: 38913275 PMCID: PMC11286652 DOI: 10.1007/s11136-024-03686-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 06/25/2024]
Abstract
PURPOSE In Australian adults diagnosed with a sleep disorder(s), this cross-sectional study compares the empirical relationships between two generic QoL instruments, the EuroQoL 5-dimension 5-level (EQ-5D-5L) and ICEpop CAPability measure for Adults (ICECAP-A), and three sleep-specific metrics, the Epworth Sleepiness Scale (ESS), 10-item Functional Outcomes of Sleep Questionnaire (FOSQ-10), and Pittsburgh Sleep Quality Index (PSQI). METHODS Convergent and divergent validity between item/dimension scores was examined using Kendall's Tau-B correlation, with correlations below 0.30 considered weak, between 0.30 and 0.50 moderate and those above 0.50 strong (indicating that instruments were measuring similar constructs). Exploratory factor analysis (EFA) was conducted to identify shared underlying constructs. RESULTS A total of 1509 participants (aged 18-86 years) were included in the analysis. Convergent validity between dimensions/items of different instruments was weak to moderate. A 5-factor EFA solution, representing 'daytime dysfunction', 'fatigue', 'wellbeing', 'physical health', and 'perceived sleep quality', was simplest with close fit and fewest cross-loadings. Each instrument's dimensions/items primarily loaded onto their own factor, except for the EQ-5D-5L and PSQI. Nearly two-thirds of salient loadings were of excellent magnitude (0.72 to 0.91). CONCLUSION Moderate overlap between the constructs assessed by generic and sleep-specific instruments indicates that neither can fully capture the complexity of QoL alone in general disordered sleep populations. Therefore, both are required within economic evaluations. A combination of the EQ-5D-5L and, depending on context, ESS or PSQI offers the broadest measurement of QoL in evaluating sleep health interventions.
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Affiliation(s)
- Taylor-Jade Woods
- Health Economics Unit, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
| | - Billingsley Kaambwa
- Health Economics Unit, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
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22
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Tan YJ, Ong SC, Goh SP, Chen G, Yong VS, Khor WW, Kan YM, Choong YY, Zameram AM, Tan LY, Voo JYH, Lam KK, Yen CH, Wahab MJA, Abdulla ZB. Translation, cross-cultural adaptation, and psychometric validation of the Malay version of the Assessment of Quality of Life-6 Dimensions (Malay-AQoL-6D) instrument among Malaysians living with chronic heart failure. J Patient Rep Outcomes 2024; 8:79. [PMID: 39052204 PMCID: PMC11272755 DOI: 10.1186/s41687-024-00763-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND This study aimed to translate and culturally adapt the Assessment of Quality of Life (AQoL)-6D into Malay (Malay-AQoL-6D), and assesses the instrument's acceptability, reliability, and validity among Malaysians living with chronic heart failure (HF). METHODS The translation and cross-cultural adaptation process adhered to international guidelines. The Malay-AQoL-6D underwent content and face validity assessments via expert review, and pretesting among healthy individuals and patients with chronic conditions. Subsequent psychometric validation utilised clinico-sociodemographic data and paired AQoL-6D and EQ-5D-5L data from a health-related quality-of-life (HRQoL) survey involving Malay-speaking patients with HF, which encompassed assessments of Malay-AQoL-6D acceptability, internal consistency and test-retest reliability, as well as its construct, concurrent, convergent and divergent, and known-group validity. RESULTS The Malay-AQoL-6D was deemed acceptable among clinicians and local patients, achieving a 90.8% completion rate among 314 patients surveyed. The instrument demonstrated strong content validity (item-level content validity index [CVI]: 0.83-1.00, average CVI: 0.98), internal consistency (Cronbach's alpha: 0.72-0.89; MacDonald's omega: 0.82-0.90, excluding the Senses dimension), and test-retest reliability (average intraclass correlation coefficients: 0.79-0.95). Confirmatory factor analysis confirmed the instrument's two-level, six-factor structure (Satorra-Bentler [SB]-scaled χ2(df: 164): 283.67, p-value < 0.001; root mean square error of approximation [RMSEA]: 0.051; comparative fix index [CFI]: 0.945, Tucker-Lewis index [TLI]: 0.937; standardised root mean-squared error [SRMR]: 0.058). The Malay-AQoL-6D's concurrent validity was evident through its good agreement with EQ-5D-5L. Multiple hypothesis tests further affirmed its construct and known-group validity. The Malay-AQoL-6D's psychometric properties remained consistent across different missing data techniques. CONCLUSION The findings suggest that Malay-AQoL-6D could be a culturally acceptable, reliable, and valid HRQoL measure for quantifying HRQoL among the local HF population. Future studies are necessary to further validate the instrument against other measures and confirm the instrument's test-retest reliability and responsiveness, which are possible with the availability of the Malay-AQoL-6D.
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Affiliation(s)
- Yi Jing Tan
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Penang, 11800, Malaysia
- Seri Manjung Hospital, Ministry of Health Malaysia, Seri Manjung, Perak, 32040, Malaysia
| | - Siew Chin Ong
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Penang, 11800, Malaysia.
| | - Sook Pin Goh
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Penang, 11800, Malaysia
- Tapah Hospital, Ministry of Health Malaysia, Tapah, Perak, 35000, Malaysia
| | - Gang Chen
- Centre for Health Economics, Monash University, Caulfield East, VIC, 3145, Australia
| | - Vee Sim Yong
- Clinical Research Centre, Hospital Queen Elizabeth II, Institute for Clinical Research, National Institute of Health, Ministry of Health Malaysia, Kota Kinabalu, Sabah, 88300, Malaysia
| | - Wei Wern Khor
- Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Sarawak, 93586, Malaysia
| | - Ying Min Kan
- Sungai Dua Health Clinic, Ministry of Health Malaysia, Butterworth, Penang, 13800, Malaysia
| | - Yong Ying Choong
- Seri Manjung Hospital, Ministry of Health Malaysia, Seri Manjung, Perak, 32040, Malaysia
| | | | - Lin Yuing Tan
- Teluk Intan Hospital, Ministry of Health Malaysia, Teluk Intan, Perak, 36000, Malaysia
| | - James Yau Hon Voo
- Duchess of Kent Hospital, Ministry of Health Malaysia, Sandakan, Sabah, 90000, Malaysia
| | - Kar Kei Lam
- Duchess of Kent Hospital, Ministry of Health Malaysia, Sandakan, Sabah, 90000, Malaysia
| | - Chia How Yen
- Clinical Research Centre, Hospital Queen Elizabeth II, Institute for Clinical Research, National Institute of Health, Ministry of Health Malaysia, Kota Kinabalu, Sabah, 88300, Malaysia
| | | | - Zarina Banu Abdulla
- Penang General Hospital, Ministry of Health Malaysia, Georgetown, Penang, 10990, Malaysia
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Gabrys L, Schaller A, Peters S, Barzel A, Berrisch-Rahmel S, Dreinhöfer KE, Eckert K, Göhner W, Geidl W, Krupp S, Lange M, Nebel R, Pfeifer K, Reusch A, Schmidt-Ohlemann M, Sewerin P, Steindorf K, Ströhle A, Sudeck G, Wäsche H, Wolf S, Wollesen B, Thiel C. [DNVF Memorandum: Objectives and Methods of Physical Activity-Related Health Services Research]. DAS GESUNDHEITSWESEN 2024. [PMID: 39047784 DOI: 10.1055/a-2340-1669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
The DNVF Memorandum: Objectives and Methods of Physical Activity-Related Health Services Research summarizes, for the first time, the highly interdisciplinary and interprofessional field of physical activity-based health care in the German healthcare system. In addition to providing a conceptual framework and definition of key measures and concepts in physical activity-related health care research, existing research gaps and needs are identified, and methods for advancing this relatively young field of research are described. A particular focus of this study is the relevant outcome parameters and their standardized assessment using established and valid measurement tools. The memorandum aims to establish a general understanding of the complex subject of promoting physical activity and sports therapy in the context of healthcare, to give an impulse to new research initiatives, and to integrate the currently available strong evidence on the effectiveness of physical activity and exercise into healthcare.
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Affiliation(s)
- Lars Gabrys
- ESAB Fachhochschule für Sport und Management Potsdam, Gesundheitssport und Prävention, Potsdam, Germany
| | - Andrea Schaller
- Universität der Bundeswehr München, Institut für Sportwissenschaft, Arbeitsbereich Gesundheit, Betriebliche Gesundheitsförderung und Prävention, München, Germany
| | - Stefan Peters
- Deutscher Verband für Gesundheitssport und Sporttherapie e. V., Deutscher Verband für Gesundheitssport und Sporttherapie e. V., Hürth-Efferen, Germany
- Universität der Bundeswehr, Institut für Sportwissenschaft, Arbeitsbereich Gesundheit, Betriebliche Gesundheitsförderung und Prävention, München, Germany
| | - Anne Barzel
- Universitätsklinikum Ulm, Institut für Allgemeinmedizin, Ulm, Germany
| | - Susanne Berrisch-Rahmel
- Projektgruppe PG 05 Prävention der Deutschen Gesellschaft für Kardiologie, Herz- und Kreislaufforschung e.V., Sprecherin der AG Sport und Prävention des Bundesverband niedergelassener Kardiologen e.V., Düsseldorf, Germany
| | - Karsten E Dreinhöfer
- Medical Park AG, Orthopädie und Unfallchirurgie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Katharina Eckert
- IST-Hochschule für Management GmbH, Gesundheitsmanagement & Public Health, Düsseldorf, Germany
| | - Wiebke Göhner
- Katholische Hochschule Freiburg, Bereich Gesundheitspsychologie, Freiburg, Germany
| | - Wolfgang Geidl
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Sportwissenschaft und Sport, Lehrstuhl Bewegung und Gesundheit, Erlangen, Germany
| | - Sonja Krupp
- Forschungsgruppe Geriatrie Lübeck, Krankenhaus Rotes Kreuz Lübeck - Geriatriezentrum, Lübeck, Germany
| | - Martin Lange
- IST-Hochschule für Management GmbH, Fachbereich Fitness & Gesundheit, Düsseldorf, Germany
| | - Roland Nebel
- Deutsche Gesellschaft zur Prävention und Rehabilitation von Herz-Kreislauferkrankungen e.V. (DGPR), Klinik Roderbirken der Deutschen Rentenversicherung Rheinland, Leichlingen, Germany
| | - Klaus Pfeifer
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Sportwissenschaft und Sport, Lehrstuhl Bewegung und Gesundheit, Erlangen, Germany
| | - Andrea Reusch
- Zentrum Patientenschulung und Gesundheitsförderung, (ZePG e.V.), Würzburg, Germany
| | | | - Philipp Sewerin
- Ruhr-Universität Bochum, Rheumazentrum Ruhrgebiet, Bochum, Germany
| | - Karen Steindorf
- Nationales Centrum für Tumorerkrankungen (NCT) Heidelberg, DKFZ, Abteilung für Bewegung, Präventionsforschung und Krebs, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
| | - Andreas Ströhle
- Charite Universitatsmedizin Berlin, Klinik für Psychiatrie und Psychotherapie Campus Charité Mitte, Berlin, Germany
| | - Gorden Sudeck
- Eberhard Karls Universität Tübingen, Arbeitsbereich Bildungs- und Gesundheitsforschung im Sport, Institut für Sportwissenschaft, Tübingen, Germany
- Eberhard Karls Universität Tübingen, Interfakultäres Forschungsinstitut für Sport und körperliche Aktivität, Tübingen, Germany
| | - Hagen Wäsche
- Universität Koblenz-Landau Fachbereich 3 Mathematik/Naturwissenschaften, Institut für Sportwissenschaft, Koblenz, Germany
| | - Sebastian Wolf
- Eberhard Karls Universität Tübingen, Arbeitsbereich Bildungs- und Gesundheitsforschung im Sport, Institut für Sportwissenschaft, Tübingen, Germany
| | - Bettina Wollesen
- Universität Hamburg, Arbeitsbereich Bewegungs- und Trainingswissenschaft, Fakultät für Psychologie und Bewegungswissenschaft, Hamburg, Germany
| | - Christian Thiel
- Hochschule für Gesundheit Bochum, Studienbereich Physiotherapie, Department für Angewandte Gesundheitswissenschaften, Bochum, Germany
- Ruhr-Universität Bochum, und Forschungsbereich Trainingswissenschaft, Fakultät für Sportwissenschaft, Bochum, Germany
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de Abreu JM, Nunes T, Almiro PA, Figueiredo J, Corte-Real A. Long-Term Benefits of Photobiomodulation Therapy on Health-Related Quality of Life in Burning Mouth Syndrome Patients: A Prospective Study. J Clin Med 2024; 13:4272. [PMID: 39064312 PMCID: PMC11278133 DOI: 10.3390/jcm13144272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/18/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
Background/Objectives: Burning Mouth Syndrome (BMS) patients experience a reduction in health-related quality of life and an increased intake of medication. Photobiomodulation with low-level laser therapy has been demonstrated to be an efficacious treatment for BMS. However, its long-term benefits remain relatively unknown. This study aimed to evaluate the impact of prolonged Photobiomodulation with low-level laser therapy on BMS patients by examining the efficacy of an outpatient protocol in a real-world setting. Methods: A prospective study was designed to address the research question. Photobiomodulation was performed, irradiating the affected areas once every two weeks for 12 months. Health-related quality of life was assessed using the EQ-5D-5L questionnaire at the initial consultation and after 6 months and 12 months of treatment. Additionally, the patients' pharmacological profile was also monitored. Nonparametric statistical analysis was performed (p < 0.05 was considered statistically significant). Results: The study was completed by 15 individuals, comprising 14 females and 1 male. The results indicated a statistically significant improvement (p < 0.001) in four of the five dimensions of the health-related quality of life questionnaire, namely self-care, usual activities, pain/discomfort, and anxiety/depression, along with the patients' perceived health level. A total of 13 participants reported suspending or reducing their intake of medications for Burning Mouth Syndrome. Conclusions: Therefore, Photobiomodulation with low-level laser therapy has a positive effect on improving patients' quality of life and reducing BMS symptoms, contributing to a subsequent reduction or suspension of previous medications. These findings support the efficacy of the applied protocol. Given the innovative methodology and promising results, further research is warranted.
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Affiliation(s)
- João Mendes de Abreu
- Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Stomatology Service, Head, Neck & Skin Surgery Department, Coimbra Hospital and University Centre, 3004-561 Coimbra, Portugal
- Clinical and Academic Centre of Coimbra, 3004-561 Coimbra, Portugal
| | - Tiago Nunes
- Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical and Academic Centre of Coimbra, 3004-561 Coimbra, Portugal
- Forensic Dentistry Laboratory, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Pedro A. Almiro
- Research Centre for Psychology, Autonomous University, 1169-023 Lisbon, Portugal
| | - José Figueiredo
- Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Stomatology Service, Head, Neck & Skin Surgery Department, Coimbra Hospital and University Centre, 3004-561 Coimbra, Portugal
- Clinical and Academic Centre of Coimbra, 3004-561 Coimbra, Portugal
| | - Ana Corte-Real
- Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical and Academic Centre of Coimbra, 3004-561 Coimbra, Portugal
- Forensic Dentistry Laboratory, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
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Hays RD, Edelen MO, Rodriguez A, Qureshi N, Feeny D, Herman PM. Comparison of the EQ-5D-5L and the patient-reported outcomes measurement information system preference score (PROPr) in the United States. J Patient Rep Outcomes 2024; 8:76. [PMID: 39028485 PMCID: PMC11264606 DOI: 10.1186/s41687-024-00749-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/23/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND In contrast to prior research, our study presents longitudinal comparisons of the EQ-5D-5L and Patient-Reported Outcomes Measurement Information System (PROMIS) preference (PROPr) scores. This fills a gap in the literature, providing a much-needed understanding of these preference-based measures and their applications in healthcare research. Furthermore, our study provides equations to estimate one measure from the other, a tool that can significantly facilitate comparisons across studies. METHODS We administered a health survey to 4,098 KnowledgePanel® members living in the United States. A subset of 1,256 (82% response rate) with back pain also completed the six-month follow-up survey. We then conducted thorough cross-sectional and longitudinal analyses of the two measures, including product-moment correlations between scores, associations with demographic variables, and health conditions. To estimate one measure from the other, we used ordinary least squares (OLS) regression with the baseline data from the general population. RESULTS The correlation between the EQ-5D-5L and PROPr scores was 0.69, but the intraclass correlation was only 0.34 because the PROPr had lower (less positive) mean scores on the 0 (dead) to 1 (perfect health) continuum than the EQ-5D-5L. The associations between the two preference measures and demographic variables were similar at baseline. The product-moment correlation between unstandardized beta coefficients for each preference measure regressed on 22 health conditions was 0.86, reflecting similar patterns of unique associations. Correlations of change from baseline to 6 months in the two measures with retrospective perceptions of change were similar. Adjusted variance explained in OLS regressions predicting one measure from the other was 48%. On average, the predicted values were within a half-standard deviation of the observed EQ-5D-5L and PROPr scores. The beta-binomial regression model slightly improved over the OLS model in predicting the EQ-5D-5L from the PROPr but was equivalent to the OLS model in predicting the PROPr. CONCLUSION Despite substantial mean differences, the EQ-5D-5L and PROPr have similar cross-sectional and longitudinal associations with other variables. We provide the OLS regression equations for use in cost-effectiveness research and meta-analyses. Future studies are needed to compare these measures with different conditions and interventions to provide more information on their relative validity.
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Affiliation(s)
- Ron D Hays
- Division of General Internal Medicine and Health Services Research, UCLA Department of Medicine, 1100 Glendon Avenue Suite 850, Los Angeles, CA, USA.
| | - Maria Orlando Edelen
- Patient Reported Outcomes, Value and Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Nabeel Qureshi
- Behavioral and Policy Sciences, RAND Corporation, Santa Monica, CA, USA
| | - David Feeny
- Department of Economics, McMaster University, Hamilton, ON, Canada
| | - Patricia M Herman
- Behavioral and Policy Sciences, RAND Corporation, Santa Monica, CA, USA
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Coetzee M, Clifford AM, Jordaan JD, Louw QA. Health equity profile of knee replacement patients in the South African public sector: A descriptive study. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2024; 80:2027. [PMID: 39114425 PMCID: PMC11304364 DOI: 10.4102/sajp.v80i1.2027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/09/2024] [Indexed: 08/10/2024] Open
Abstract
Background Knee replacement surgery can significantly improve the quality of life of patients with severe knee osteoarthritis. Equitable access to knee replacement surgery is important to ensure that everyone, regardless of their socioeconomic status or geographical location, have fair and timely access. Objectives The aim of our study was to (1) describe the health equity profile and quality of life of patients awaiting knee replacement at a single academic hospital in South Africa and to (2) describe the association between these health equity factors and the waiting time. Method A cross-sectional survey and retrospective record review of patients awaiting knee replacement was conducted using the PROGRESS-Plus health equity framework. Chi-square statistics were used to calculate association between health equity factors and the waiting time. Results Three-hundred and two (N = 302) patients (77% female; mean age 67 years) participated, of whom one in three patients waited 5 years or longer for surgery. Elderly patients (> 70 years) and patients from lower socio-economic background were less likely to have equitable access to surgery. Conclusion The current screening protocol for knee replacement surgery in the public health care sector does not provide equitable access to surgery. A more holistic screening approach alongside selective surgical prioritisation and rehabilitation could reduce the waiting list and facilitate equitable access to care. Clinical implications Health equity factors such as socioeconomic status, age, and other patient characteristics such as life roles and employability should be taken into consideration when screening patients for elective knee replacement waiting lists.
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Affiliation(s)
- Marisa Coetzee
- Division of Physiotherapy, Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Amanda M. Clifford
- Division of Physiotherapy, Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Health Research Institute, Ageing Research Centre, School of Allied Health, University of Limerick, Limerick, Ireland
| | - Jacobus D. Jordaan
- Department of Orthopaedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Quinette A. Louw
- Division of Physiotherapy, Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Taylor PJ, Adeyemi I, Marlow K, Cottam S, Airnes Z, Hartley S, Howells V, Dunn BD, Elliott RA, Hann M, Latham C, Robinson C, Turpin C, Kellett S. The Relational Approach to Treating Self-Harm (RELATE): study protocol for a feasibility randomised controlled trial study of cognitive analytic therapy for adults who self-harm versus treatment at usual. Pilot Feasibility Stud 2024; 10:101. [PMID: 39026281 PMCID: PMC11256374 DOI: 10.1186/s40814-024-01526-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/01/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Self-harm is a prevalent behaviour that has a major detrimental impact on a person's life. Psychological therapies have the potential to help, but evidence of effective interventions remains limited. Access and acceptability of interventions can also be a significant challenge, with individuals either being unable to access help or having to endure long waiting lists. Cognitive analytic therapy (CAT) is a time-limited and relationally-focused psychotherapy that may provide a valuable treatment option for people who self-harm. This protocol outlines the methodology for the first feasibility randomised controlled trial (RCT) of CAT for adults that self-harm. The trial will aim to determine the feasibility, acceptability and safety of undertaking larger-scale evaluations of CAT for self-harm within an RCT context. METHOD An RCT design with 1:1 allocation to CAT plus treatment as usual (TAU) or TAU alone. Participants will be adult outpatients with three or more instances of self-harm in the past year (target sample of n = 60). CAT will be 8 one-to-one weekly 60-min sessions plus a follow-up session up to 8 weeks after the last session. Assessments will occur at baseline, 12 weeks and 18 weeks after randomisation. Qualitative interviews with participants will gain insights into the feasibility and acceptability of CAT. Feasibility outcomes will be judged against progression criteria. DISCUSSION CAT may be an effective and accessible treatment option for people who self-harm, providing a more relationally orientated alternative to more behavioural therapies. The proposed feasibility RCT is an important first step in evaluating CAT as a treatment for self-harm. TRIAL REGISTRATION The trial was pre-registered (21/10/22) on ISR CTN (ISRCTN code: ISRCTN75661422).
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Affiliation(s)
- Peter James Taylor
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK.
| | - Isabel Adeyemi
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Katie Marlow
- Rotherham, Doncaster, and South Humber NHS Foundation Trust, Doncaster, UK
| | - Sarah Cottam
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Zerena Airnes
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Victoria Howells
- Rotherham, Doncaster, and South Humber NHS Foundation Trust, Doncaster, UK
| | | | - Rachel A Elliott
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Mark Hann
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Cameron Latham
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Catherine Robinson
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Clive Turpin
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Stephen Kellett
- Rotherham, Doncaster, and South Humber NHS Foundation Trust, Doncaster, UK
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Pereira MP, Zeidler C, Szymczak H, Bischoff C, Tsianakas A, Ständer S, Apfelbacher C. Acceptability and perceived benefits of validated pruritus assessment instruments in the dermatological office and clinic: The perspectives of patients and physicians. J Eur Acad Dermatol Venereol 2024. [PMID: 38975785 DOI: 10.1111/jdv.20148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/22/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Several patient-reported outcome measures (PROMs) have been developed for research to assess the multiple dimensions of chronic pruritus (CP). The acceptability and perceived benefits of their use in clinical practice remain unknown. OBJECTIVES To assess the acceptability and perceived benefits of validated PROMs from the perspective of patients and physicians in dermatological offices and clinics. METHODS Patients with CP due to atopic dermatitis, psoriasis, chronic prurigo or chronic urticaria were recruited at 10 dermatological offices and two dermatological clinics in Germany. Patients completed a set of validated PROMs on pruritus intensity (numerical rating scale, NRS), symptom control (itch-controlled days, ItchCD), quality of life (Dermatology Life Quality Index, DLQI; 5-pruritus life quality, 5PLQ) and general health status (EuroQol, EQ-VAS). Acceptability (relevance, difficulty of completion, length) and benefits (usefulness, feasibility) of these tools were assessed on a NRS (0-10) by patients and physicians, respectively. Data were analysed descriptively. Linear regression was used to study potential associations between age, sex, occupation, office versus clinic, change of therapy and physician-reported benefits. RESULTS N = 523 patients (46% male, average age: 53.5 years) participated. Acceptability of PROMs by patients was high, indicated by low difficulty (Md = 0, IQR = 0-1 for all PROMs) and high relevance (Md = 8, IQR = 4-10 for all PROMs). Also, most patients (89-95%) rated length of the questionnaires as 'exactly right'. Physicians rated the NRS as the most beneficial instrument (feasibility: Md = 8, IQR = 6-10; usefulness: Md = 9, IQR = 7-10). Hierarchical linear regression revealed that only recruitment site (dermatological office vs. clinic) was significantly associated with usefulness and feasibility (higher ratings for clinical context; βs = 0.149-0.258, ps <0.05; except feasibility for EQ5d, β = ns). CONCLUSION PROMs are welcomed by patients, while physicians consider instruments measuring pruritus intensity and impairment of quality of life as beneficial for the clinical routine. Widespread implementation of PROMs in daily clinical work is needed to improve care.
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Affiliation(s)
- M P Pereira
- Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Immunology and Allergology, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Berlin, Germany
- Department of Dermatology, Center of Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - C Zeidler
- Department of Dermatology, Center of Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - H Szymczak
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - C Bischoff
- Department of Dermatology, Center of Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - A Tsianakas
- Department of Dermatology, Fachklinik Bad Bentheim, Bad Bentheim, Germany
| | - S Ständer
- Department of Dermatology, Center of Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - C Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Dardenne N, Donneau AF, Bruyère O. Mapping the Lequesne Functional Index Into the EQ-5D-5L Utility Index in Patients With Knee Osteoarthritis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024:S1098-3015(24)02756-6. [PMID: 38977193 DOI: 10.1016/j.jval.2024.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 06/06/2024] [Accepted: 06/21/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVE This study aimed to map the Lequesne index onto the EuroQol 5 Dimension (EQ-5D-5L) utility index for patients with knee osteoarthritis. METHODS Baseline data from a previous randomized controlled trial were used; 461 patients were involved in the mapping development, and 230 in the validation phase. Various modeling techniques, including generalized linear models, tobit, and beta regression, were used. Factors such as age, sex, and body mass index were considered as covariates. Model selection was based on criteria such as Akaike and Bayesian information criteria, adjusted R2, mean absolute error, and root mean squared error. Validation involved assessing the preselected models using mean absolute error, root mean squared error, and intraclass correlation coefficient. This study follows the Mapping Onto Preference-Based Measures Reporting Standards statement. RESULTS Five models were developed, with 2 incorporating age, sex, with or without body mass index along with the Lequesne index showing the best fit across regressions. Validation results were similar for the 3 regressions, with beta regression models exhibiting wider ranges closer to the validation data set. Intraclass correlation coefficient values were better for beta regression models. Both models tended to overpredict for lower EQ-5D-5L values and underpredict for better health status. CONCLUSION These mapping functions, the first of their kind, effectively translate the Lequesne index to EQ-5D-5L values in patients with knee osteoarthritis. They demonstrate satisfactory fit and precision, providing valuable tools for clinicians and researchers, particularly in situations where generic preference-based health-related quality of life instruments are inaccessible for utility derivation in cost-effectiveness studies.
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Affiliation(s)
- Nadia Dardenne
- Biostatistics Center (B-STAT), University Hospital and University of Liège, Liège, Belgium
| | - Anne-Françoise Donneau
- Biostatistics Center (B-STAT), University Hospital and University of Liège, Liège, Belgium
| | - Olivier Bruyère
- WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Research Unit in Public Health, Epidemiology and Health Economics, and Department of Sport and Rehabilitation Sciences, University of Liège, Liège, Belgium.
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Skovgaard Jensen J, Sørensen AS, Kruuse C, Nielsen HH, Skov CD, Jensen HB, Buckwalter MS, Bojsen-Møller J, Lambertsen KL, Holsgaard-Larsen A. The effect of robot-assisted versus standard training on motor function following subacute rehabilitation after ischemic stroke - protocol for a randomised controlled trial nested in a prospective cohort (RoboRehab). BMC Neurol 2024; 24:233. [PMID: 38965499 PMCID: PMC11223295 DOI: 10.1186/s12883-024-03734-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 06/17/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Body weight unloaded treadmill training has shown limited efficacy in further improving functional capacity after subacute rehabilitation of ischemic stroke patients. Dynamic robot assisted bodyweight unloading is a novel technology that may provide superior training stimuli and continued functional improvements in individuals with residual impairments in the chronic phase after the ischemic insult. The aim of the present study is to investigate the effect of dynamic robot-assisted versus standard training, initiated 6 months post-stroke, on motor function, physical function, fatigue, and quality of life in stroke-affected individuals still suffering from moderate-to-severe disabilities after subacute rehabilitation. METHODS Stroke-affected individuals with moderate to severe disabilities will be recruited into a prospective cohort with measurements at 3-, 6-, 12- and 18-months post-stroke. A randomised controlled trial (RCT) will be nested in the prospective cohort with measurements pre-intervention (Pre), post-intervention (Post) and at follow-up 6 months following post-intervention testing. The present RCT will be conducted as a multicentre parallel-group superiority of intervention study with assessor-blinding and a stratified block randomisation design. Following pre-intervention testing, participants in the RCT study will be randomised into robot-assisted training (intervention) or standard training (active control). Participants in both groups will train 1:1 with a physiotherapist two times a week for 6 months (groups are matched for time allocated to training). The primary outcome is the between-group difference in change score of Fugl-Meyer Lower Extremity Assessment from pre-post intervention on the intention-to-treat population. A per-protocol analysis will be conducted analysing the differences in change scores of the participants demonstrating acceptable adherence. A priori sample size calculation allowing the detection of the minimally clinically important between-group difference of 6 points in the primary outcome (standard deviation 6 point, α = 5% and β = 80%) resulted in 34 study participants. Allowing for dropout the study will include 40 participants in total. DISCUSSION For stroke-affected individuals still suffering from moderate to severe disabilities following subacute standard rehabilitation, training interventions based on dynamic robot-assisted body weight unloading may facilitate an appropriate intensity, volume and task-specificity in training leading to superior functional recovery compared to training without the use of body weight unloading. TRIAL REGISTRATION ClinicalTrials.gov. NCT06273475. TRIAL STATUS Recruiting. Trial identifier: NCT06273475. Registry name: ClinicalTrials.gov. Date of registration on ClinicalTrials.gov: 22/02/2024.
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Affiliation(s)
- Jon Skovgaard Jensen
- Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
- Department of Orthopaedics and Traumatoloy, Odense University Hospital, J.B. Winsløwsvej 4, Odense, 5000, Denmark.
| | - Anders Stengaard Sørensen
- SDU UAS Center, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark
| | - Christina Kruuse
- Department of Brain and Spinal Cord Injuries, Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Helle Hvilsted Nielsen
- Neurobiology Research Unit, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Department of Neurology, OUH, and BRIDGE - Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Cecilie Dollerup Skov
- Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Orthopaedics and Traumatoloy, Odense University Hospital, J.B. Winsløwsvej 4, Odense, 5000, Denmark
| | - Henrik Boye Jensen
- Brain and Nerve Diseases, Department of Regional Health Research, Lillebaelt Hospital, University of Southern Denmark, Kolding, Denmark
| | - Marion S Buckwalter
- Department of Neurology and Neurological Sciences, and, Department of Neurosurgery, Stanford School of Medicine, Stanford, CA, USA
| | - Jens Bojsen-Møller
- Research Unit of Muscle Physiology and Biomechanics, Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Kate Lykke Lambertsen
- Neurobiology Research Unit, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
- Department of Neurology, OUH, and BRIDGE - Brain Research Inter Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Anders Holsgaard-Larsen
- Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Orthopaedics and Traumatoloy, Odense University Hospital, J.B. Winsløwsvej 4, Odense, 5000, Denmark
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Gámiz-Molina AB, Valenza-Peña G, Raya-Benítez J, Heredia-Ciuró A, Granados-Santiago M, López-López L, Valenza MC. Association between Mid-Term Functionality and Clinical Severity in Patients Hospitalized for Pulmonary Embolism. Healthcare (Basel) 2024; 12:1323. [PMID: 38998858 PMCID: PMC11241709 DOI: 10.3390/healthcare12131323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/27/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
The aim of this study is to evaluate the relationship between clinical severity and functionality, occupational performance, and health-related quality of life in patients hospitalized with pulmonary embolism. Pulmonary embolism patients were grouped by clinical severity using the Pulmonary Embolism Severity Index. Those scoring ≥160 were in the high-severity group (HSG); those scoring < 160 in the low-moderate group (LMSG). The main variables were functionality assessed by the World Health Organization Disability Assessment Schedule (WHODAS), self-perception of occupational performance assessed by the Canadian Occupational Performance Measure (COPM), pain and fatigue assessed by a Visual Analogue Scale (VAS), and health-related quality of life assessed by the EuroQol-5Dimensions (EQ-5D). Patients were evaluated at hospital admission and at 1-month and 3-month follow-up. At admission, there were significant differences between groups in the WHODAS and health-related quality of life in favor of the LMSG. At 1-month and at 3-month follow-up, there were significant differences between the LMSG and HSG in WHODAS, COMP, NRS pain, fatigue and EQ-5D scores in favor of the LMSG. An association exists between clinical severity and mid-term functionality, self-perception of occupational performance, pain, fatigue, and health-related quality of life in PE patients.
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Affiliation(s)
| | - Geraldine Valenza-Peña
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (G.V.-P.); (A.H.-C.); (M.C.V.)
| | - Julia Raya-Benítez
- Nursing Department, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (J.R.-B.); (M.G.-S.)
| | - Alejandro Heredia-Ciuró
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (G.V.-P.); (A.H.-C.); (M.C.V.)
| | - María Granados-Santiago
- Nursing Department, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (J.R.-B.); (M.G.-S.)
| | - Laura López-López
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (G.V.-P.); (A.H.-C.); (M.C.V.)
| | - Marie Carmen Valenza
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain; (G.V.-P.); (A.H.-C.); (M.C.V.)
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Döhring J, Williamson M, Brettschneider C, Fankhänel T, Luppa M, Pabst A, Weißenborn M, Zöllinger I, Czock D, Frese T, Gensichen J, Hoffmann W, König HH, Thyrian JR, Wiese B, Riedel-Heller S, Kaduszkiewicz H. Quality of life in a high-risk group of elderly primary care patients: characteristics and potential for improvement. Qual Life Res 2024; 33:1841-1851. [PMID: 38740640 PMCID: PMC11176227 DOI: 10.1007/s11136-024-03647-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE Quality of Life (QoL) is associated with a bandwidth of lifestyle factors that can be subdivided into fixed and potentially modifiable ones. We know too little about the role of potentially modifiable factors in comparison to fixed ones. This study examines four aspects of QoL and its associations with 15 factors in a sample of elderly primary care patients with a high risk of dementia. The main objectives are (a) to determine the role of the factors in this particular group and (b) to assess the proportion of fixed and potentially modifiable factors. METHOD A high-risk group of 1030 primary care patients aged between 60 and 77 years (52.1% females) were enrolled in "AgeWell.de," a cluster-randomized, controlled trial. This paper refers to the baseline data. The multi-component intervention targets to decrease the risk of dementia by optimization of associated lifestyle factors. 8 fixed and 7 modifiable factors potentially influencing QoL served as predictors in multiple linear regressions. RESULTS The highest proportion of explained variance was found in psychological health and age-specific QoL. In comparison to health-related QoL and physical health, the modifiable predictors played a major role (corr. R2: 0.35/0.33 vs. 0.18), suggesting that they hold a greater potential for improving QoL. CONCLUSION Social engagement, body weight, instrumental activities of daily living, and self-efficacy beliefs appeared as lifestyle factors eligible to be addressed in an intervention program for improving QoL. TRIAL REGISTRATION German Clinical Trials Register, reference number: DRKS00013555. Date of registration: 07.12.2017.
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Affiliation(s)
- Juliane Döhring
- Institute of General Practice, University of Kiel, 24105, Kiel, Germany.
| | - Martin Williamson
- Institute of General Practice, University of Kiel, 24105, Kiel, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Thomas Fankhänel
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112, Halle (Saale), Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103, Leipzig, Germany
| | - Marina Weißenborn
- Department of Clinical Pharmacology and Pharmacoepidemiology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Isabel Zöllinger
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, 80336, Munich, Germany
| | - David Czock
- Department of Clinical Pharmacology and Pharmacoepidemiology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, 06112, Halle (Saale), Germany
| | - Jochen Gensichen
- Institute of General Practice/Family Medicine, University Hospital of LMU Munich, 80336, Munich, Germany
| | - Wolfgang Hoffmann
- Institute for Community Medicine, University Medicine Greifswald, 17489, Greifswald, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Jochen René Thyrian
- Institute for Community Medicine, University Medicine Greifswald, 17489, Greifswald, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), 17489, Greifswald, Germany
| | - Birgitt Wiese
- Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Institute for General Practice, 30625, Hannover, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, 04103, Leipzig, Germany
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Cheng LJ, Pan T, Chen LA, Cheng JY, Mulhern B, Devlin N, Luo N. The Ceiling Effects of EQ-5D-3L and 5L in General Population Health Surveys: A Systematic Review and Meta-Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:986-997. [PMID: 38467187 DOI: 10.1016/j.jval.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/13/2024] [Accepted: 02/28/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVES This review aims to examine the ceiling effects of EQ-5D-3L (3L) and EQ-5D-5L (5L) in general adult populations and identify the factors influencing these effects. METHODS We searched 8 databases for observational studies published in English from inception to 24 July 2023. Ceiling effects were calculated by dividing the number of participants reporting full health at dimension or profile level by the total sample size. Subgroup analysis and meta-regression using the metafor package in R software were performed. RESULTS We identified 94 studies from 70 articles, including 4 543 647 adults across 37 countries. The global pooled proportion of individuals reporting full health ("11111") was 56% (95% CI 51%-62%) for 3L and 49% (95% CI 44%-54%) for 5L. The self-care dimension showed the highest ceiling effects (3L: 97%; 5L: 94%), whereas pain/discomfort had the lowest (3L: 69%; 5L: 60%). The ceiling effects in East/South-East Asia were higher than in Europe by 25% (95% CI 18%-32%) in 3L and 9% (95% CI -2%-20%) in 5L. Adjusting for mean age and proportion of males, significant regional differences persisted in the overall profile level of 3L, in all 3L dimensions (except for self-care), and 5L dimensions (except for pain/discomfort and anxiety/depression). CONCLUSIONS This review highlights significant ceiling effects in the EQ-5D, especially in Asian populations. The 5L version exhibited fewer ceiling effects than the 3L, indicating its superiority for general population surveys. Further research is crucial to understand the disparities in self-reported health outcomes between Asians and other populations.
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Affiliation(s)
- Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Tianxin Pan
- Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Le Ann Chen
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Jing Ying Cheng
- Khoo Teck Puat Hospital, Yishun Health, National Healthcare Group, Singapore
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia
| | - Nancy Devlin
- Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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Daynes E, Baldwin MM, Annals M, Gardiner N, Chaplin E, Ward S, Greening NJ, Evans RA, Singh SJ. Changes in fatigue symptoms following an exercise-based rehabilitation programme for patients with long COVID. ERJ Open Res 2024; 10:00089-2024. [PMID: 39040593 PMCID: PMC11261384 DOI: 10.1183/23120541.00089-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 04/11/2024] [Indexed: 07/24/2024] Open
Abstract
Background There is evidence to support COVID-19 rehabilitation programmes improving persistent COVID-19 symptoms; however, there is concern that therapies that include an exercise component may increase fatigue and post-exertional symptom exacerbation (PESE). The objectives of the present study were to determine the effect of a 6-week COVID-19 rehabilitation programme on fatigue and PESE in individuals with ongoing COVID-19 symptoms. Methods After a routine medical assessment, individuals with persistent COVID-19 symptoms were enrolled on a 6-week COVID-19 specific rehabilitation programme. The programme included symptom-titrated exercise, education and self-management advice. Fatigue was assessed pre- and post-programme using the Functional Assessment Chronic Illness Therapy Fatigue questionnaire (FACIT). Exercise capacity (Incremental and Endurance Shuttle Walking Test (ISWT and ESWT)) and PESE (DePaul Symptom Questionnaire (DSQ)) were also assessed pre- and post-programme. Composite scores were calculated for the frequency and severity domains of the DSQ. Results 148 patients (median (IQR) age 59 (49-72) years, 82 (55%) female, 81 (54%) hospitalised) completed the COVID-19 rehabilitation programme. FACIT score was reduced pre- to post-programme by a mean (CI) change of -5 (-7- -4); p<0.01. Exercise capacity increased by 82 (65-99) m for the ISWT and 398 (333-462) s for the ESWT (n=148). PESE was assessed in 44 patients. The DSQ frequency and severity composite score improved by 20 (13-28) and 19 (13-26) points, respectively (p<0.01, n=44). Conclusion These data demonstrate the potential benefits of a COVID-19 rehabilitation programme in improving fatigue, exercise capacity and symptom exacerbation in those with persistent COVID-19 symptoms.
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Affiliation(s)
- Enya Daynes
- Centre for Exercise and Rehabilitation Sciences, NIHR Leicester Biomedical Research Centre Respiratory, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Molly M. Baldwin
- Centre for Exercise and Rehabilitation Sciences, NIHR Leicester Biomedical Research Centre Respiratory, Leicester, UK
| | - Matthew Annals
- Centre for Exercise and Rehabilitation Sciences, NIHR Leicester Biomedical Research Centre Respiratory, Leicester, UK
| | - Nikki Gardiner
- Centre for Exercise and Rehabilitation Sciences, NIHR Leicester Biomedical Research Centre Respiratory, Leicester, UK
| | - Emma Chaplin
- Centre for Exercise and Rehabilitation Sciences, NIHR Leicester Biomedical Research Centre Respiratory, Leicester, UK
| | - Sarah Ward
- Centre for Exercise and Rehabilitation Sciences, NIHR Leicester Biomedical Research Centre Respiratory, Leicester, UK
| | - Neil J. Greening
- Centre for Exercise and Rehabilitation Sciences, NIHR Leicester Biomedical Research Centre Respiratory, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Rachael A. Evans
- Centre for Exercise and Rehabilitation Sciences, NIHR Leicester Biomedical Research Centre Respiratory, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Sally J. Singh
- Centre for Exercise and Rehabilitation Sciences, NIHR Leicester Biomedical Research Centre Respiratory, Leicester, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
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Schneider S, Wertli MM, Henzi A, Hebeisen M, Brunner F. Effect of an interdisciplinary inpatient program for patients with complex regional pain syndrome in reducing disease activity-a single-center prospective cohort study. PAIN MEDICINE (MALDEN, MASS.) 2024; 25:459-467. [PMID: 38530793 PMCID: PMC11224586 DOI: 10.1093/pm/pnae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/02/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE The aim of this study was to evaluate the benefit of inpatient treatment in reducing disease activity in patients with complex regional pain syndrome (CRPS) who have exhausted outpatient options. Furthermore, the study sought to identify patient-related outcome variables that predict a reduction in disease activity. METHODS The primary outcome was disease severity (CRPS Severity Score, range 0-16 points). Secondary outcomes included depression, anxiety, physical function, pain interference, fatigue, sleep disturbance, and the ability to participate in social roles and activities, all of which were assessed using the PROMIS-29. Furthermore, pain catastrophizing, neuropathic pain, quality of life, pain self-efficacy, medication intake, and the patient's global impression of change were examined in accordance with current international agreed recommendations, assessed at discharge, 3-month, and 6-month post-discharge. Mixed-effects models were conducted to identify baseline variables associated with CRPS severity. RESULTS Twenty-five patients completed the program (mean age 49.28 [SD 11.23] years, 92% females, mean symptom duration 8.5 [SD 6.5] months). Results showed a significant reduction between baseline and discharge of disease activity (CSS -2.36, P < .0001), pain (PROMIS-29 pain -0.88, P = .005), and emotional function (PROMIS-29 depression -5.05, P < .001; fatigue -4.63, P = .002). Moderate evidence for a reduction between baseline and discharge could be observed for pain interference (+2.27, P = .05), social participation (PROMIS-29 + 1.93, P = .05), anxiety (PROMIS-29 -3.32, P = .02) and physical function (PROMIS-29 + 1.3, P = .03). On discharge, 92% of patients (23 of 25) reported improvement in their overall condition. In the follow-up period, medication intake could be reduced after 3 (MQS -8.22, P = .002) and 6 months (MQS -8.69, P = .001), and there was further improvement in social participation after 3 months (PROMIS-29 + 1.72, 0.03) and sleep after 6 months (PROMIS-29 + 2.38, 0.008). In the mixed models, it was demonstrated that patients experiencing less pain at baseline also exhibited lower disease activity. CONCLUSION The results of this study confirm that inpatient interdisciplinary treatment of CRPS patients improves disease activity, pain, physical function, emotional function, and social participation. Most improvements were maintained for up to 6 months after discharge. The majority of patients reported that their overall condition had improved during the study period.
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Affiliation(s)
- Stephanie Schneider
- Department of Physical Medicine and Rheumatology, Balgrist University Hospital, 8008 Zurich, Switzerland
| | - Maria M Wertli
- Department of Internal Medicine, Kantonsspital Baden, 5404 Baden, Switzerland
- Department of General Internal Medicine, University Hospital Bern, University of Bern, 3010 Bern, Switzerland
| | - Anna Henzi
- Department of Physical Medicine and Rheumatology, Balgrist University Hospital, 8008 Zurich, Switzerland
| | - Monika Hebeisen
- Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, 8001 Zurich, Switzerland
| | - Florian Brunner
- Department of Physical Medicine and Rheumatology, Balgrist University Hospital, 8008 Zurich, Switzerland
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Hansen NM, Kamper AL, Rix M, Feldt-Rasmussen B, Berg P, Astrup A, Salomo L. Health-Related Quality of Life during 26-Week Intervention with the New Nordic Renal Diet. Nutrients 2024; 16:2038. [PMID: 38999786 PMCID: PMC11243029 DOI: 10.3390/nu16132038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024] Open
Abstract
The New Nordic Renal Diet (NNRD) is a whole-food approach, tailored to meet recommended guidelines in patients with moderate chronic kidney disease (stage 3b-4). The NNRD improved various metabolic and physiological endpoints during a 26-week randomized controlled study. Here, we examined the effect of dietary intervention on health-related quality of life (HRQoL). Sixty participants were recruited (NNRD group n = 30, control group n = 30) and 58 completed the study. During the intervention, the NNRD group received food boxes, and recipes once a week. The control group continued their habitual diet. HRQoL was examined at baseline and at the end of the intervention using the validated EuroQol-5D-5L, including a 5-point scale Likert questionnaire at the end of the intervention. Assessed by the EuroQol-5D-5L questionnaire, the NNRD group experienced a reduction in pain/discomfort during the intervention by 26% [-0.44 points (95% CI; -0.73, -0.16)], compared with no change in the control group [0.25 points (95% CI; -0.02, 0.53)] and a between-group difference of -0.70 points (95% CI; -1.03, -0.37, p < 0.001). A larger decrease of body fat mass was associated with a larger decrease in pain/discomfort (p = 0.014). In addition, the NNRD group reported an overall improvement in conducting usual daily activities by 23% [-0.30-point (95% CI; -0.50, -0.11)], while no change was seen in the control group [-0.02 points (95% CI; -0.21, 0.17)], with a between-group difference -0.28 points (95% CI; -0.51, -0.06, p = 0.014). A larger decrease in 24 h urine phosphorus excretion, used as a marker of compliance, was associated with a larger improvement in conducting usual daily activities (p = 0.036). The NNRD group had a clinically relevant improvement in various HRQoL outcomes.
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Affiliation(s)
- Nikita Misella Hansen
- Department of Nephrology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Anne-Lise Kamper
- Department of Nephrology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Marianne Rix
- Department of Nephrology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Bo Feldt-Rasmussen
- Department of Nephrology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Peder Berg
- Department of Biomedicine, Aarhus University, 8000 Aarhus, Denmark
| | - Arne Astrup
- Department of Obesity and Nutritional Sciences, Novo Nordisk Foundation, 2900 Hellerup, Denmark
| | - Louise Salomo
- Department of Nephrology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
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Andronis L, Waugh N, Zanganeh M, Krishnamoorthy A, Parsons N, Hull M, Wheatstone P, Arasaradnam RP. Impact of colonoscopy on health-related quality of life: findings from the RECEDE study. Health Qual Life Outcomes 2024; 22:49. [PMID: 38926801 PMCID: PMC11210081 DOI: 10.1186/s12955-024-02262-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/28/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Colonoscopy is a valuable diagnostic tool but the procedure and the preparation for it cause anxiety and discomfort that impacts on patients' health-related quality of life (HRQoL). The 'disutility' of undergoing an invasive colonoscopy needs to be considered and accounted for in comprehensive cost-utility analyses that compare different diagnostic strategies, yet there is little empirical evidence that can be used in such studies. To fill this gap, we collected and analysed data on the effect of a colonoscopy examination on patients' HRQoL that can be used in economic evaluations. METHODS Patients scheduled to undergo a colonoscopy at a large NHS hospital were asked to complete the EuroQol EQ-5D-5 L instrument: (i) before the procedure, at the time of consent (T1), (ii) while undergoing bowel preparation (T2) and (iii) within 24 h after the procedure (T3). Complete responses were translated into preference-based HRQoL (utility) values using a UK-specific value set and were analysed using descriptive and inferential statistical analyses. RESULTS Two-hundred and seventy-one patients with gastrointestinal symptoms referred for a colonoscopy provided complete EQ-5D-5 L questionnaires at all three assessment points. At T1, the mean EQ-5D-5 L value was 0.76 (95%CI: 0.734-0.786). This value dropped to 0.727 at T2 (95%CI: 0.7-0.754, before increasing again to 0.794 (95%CI: 0.768-0.819) at T3. Both changes were statistically significant (p-value < 0.001). CONCLUSIONS Preference-based HRQoL (utility) values reported by patients undergoing a colonoscopy dropped during bowel preparation and rose again shortly after the colonoscopy. This pattern was largely consistent across patients with different characteristics, symptoms and diagnoses.
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Affiliation(s)
- L Andronis
- Warwick Evidence, University of Warwick, Coventry, UK.
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
| | - N Waugh
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - M Zanganeh
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - A Krishnamoorthy
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - N Parsons
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - M Hull
- Dept of Molecular Medicine, University of Leeds, Leeds, UK
| | - P Wheatstone
- Patient and Public representative, University of Leeds, Leeds, UK
| | - R P Arasaradnam
- Institute of Precision Diagnostics & Translational Medicine, UHCW, Coventry, UK
- Leicester Cancer Centre, University of Leicester, Leicester, UK
- Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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Jang JH, Jun HJ, Lee C, Sohn E, Kwon O, Kang DH, Umar M, Jung IC, Jeong SJ. Therapeutic Potential of Combined Herbal Medicine and Electroacupuncture in Mild Cognitive Impairment Through Cytokine Modulation: An Observational Study. Neuropsychiatr Dis Treat 2024; 20:1331-1344. [PMID: 38919562 PMCID: PMC11198010 DOI: 10.2147/ndt.s465650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 06/11/2024] [Indexed: 06/27/2024] Open
Abstract
Purpose We aimed to investigate the efficacy of a combined herbal formula and electroacupuncture (EA) for mild cognitive impairment (MCI), a neurodegenerative disease leading to dementia, and its underlying mechanisms of action. Patients and Methods This was a prospective open-label observational pilot study at Daejeon Korean Medicine Hospital of Daejeon University in South Korea from March 2022 to March 2023. We included six Korean patients (50% male) aged ≥ 45 years and < 85 years with MCI, a clinical dementia rating score of 0.5, and a Montreal Cognitive Assessment-Korea (MoCA-K) score ≤ 22. The exclusion criterion was impaired cognitive function. Patients received combined therapy, including a herbal formula and EA, for 12-24 weeks. We prescribed the herbal formulas Gamiguibi-tang, Yukmijihwang-tang, and Banhasasim-tang to the patients for at least 70% of the treatment period, in combination with EA. Moreover, we investigated changes in cognitive and cognition-related symptoms and cytokine expression in the blood following combined traditional medicine therapy. At baseline and after 12 and 24 weeks, we administered the MoCA-K and cognitive-related questionnaires. We analyzed network pharmacology to reflect the herbal formula intervention mechanism comprehensively. Results The median score [interquartile range] of MoCA-K at baseline was 19.5 [16.0, 22.0], which improved significantly (24.5 [24.0, 26.0], p < 0.01) over 24 weeks following combined therapy. We obtained no significant conclusion regarding cytokine changes due to the small sample size. In network pharmacology, we analyzed the brain, head, heart, peripheral nerves, peripheral nervous system, and pancreas as the enriched organs from the common targets of the three herbal formulas. Conclusion Combined herbal medicine and EA improved cognitive function in patients with MCI. We assume the underlying mechanism of herbal formulas to be antioxidative and anti-inflammatory changes in cytokine expression. Combined traditional medicine has potential therapeutic application in preventing MCI progression to dementia.
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Affiliation(s)
- Jung-Hee Jang
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Hyeong Joon Jun
- Korean Medicine Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - ChaYoung Lee
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Eunjin Sohn
- Korean Medicine Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Ojin Kwon
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Dong-Hoon Kang
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Muhammad Umar
- Korean Medicine Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
| | - In Chul Jung
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Soo-Jin Jeong
- Korean Medicine Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Christodoulou E, Mpali T, Dimitriadou ME, Koutelidakis AE. Mindfulness, Gut-Brain Axis, and Health-Related Quality of Life: The Paradigm of IBD Patients. Healthcare (Basel) 2024; 12:1209. [PMID: 38921323 PMCID: PMC11202893 DOI: 10.3390/healthcare12121209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/06/2024] [Accepted: 06/13/2024] [Indexed: 06/27/2024] Open
Abstract
Health-related quality of life (HRQoL) is a comprehensive measure that evaluates an individual's well-being across physical, mental, and social dimensions. Enhancing HRQoL, particularly in individuals with chronic conditions like inflammatory bowel diseases (IBD), necessitates a holistic approach. Mindfulness, a scientifically supported strategy for managing anxiety, has shown promise in improving both physical and mental health. Its benefits may be partly explained through its effects on the gut-brain axis (GBA), a bidirectional communication link between the gastrointestinal system and the central nervous system. By exploring the interplay between mindfulness and the GBA, this study aims to uncover how these elements collectively influence HRQoL in both healthy individuals and those with IBD, offering insights into potential therapeutic pathways. A cross-sectional investigation involved 338 adults, including 50 IBD patients, utilizing validated Greek scales for Mindfulness (MAAS-15), Mediterranean Diet (14-MEDAS), and HRQoL (EQ-5D-5L). The questionnaire gathered demographic, anthropometric, and lifestyle data. Among healthy participants, EQ-5D-5L showed a moderate correlation with the MAAS-15 scale (r = 0.389, p < 0.05) and a low correlation with 14-MEDAS (r = 0.131, p < 0.05). IBD patients exhibited significantly lower mean EQ-5D-5L scores than healthy individuals (0.75 vs. 0.85, p < 0.05). MAAS-15 demonstrated a robust correlation (r = 0.414, p < 0.001) with EQ-5D-5L in IBD patients. Elevated mindfulness levels emerged as predictive factors for higher HRQoL in IBD patients (OR: 1.101, 95% CI: 1.008, 1.202, p < 0.05, compared to low mindfulness). In summary, factors influencing the GBA, including mindfulness and the Mediterranean diet, exhibit positive associations with HRQoL. Increased mindfulness levels predict better HRQoL in IBD patients, emphasizing the potential for clinical trials to validate these cross-sectional study findings.
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Affiliation(s)
| | | | | | - Antonios E. Koutelidakis
- Laboratory of Nutritional and Public Health, Department of Food Science and Nutrition, University of the Aegean, 81400 Myrina, Greece; (E.C.)
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Pietruszka-Wałęka E, Rząd M, Rożyńska R, Miklusz P, Zieniuk-Lesiak E, Żabicka M, Jahnz-Różyk K. Quality of Life in Follow-Up up to 9 Months after COVID-19 Hospitalization among the Polish Population-A Prospective Single Center Study. Biomedicines 2024; 12:1282. [PMID: 38927489 PMCID: PMC11201014 DOI: 10.3390/biomedicines12061282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/30/2024] [Accepted: 06/07/2024] [Indexed: 06/28/2024] Open
Abstract
The consequences of COVID-19 constitute a significant burden to healthcare systems worldwide. Conducting an HRQoL assessment is an important aspect of the evaluation of the impact of the disease. The aim of this study was to investigate the prevalence of persistent symptoms and their impact on HRQoL and health status in COVID-19 convalescents. The study group consists of 46 patients who required hospitalization due to respiratory failure and who were subsequently evaluated 3 and 9 months after hospital discharge. At the follow-up visits, the patients were asked to assess their HRQoL using the EQ-5D-5L questionnaire. The results of chest CT, 6MWT, as well as the severity of the course of COVID-19 were also considered in the analysis. The obtained results have identified fatigue as the most common persistent symptom. The majority of the convalescents reported an impairment of HRQoL in at least one domain (80% and 82% after 3 and 9 months, respectively), of which the most common was that of pain/discomfort. The presence of ongoing symptoms may affect HRQoL in particular domains. The 6MWT outcome correlates with HRQoL 3 months after hospital discharge. Therefore, it may be useful in identifying patients with reduced HRQoL, allowing early interventions aimed at its improvement.
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Affiliation(s)
- Ewa Pietruszka-Wałęka
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Michał Rząd
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Renata Rożyńska
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Piotr Miklusz
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Emilia Zieniuk-Lesiak
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Magdalena Żabicka
- Department of Radiology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
| | - Karina Jahnz-Różyk
- Department of Internal Medicine, Pneumonology, Allergology and Clinical Immunology, Military Institute of Medicine—National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
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Cherng HRR, Qu M, Zafari Z, Bentzen SM, Armstrong TS, Gondi V, Brown PD, Mehta M, Mishra MV. Evaluating the sensitivity of EQ-5D-5L in patients with brain metastases: a secondary analysis of NRG CC001. J Natl Cancer Inst 2024; 116:983-989. [PMID: 38281073 PMCID: PMC11160499 DOI: 10.1093/jnci/djae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 01/29/2024] Open
Abstract
BACKGROUND EuroQoL EQ-5D-5L is a commonly used measure of health-related quality of life in clinical trials given the use of its index score as a measure of health utilities. It is unclear whether EQ-5D-5L is sensitive to changes in neurocognitive function and progression that occur following brain radiation. This study sought to evaluate the sensitivity of EQ-5D-5L in reflecting these changes. METHODS A secondary analysis of NRG Oncology CC001 was performed. Mean EQ-5D-5L index and visual analog scale (VAS) score changes from baseline between groups of patients stratified by neurocognitive function and intracranial progression status were assessed. MD Anderson Symptom Inventory for brain tumor (MDASI-BT) symptom and interference items were also analyzed between groups. RESULTS EQ-5D-5L mean index and VAS score changes between patients who had cognitive failure and those who had preserved cognition showed no statistically significant differences at any timepoint. In contrast, VAS changes at 4 months (1.61 vs -5.13, P = .05) and 6 months (8.17 vs -0.14, P = .04) were significantly improved in the patients who survived without intracranial progression. MDASI-BT cognitive factor scores were improved in the cohort of patients with preserved neurocognitive function at 2 months (1.68 vs 2.08, P = .05) and 4 months (1.35 vs 1.83, P = .04). MDASI-BT symptom interference was significantly associated with intracranial progression at 4 months, but not with neurocognitive status. CONCLUSION EQ-5D-5L index and VAS scores were not sensitive to neurocognitive changes that patients experienced, but VAS scores were sensitive to progression. This study challenges the routine use of EQ-5D as a quality of life metric in brain metastases clinical trials that are focused on preventing neurocognitive dysfunction. TRIAL REGISTRATION NCT# 02360215.
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Affiliation(s)
- Hua-Ren R Cherng
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD, USA
| | - Melody Qu
- Department of Radiation Oncology, London Regional Cancer Centre, London, ON, Canada
| | - Zafar Zafari
- Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Søren M Bentzen
- Division of Biostatistics and Bioinformatics, University of Maryland Greenebaum Cancer Center, and Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Terri S Armstrong
- Neuro-Oncology Branch, National Cancer Institute Center for Cancer Research, Bethesda, MD, USA
| | - Vinai Gondi
- Department of Radiation Oncology, Northwestern Medicine Cancer Center and Proton Center, Warrenville, IL, USA
| | - Paul D Brown
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Minesh Mehta
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Mark V Mishra
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
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Gerber F, Gupta R, Lejone TI, Tahirsylaj T, Lee T, Sanchez-Samaniego G, Kohler M, Haldemann MI, Raeber F, Chitja M, Mathulise M, Kabi T, Mokaeane M, Maphenchane M, Molulela M, Khomolishoele M, Mota M, Masike S, Bane M, Sematle MP, Makabateng R, Mphunyane M, Phaaroe S, Basler DB, Kindler K, Burkard T, Briel M, Chammartin F, Labhardt ND, Amstutz A. Community-based management of arterial hypertension and cardiovascular risk factors by lay village health workers for people with controlled and uncontrolled blood pressure in rural Lesotho: joint protocol for two cluster-randomized trials within the ComBaCaL cohort study (ComBaCaL aHT Twic 1 and ComBaCaL aHT TwiC 2). Trials 2024; 25:365. [PMID: 38845045 PMCID: PMC11157768 DOI: 10.1186/s13063-024-08226-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 06/03/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Arterial hypertension (aHT) is a major cause for premature morbidity and mortality. Control rates remain poor, especially in low- and middle-income countries. Task-shifting to lay village health workers (VHWs) and the use of digital clinical decision support systems may help to overcome the current aHT care cascade gaps. However, evidence on the effectiveness of comprehensive VHW-led aHT care models, in which VHWs provide antihypertensive drug treatment and manage cardiovascular risk factors is scarce. METHODS Using the trials within the cohort (TwiCs) design, we are assessing the effectiveness of VHW-led aHT and cardiovascular risk management in two 1:1 cluster-randomized trials nested within the Community-Based chronic disease Care Lesotho (ComBaCaL) cohort study (NCT05596773). The ComBaCaL cohort study is maintained by trained VHWs and includes the consenting inhabitants of 103 randomly selected villages in rural Lesotho. After community-based aHT screening, adult, non-pregnant ComBaCaL cohort participants with uncontrolled aHT (blood pressure (BP) ≥ 140/90 mmHg) are enrolled in the aHT TwiC 1 and those with controlled aHT (BP < 140/90 mmHg) in the aHT TwiC 2. In intervention villages, VHWs offer lifestyle counseling, basic guideline-directed antihypertensive, lipid-lowering, and antiplatelet treatment supported by a tablet-based decision support application to eligible participants. In control villages, participants are referred to a health facility for therapeutic management. The primary endpoint for both TwiCs is the proportion of participants with controlled BP levels (< 140/90 mmHg) 12 months after enrolment. We hypothesize that the intervention is superior regarding BP control rates in participants with uncontrolled BP (aHT TwiC 1) and non-inferior in participants with controlled BP at baseline (aHT TwiC 2). DISCUSSION The TwiCs were launched on September 08, 2023. On May 20, 2024, 697 and 750 participants were enrolled in TwiC 1 and TwiC 2. To our knowledge, these TwiCs are the first trials to assess task-shifting of aHT care to VHWs at the community level, including the prescription of basic antihypertensive, lipid-lowering, and antiplatelet medication in Africa. The ComBaCaL cohort and nested TwiCs are operating within the routine VHW program and countries with similar community health worker programs may benefit from the findings. TRIAL REGISTRATION ClinicalTrials.gov NCT05684055. Registered on January 04, 2023.
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Affiliation(s)
- Felix Gerber
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
| | | | - Thabo Ishmael Lejone
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Thesar Tahirsylaj
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Tristan Lee
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Giuliana Sanchez-Samaniego
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Maurus Kohler
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Maria-Inés Haldemann
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Fabian Raeber
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Dave Brian Basler
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Kevin Kindler
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- Faculty of Business, Economics and Informatics, University of Zurich, Zurich, Switzerland
| | - Thilo Burkard
- Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, Basel, Switzerland
- Department of Cardiology, University Hospital Basel, Basel, Switzerland
| | - Matthias Briel
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Frédérique Chammartin
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Niklaus Daniel Labhardt
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Alain Amstutz
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Oslo Center for Biostatistics and Epidemiology, Oslo University Hospital, University of Oslo, Oslo, Norway
- Bristol Medical School, University of Bristol, Bristol, UK
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Schmidt J, Düvel JA, Elkenkamp S, Greiner W. Comparing the EQ-5D-5L and stroke impact scale 2.0 in stroke patients: an analysis of measurement properties. Health Qual Life Outcomes 2024; 22:45. [PMID: 38835023 DOI: 10.1186/s12955-024-02252-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/20/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Stroke has evolved to become a chronic disease and a major public health challenge. To adequately capture the full disease burden of stroke patients, the assessment of health-related quality of life (HRQoL) and thus the performance of respective measures is increasingly relevant. The aim of this analysis was to compare the measurement properties of two self-report instruments, the EQ-5D-5L and the Stroke Impact Scale 2.0. METHODS The data used for the analysis was derived from a quasi-experimental case management study for mildly to moderately affected incident stroke and transient ischemic attack (TIA) patients aged ≥ 18 in Germany. Data was collected patient-individually at 3, 6 and 12 months after initial stroke. The EQ-5D-5L and SIS 2.0 were compared in terms of feasibility, ceiling and floor effects, responsiveness and known-groups validity (Kruskal-Wallis H and Wilcoxon rank-sum test). RESULTS A response for all three follow-ups is available for n = 855 patients. The feasibility of the EQ-5D-5L is determined as good (completion rate: 96.4-96.6%, ≥ one item missing: 3.2 - 3.3%), whereas the SIS 2.0 is moderately feasible (overall completion rate: 44.9-46.1%, ≥ one item missing in domains: 4.7 - 28.7%). The SIS 2.0 shows substantial ceiling effects in comparable domains (physical function: 10.4 - 13%, others: 3.5-31.3%) which are mainly larger than ceiling effects in the EQ-5D-5L index (17.1-21.5%). In terms of responsiveness, the EQ-5D-5L shows small to moderate change while the SIS 2.0 presents with moderate to large responsiveness. The EQ-5D-5L index, mobility, usual activities and Visual Analogue Scale show known-groups validity (p < 0.05). Content-related domains of the SIS 2.0 show known-groups validity as well (p < 0.05). However, it is compromised in the emotion domain in both measures (p > 0.05). CONCLUSIONS The EQ-5D-5L seems to be slightly more suitable for this cohort. Nonetheless, the results of both measures indicate limited suitability for TIA patients. Large-scale studies concerning responsiveness and known-groups validity are encouraged. TRIAL REGISTRATION The study was registered in the German Clinical Trials Register, retrospective registration on 21.09.2022. REGISTRATION ID DRKS00030297.
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Affiliation(s)
- Juliana Schmidt
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, Germany.
| | - Juliane Andrea Düvel
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Svenja Elkenkamp
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Wolfgang Greiner
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, Germany
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Alebouyeh F, Boutron I, Ravaud P, Tran VT. Psychometric properties and domains covered by patient-reported outcome measures used in trials assessing interventions for chronic pain. J Clin Epidemiol 2024; 170:111362. [PMID: 38615827 DOI: 10.1016/j.jclinepi.2024.111362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 04/03/2024] [Accepted: 04/07/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVES To identify the patient-reported outcome measures (PROMs) used in clinical trials assessing interventions for chronic pain, describe their psychometric properties, and the clinical domains they cover. STUDY DESIGN AND SETTING We identified phase 3 or 4 interventional trials: on adult participants (aged >18 years), registered in clinicaltrials.gov between January 1, 2021 and December 31, 2022, and which provided "chronic pain" as a keyword condition. We excluded diagnostic studies and phase 1 or 2 trials. In each trial, one reviewer extracted all outcomes registered and identified those captured using PROMs. For each PROM used in more than 1% of identified trials, two reviewers assessed whether it covered the six important clinical domains from the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT): pain, emotional functioning, physical functioning, participant ratings of global improvement and satisfaction with treatment, symptoms and adverse events, and participant disposition (eg, adherence to medication). Second, reviewers searched PubMed for both the initial publication and latest review reporting the psychometric properties of each PROM and assessed their content validity, structural validity, internal consistency, reliability, measurement error, hypotheses testing, criterion validity, and responsiveness using published criteria from the literature. RESULTS In total, 596 trials assessing 4843 outcomes were included in the study (median sample size 60, interquartile range 40-100). Trials evaluated behavioral (22%), device-based (21%), and drug-based (10%) interventions. Of 495 unique PROMs, 55 were used in more than 1% trials (16 were generic pain measures; 8 were pain measures for specific diseases; and 30 were measures of other symptoms or consequences of pain). About 50% PROMs had more than 50% of psychometric properties rated as sufficient. Scales often focused on a single clinical domain. Only 25% trials measured at least three clinical domains from IMMPACT. CONCLUSION Half of PROMs used in trials assessing interventions for chronic pain had sufficient psychometric properties for more than 50% of criteria assessed. Few PROMs assessed more than one important clinical domain. Only 25% of trials measured more than 3/6 clinical domains considered important by IMMPACT.
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Affiliation(s)
- Farzaneh Alebouyeh
- Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, AP-HP, Paris, France
| | - Isabelle Boutron
- Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, AP-HP, Paris, France; Université Paris Cité, CRESS, INSERM, INRAE, Paris, France
| | - Philippe Ravaud
- Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, AP-HP, Paris, France; Université Paris Cité, CRESS, INSERM, INRAE, Paris, France; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Viet-Thi Tran
- Centre d'Epidémiologie Clinique, Hôpital Hôtel-Dieu, AP-HP, Paris, France; Université Paris Cité, CRESS, INSERM, INRAE, Paris, France.
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Downs J, Norman R, Mulhern B, Jacoby P, Reddihough D, Choong CS, Finlay-Jones A, Blackmore AM. Psychometric Properties of the EQ-5D-Y-5L for Children With Intellectual Disability. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:776-783. [PMID: 38467188 DOI: 10.1016/j.jval.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/25/2024] [Accepted: 02/28/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVES The EQ-5D-Y-5L is a generic preference-based measure of health-related quality of life for children. This study aimed to describe the distributional properties, test-retest reliability, and convergent validity of the EQ-5D-Y-5L in children with intellectual disability (ID). METHODS Caregivers of children with ID (aged 4 to 18 years) completed an online survey, including a proxy-report EQ-5D-Y-5L, the Quality-of-life Inventory-Disability, and disability-appropriate measures corresponding to the EQ-5D dimensions: mobility, self-care (SC), usual activities (UA), pain/discomfort (PD), and worry/sadness/unhappiness. Twenty-one participants repeated the EQ-5D-Y-5L a few weeks later. Test-retest reliability was computed using weighted kappa and intraclass correlation coefficients, and convergent validity using Spearman's and Pearson's correlation coefficients. RESULTS Caregivers of 234 children completed the survey, with <1% missing values. Only 1.7% reported "no problems" on all dimensions (11111). The dimensions with the lowest percentage of "no problems" were SC and UA (both 8%). Test-retest reliability coefficients were fair to substantial for 4 dimensions (weighted kappa .30 to .79) but low for PD and overall health, as measured by the visual analog scale (EQ-VAS). Convergent validity was strong (Spearman's correlation .65 to .87) for mobility, SC, and PD; moderate to strong for worry/sadness/unhappiness (.47 to .60) and the EQ-VAS (Pearson's correlation .49); and weak to moderate for UA (.21 to .52). CONCLUSIONS Convergent validity was generally good; test-retest reliability varied. Children with ID had lower scores on SC and UA than other populations, and their EQ-VAS could fluctuate greatly, indicating poorer and less stable health-related quality of life.
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Affiliation(s)
- Jenny Downs
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Nedlands, WA, Australia; School of Allied Health, Curtin University, Bentley, WA, Australia
| | - Richard Norman
- Population Health, Curtin University, Bentley, WA, Australia
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, NSW, Australia
| | - Peter Jacoby
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Nedlands, WA, Australia
| | - Dinah Reddihough
- Murdoch Children's Research Institute, Parkville, Vic, Australia; Department of Paediatrics, University of Melbourne, Vic, Australia; Royal Children's Hospital, Melbourne, Vic, Australia
| | - Catherine S Choong
- Perth Children's Hospital, Nedlands, WA, Australia; School of Medicine, The University of Western Australia, Nedlands, WA, Australia
| | - Amy Finlay-Jones
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Nedlands, WA, Australia; Population Health, Curtin University, Bentley, WA, Australia
| | - A Marie Blackmore
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Nedlands, WA, Australia.
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Wiertz CMH, Hemmen B, Sep SJS, Verbunt JA. Caregiver burden and impact on COVID-19 patient participation and quality of life one year after ICU discharge - A prospective cohort study. PATIENT EDUCATION AND COUNSELING 2024; 123:108221. [PMID: 38460347 DOI: 10.1016/j.pec.2024.108221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVES to investigate changes in caregiver strain, mental health complaints and QoL in caregivers of COVID-19 ICU survivors in the first year after discharge, and their associations with patients' participation and quality of life. METHODS Post-ICU COVID-19 survivors, needing inpatient rehabilitation and their informal caregivers were included. Caregiver self-administered questionnaires included quality of life, self-rated health, caregiver strain, anxiety and depression symptoms, post-traumatic stress and coping style. Patients' participation in society was assessed and quality of life. RESULTS 67 patients (78% male) and 57 caregivers (23.6% male) were included. Three months post-ICU, caregivers experienced caregiver strain (32%), anxiety (41%), depressive symptoms (16%) and PTSD (24%). One year post-ICU, rates decreased, still being 11%, 26%, 10% and 5%, respectively. Caregiver anxiety symptoms and self-rated health at three months were associated with worse patient levels of participation and quality of life one year after ICU discharge (p < 0.05). CONCLUSIONS COVID-19 caregivers experience high levels of mental health complaints one year after a patient's ICU discharge. Furthermore, our results indicate that patient participation levels and quality of life one year after ICU discharge may be negatively associated by caregiver complaints. PRACTICAL IMPLICATIONS Counselling and routine assessment of emotional complaints and unmet needs of the informal caregiver should be incorporated and addressed in the rehabilitation treatment of (COVID-19) post-ICU patients.
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Affiliation(s)
- Carolina M H Wiertz
- Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands; Department of Rehabilitation Medicine Research School CAPHRI, Maastricht University, Maastricht, the Netherlands.
| | - Bena Hemmen
- Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands; Department of Rehabilitation Medicine Research School CAPHRI, Maastricht University, Maastricht, the Netherlands; Department of Rehabilitation Medicine, Zuyderland, Heerlen, the Netherlands
| | - Simone J S Sep
- Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands; Department of Rehabilitation Medicine Research School CAPHRI, Maastricht University, Maastricht, the Netherlands
| | - Jeanine A Verbunt
- Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands; Department of Rehabilitation Medicine Research School CAPHRI, Maastricht University, Maastricht, the Netherlands
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Vieira RJ, Leemann L, Briggs A, Pereira AM, Savouré M, Kuna P, Morais-Almeida M, Bewick M, Azevedo LF, Louis R, Klimek L, Bahbah F, Samolinski B, Anto JM, Zuberbier T, Fonseca JA, Bousquet J, Sousa-Pinto B. Poor Rhinitis and Asthma Control Is Associated With Decreased Health-Related Quality of Life and Utilities: A MASK-air Study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1530-1538.e6. [PMID: 38561141 DOI: 10.1016/j.jaip.2024.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/15/2024] [Accepted: 03/21/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Allergic rhinitis (AR) and asthma may affect health-related quality of life. However, national estimates on the quality of life of patients with AR or asthma are lacking. OBJECTIVE To provide estimates for utility scores and EuroQoL five-dimension (EQ-5D) visual analog scale (VAS) for patients with AR or asthma. METHODS We conducted a cross-sectional study using direct patient data from the MASK-air app on European MASK-air users with self-reported AR or asthma. We used a multi-attribute instrument (EQ-5D) to measure quality of life (as utility scores and EQ-5D VAS values). Mean scores were calculated per country and disease control level using multilevel regression models with poststratification, accounting for age and sex biases. RESULTS We assessed data from 7905 MASK-air users reporting a total of up to 82,737 days. For AR, utilities ranged from 0.86 to 0.99 for good control versus 0.72 to 0.85 for poor control; EQ-5D VAS levels ranged from 78.9 to 87.9 for good control versus 55.3 to 64.2 for poor control. For asthma, utilities ranged from 0.84 to 0.97 for good control versus 0.73 to 0.87 for poor control; EQ-5D VAS levels ranged from 68.4 to 81.5 for good control versus 51.4 to 64.2 for poor control. Poor disease control was associated with a mean loss of 0.14 utilities for both AR and asthma. For the same control levels, AR and asthma were associated with similar utilities and EQ-5D VAS levels. However, lower values were observed for asthma plus AR compared with AR alone. CONCLUSIONS Poor AR or asthma control are associated with reduced quality of life. The estimates obtained from mobile health data may provide valuable insights for health technology assessment studies.
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Affiliation(s)
- Rafael José Vieira
- Department of Community Medicine, Information, and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Lucas Leemann
- Department of Political Science, University of Zurich, Zurich, Switzerland
| | - Andrew Briggs
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ana Margarida Pereira
- Department of Community Medicine, Information, and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Marine Savouré
- Inserm, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, Villejuif, France; Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Sud, Villejuif, France
| | - Piotr Kuna
- Division of Internal Medicine, Asthma, and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | | | - Michael Bewick
- University of Central Lancashire Medical School, Preston, United Kingdom
| | - Luís Filipe Azevedo
- Department of Community Medicine, Information, and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Renaud Louis
- Department of Pulmonary Medicine, CHU Liège, Liège, Belgium; GIGA I3 Research Group, University of Liège, Liège, Belgium
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany; Center for Rhinology and Allergology, Wiesbaden, Germany
| | | | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards, Allergology and Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Josep M Anto
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Torsten Zuberbier
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin, Germany
| | - João A Fonseca
- Department of Community Medicine, Information, and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
| | - Jean Bousquet
- Institute of Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin, Germany; MASK-air SAS, Montpellier, France.
| | - Bernardo Sousa-Pinto
- Department of Community Medicine, Information, and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal; Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine, University of Porto, Porto, Portugal
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Cheng LJ, Engel L, Chen LA, Soh SZY, Koh GCH, Luo N. Using EQ-5D for Proxy Assessment of Health-Related Quality of Life in Residential Care Facilities: A Systematic Review of Feasibility and Psychometric Properties. J Am Med Dir Assoc 2024; 25:104870. [PMID: 38043585 DOI: 10.1016/j.jamda.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVES The accurate assessment of Health-Related Quality of Life (HRQoL) in residents of residential care facilities (RCF) necessitates the use of proxy-reported instruments that possess robust psychometric properties. Generally, these instruments are modified versions of self-reported tools, with adjustments made to pronouns and instructions to better suit the respondent. Among such tools, the EQ-5D has emerged as a prominent instrument for evaluating HRQoL within RCF settings. This review aimed to synthesize evidence on psychometric properties of the proxy version of EQ-5D. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Residents in RCF. METHODS An extensive search was conducted across 8 databases, covering articles from inception to May 29, 2023. We included a total of 20 articles reporting data that can be used to evaluate psychometric properties of this instrument in RCF. The quality appraisal employed the COSMIN Risk of Bias checklist, and data synthesis followed COSMIN methodology. RESULTS Most of the included studies were conducted in Europe, with 75% using nursing staff as proxies. Missing data rates were 5% for EQ-5D and 26% for EQ VAS. Evidence of moderate certainty on construct validity of the EQ-5D index was inconsistent, although the EQ VAS showed sufficient construct validity supported by high certainty. EQ-5D index responsiveness evidence was limited, characterized by low certainty and inconsistency. Proxy-resident agreement ranged from poor to moderate, and improved with repeated administration for the "mobility" and "usual activities" dimensions. The lowest agreement was observed when staff served as proxies or the proxy-proxy perspective was adopted. CONCLUSIONS AND IMPLICATIONS This review offers an overview of the psychometric properties of EQ-5D as a proxy HRQoL measure in RCF. The suboptimal evidence on psychometric properties of EQ-5D indicated the need for more validation studies and cautious use of the instrument in RCF.
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Affiliation(s)
- Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Lidia Engel
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Le Ann Chen
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Sonia Zhi Yi Soh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Gerald Choon-Huat Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Dean's Office and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Medicine, National University Hospital, Singapore
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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Ashe MC, Dos Santos IK, Alfares H, Chudyk AM, Esfandiari E. Outcomes and instruments used in social prescribing: a modified umbrella review. Health Promot Chronic Dis Prev Can 2024; 44:244-269. [PMID: 38916553 PMCID: PMC11346766 DOI: 10.24095/hpcdp.44.6.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
INTRODUCTION Previous social prescribing work highlights a range in the types and number of outcomes used in published studies. We aimed to describe social prescribing outcome core areas and instruments to build capacity for future research and program evaluation. METHODS This was a modified umbrella review following standard guidelines. We registered the study and searched multiple databases (all languages and years); inclusion criteria were peer-reviewed publications containing outcomes for self-described social prescribing for adults aged 18 years and older. The last search date was 9 July 2023. From the included systematic reviews, we identified primary studies using the same inclusion criteria. For primary studies, we sorted extracted outcomes and instruments into six core areas using a published taxonomy. We located information on instruments' description and measurement properties and conducted two rating rounds for (1) the quality of systematic reviews and (2) reporting of instruments in primary studies. We conducted a narrative synthesis of reviews, primary studies and outcomes (PROSPERO 2023 CRD42023434061). RESULTS We identified 10 systematic reviews and 33 primary studies for inclusion in our review. Outcomes covered most core taxonomy areas, with an emphasis on psychosocial factors (e.g. well-being) and less emphasis on cognition, physical activity, and caregivers and volunteers. We noted few studies provided detailed information on demographic data of participants or measurement properties of instruments. CONCLUSION This synthesis provides an overview and identifies knowledge gaps for outcomes and instruments used in social prescribing interventions. This work forms the basis of our next step of identifying social prescribing-related outcomes that matter most across interested parties, such as individuals providers and decision makers.
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Affiliation(s)
- Maureen C Ashe
- Department of Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada
- Edwin S.H. Leong Centre for Healthy Aging, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Isis Kelly Dos Santos
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Hadil Alfares
- Department of Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada
- Edwin S.H. Leong Centre for Healthy Aging, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Anna M Chudyk
- College of Pharmacy, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Elham Esfandiari
- Department of Family Practice, The University of British Columbia, Vancouver, British Columbia, Canada
- Edwin S.H. Leong Centre for Healthy Aging, The University of British Columbia, Vancouver, British Columbia, Canada
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Cheuk Wai Ng C, Wai Ling Cheung A, Lai Yi Wong E. Exploring potential EQ-5D bolt-on dimensions with a qualitative approach: an interview study in Hong Kong SAR, China. Health Qual Life Outcomes 2024; 22:42. [PMID: 38816769 PMCID: PMC11141055 DOI: 10.1186/s12955-024-02259-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/14/2024] [Indexed: 06/01/2024] Open
Abstract
PURPOSE The introduction of bolt-on dimensions in EQ-5D instruments is growing common, but most bolt-on studies have targeted the diseased population and obtained bolt-on from other existing Health-related Quality of Life (HRQoL) instruments. As the qualitative approach offers important evidence to support the consistency and design of the potential bolt-on items, this paper studies the Hong Kong SAR community's perception of the current EQ-5D-5 L instrument and identifies potential bolt-on via a qualitative approach. METHODS A representative sample mix was recruited based on the age group, gender, and education level composition of the Hong Kong SAR community by quota sampling. Semi-structured interviews were conducted and the interviews were transcribed and coded to identify emergent and recurrent themes. RESULTS Thirty interviews were conducted and the majority of the interviewees considered the EQ-5D-5 L insufficiently comprehensive to illustrate their HRQoL. While some key HRQoL aspects included in the EQ-5D matched with the community's HRQoL perception, respondents showed concern about the potential overlap of the existing HRQoL dimension, the optimal number or attributes, and the appropriateness of the EQ-VAS. Among the potential bolt-on dimensions that emerged, 'Sleep', 'Interpersonal Relationship', and 'Satisfaction' were the key potential bolt-on dimensions identified and emphasized in the interviews. CONCLUSIONS The qualitative findings of the study illustrate the possible gap between EQ-5D-5 L measurements and community HRQoL perception, while the findings support the development of EQ-5D bolt-on dimensions in the target community with content and face validity.
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Affiliation(s)
- Clement Cheuk Wai Ng
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Annie Wai Ling Cheung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Lai Yi Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Rm418, School of Public Health Building, Prince of Wales Hospital, Sha Tin, New Territories, Hong Kong SAR, China.
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