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Stenberg U, Westfal L, Dybesland Rosenberger A, Ørstavik K, Flink M, Holmen H, Systad S, Westermann KF, Velvin G. A scoping review of health literacy in rare disorders: key issues and research directions. Orphanet J Rare Dis 2024; 19:328. [PMID: 39243094 PMCID: PMC11380335 DOI: 10.1186/s13023-024-03332-5] [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: 10/25/2023] [Accepted: 08/21/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND The ability to find, understand, appraise and utilise health information is crucial among individuals living with rare disorders. The aim of this study was to give a comprehensive overview of the literature on health literacy in adult persons with rare disorders. METHODS We applied a scoping review methodology and performed a systematic search in 2021 in bibliographic databases. Searches were conducted in Medline (Ovid), Embase (Ovid), PsycInfo (Ovid), CINAHL (ebsco), and ERIC (Ovid). References were sorted and evaluated for inclusion using EndNote and Covidence. This review was guided by the question "What are the characteristics of research on health literacy in rare disorders?" RESULTS The database searches yielded 75 eligible reports. A total of 6223 individuals with rare disorders were represented alongside 1707 caregivers. The reports in this review have included study participants representing a total of 80 different rare disorders with unique ORPHA and ICD-10 codes. The results revealed that persons with rare disorders often exhibit gaps in health literacy through a lack of knowledge and access to information related to self-management, their own diagnosis and health, as well as daily coping and social rights. In addition, the importance of aid and information from healthcare personnel and the significance of getting social support from others in the same situation were accentuated. CONCLUSION This review emphasizes the importance of reinforcing health literacy among persons with rare disorders through peer support and education. This is the first review to give a comprehensive and state-of-the-art overview of literature investigating health literacy among persons with rare disorders and offers a basis for further research.
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Affiliation(s)
- Una Stenberg
- Frambu Resource Center for Rare Disorders, Sandbakkveien 18, Siggerud, 1404, Norway.
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Postboks 4959 Nydalen, Oslo, 0424, Norway.
| | - Lydia Westfal
- Frambu Resource Center for Rare Disorders, Sandbakkveien 18, Siggerud, 1404, Norway
| | - Andreas Dybesland Rosenberger
- National Neuromuscular Centre Norway, University Hospital of North-Norway, Hansine Hansens vei 37, Tromsø, 9019, Norway
| | - Kristin Ørstavik
- Section for Rare Neuromuscular Disorders and Unit for Congenital and Hereditary Neuromuscular Disorders (EMAN), Department of Neurology, Oslo University Hospital, Postboks 4950 Nydalen, Oslo, 0424, Norway
| | - Maria Flink
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solnavägen 1, Solna, 171 77, Sweden
| | - Heidi Holmen
- Oslo Metropolitan University, Postbox 4, St. Olavs place, Oslo, N-0130, Norway
| | - Silje Systad
- National Centre for Rare Epilepsy-Related Disorders, Department of Rare Disorders, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Postboks, 4950 Nydalen, 0424, Oslo, Norway
| | - Karl Fredrik Westermann
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Postboks 4959 Nydalen, Oslo, 0424, Norway
| | - Gry Velvin
- TRS Resource Centre for Rare Diseases, Sunnaas Rehabilitation Hospital, Bjørnemyrveien 11, 1453, Bjørnemyr, Norway
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Smith IC, Chakraborty S, Bourque PR, Sampaio ML, Melkus G, Lochmüller H, Woulfe J, Parks RJ, Brais B, Warman-Chardon J. Emerging and established biomarkers of oculopharyngeal muscular dystrophy. Neuromuscul Disord 2023; 33:824-834. [PMID: 37926637 DOI: 10.1016/j.nmd.2023.09.010] [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: 07/28/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 11/07/2023]
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is a rare, primarily autosomal dominant, late onset muscular dystrophy commonly presenting with ptosis, dysphagia, and subsequent weakness of proximal muscles. Although OPMD diagnosis can be confirmed with high confidence by genetic testing, the slow progression of OPMD poses a significant challenge to clinical monitoring and a barrier to assessing the efficacy of treatments during clinical trials. Accordingly, there is a pressing need for more sensitive measures of OPMD progression, particularly those which do not require a muscle biopsy. This review provides an overview of progress in OPMD biomarkers from clinical assessment, quantitative imaging, histological assessments, and genomics, as well as hypothesis-generating "omics" approaches. The ongoing search for biomarkers relevant to OPMD progression needs an integrative, longitudinal approach combining validated and experimental approaches which may include clinical, imaging, demographic, and biochemical assessment methods. A multi-omics approach to biochemical biomarker discovery could help provide context for differences found between individuals with varying levels of disease activity and provide insight into pathomechanisms and prognosis of OPMD.
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Affiliation(s)
- Ian C Smith
- The Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada
| | | | - Pierre R Bourque
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; Department of Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, ON K1H 8L6, Canada; Eric Poulin Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON K1Y 4E9, Canada
| | - Marcos L Sampaio
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; Eric Poulin Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON K1Y 4E9, Canada; Department of Medical Imaging, The Ottawa Hospital, Ottawa, Ontario K1Y 4E9, Canada; Department of Radiology, Radiation Oncology and Medical Physics, University of Ottawa, Ottawa, ON K1H 8L6, Canada
| | - Gerd Melkus
- Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; Eric Poulin Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON K1Y 4E9, Canada; Department of Medical Imaging, The Ottawa Hospital, Ottawa, Ontario K1Y 4E9, Canada; Department of Physics, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Hanns Lochmüller
- The Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; Department of Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, ON K1H 8L6, Canada; Eric Poulin Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON K1Y 4E9, Canada; Genetics, Children's Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
| | - John Woulfe
- The Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada; Eric Poulin Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON K1Y 4E9, Canada; Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, ON K1Y 4E9, Canada
| | - Robin J Parks
- The Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada; Department of Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, ON K1H 8L6, Canada; Eric Poulin Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON K1Y 4E9, Canada
| | - Bernard Brais
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Jodi Warman-Chardon
- The Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada; Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada; Department of Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, ON K1H 8L6, Canada; Eric Poulin Centre for Neuromuscular Disease, University of Ottawa, Ottawa, ON K1Y 4E9, Canada; Genetics, Children's Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada; Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec H3A 2B4, Canada.
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Côté C, Brais B, Sèbiyo Batcho C, Brisson JD, Youssof S, Allegue DR, Gagnon C. Introducing the Dysphagiameter: a novel patient-reported outcome measure for evaluating dysphagia in oculopharyngeal muscular dystrophy - from conceptual framework to initial development. Neuromuscul Disord 2023; 33:856-865. [PMID: 37923656 DOI: 10.1016/j.nmd.2023.09.001] [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: 04/19/2023] [Revised: 09/05/2023] [Accepted: 09/10/2023] [Indexed: 11/07/2023]
Abstract
Oculopharyngeal muscular dystrophy (OPMD) is a rare late-onset muscle disease associated with progressive dysphagia. As there was no patient-reported outcome measure specific for the assessment of dysphagia in OPMD, the Dysphagiameter was developed. The Food and Drug Administration guidance was followed. In Phase 1, a systematic literature review and an expert consultation were conducted to identify the concepts of interest. It was decided that the instrument should assess difficulty swallowing using pictures of foods of various textures (part A) and impact of dysphagia on activities and participation (part B), as defined by the International Classification of Functioning, Disability and Health. In Phase 2, focus groups (n = 3) and online surveys (n = 55) were conducted to generate the items. Then, the food items for part A were selected and grouped into 17 textures by a panel of registered dietitians. Cognitive interviews were conducted (n = 23) to refine the instrument and assess its clarity and comprehensiveness. The final draft included 82 food items assessing the capacity to swallow foods and drinks (part A) and 10 items assessing the impact of dysphagia on activities and participation (part B). Item reduction and assessment of psychometrics properties, using Rasch analysis, are ongoing as part of Phase 3.
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Affiliation(s)
- Claudia Côté
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001, 12e avenue Nord, Sherbrooke (Québec) J1H 5N4, Canada; Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Clinique des maladies neuromusculaires, Hôpital de Jonquière, 2230, rue de l'Hôpital, 7e étage, Jonquière (Québec) G7X 7X2, Canada.
| | - Bernard Brais
- Department of Neurology and Neurosurgery, Faculty of Medicine and Health Sciences, McGill University, 845, rue Sherbrooke O, Montréal (Québec) H3A OG4, Canada; Rare Neurological Diseases Research Group, The Neuro (Montreal Neurological Institute-Hospital), 3801, rue University, Montréal (Québec) H3A 2B4, Canada
| | - Charles Sèbiyo Batcho
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Institut de réadaptation en déficience de Québec, 525, boul Wilfrid-Hamel, Québec (Québec) G1M 2S8, Canada; Département de réadaptation, Faculté de médecine, Université Laval, Pavillon Ferdinand-Vandry, 1050, rue de la Médecine, Québec (Québec) G1V 0A6, Canada
| | - Jean-Denis Brisson
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001, 12e avenue Nord, Sherbrooke (Québec) J1H 5N4, Canada; Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Clinique des maladies neuromusculaires, Hôpital de Jonquière, 2230, rue de l'Hôpital, 7e étage, Jonquière (Québec) G7X 7X2, Canada
| | - Sarah Youssof
- Department of Neurology, Health Sciences, The University of New Mexico, MSC10 5620, 1 University of New Mexico, Albuquerque, NM 87131, USA
| | - Dorra Rakia Allegue
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 845, rue Sherbrooke O, Montréal (Québec) H3A 0G4, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal, Pavillon Lindsay, 6363, chemin Hudson, 5e étage, Montréal (Québec) H3S 1M9, Canada
| | - Cynthia Gagnon
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 3001, 12e avenue Nord, Sherbrooke (Québec) J1H 5N4, Canada; Groupe de recherche interdisciplinaire sur les maladies neuromusculaires (GRIMN), Clinique des maladies neuromusculaires, Hôpital de Jonquière, 2230, rue de l'Hôpital, 7e étage, Jonquière (Québec) G7X 7X2, Canada
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Côté C, Fortin J, Brais B, Youssof S, Gagnon C. Cross-cultural adaptation of the SWAL-QOL and the Sydney Swallow Questionnaire (SSQ) into French-Canadian and preliminary assessment for their use in an oculopharyngeal muscular dystrophy (OPMD) population. Qual Life Res 2021; 31:293-302. [PMID: 34292466 DOI: 10.1007/s11136-021-02915-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Patient-reported outcomes (PRO) assessing dysphagia are an essential component of clinical trials to consider how patients feel and function in response to treatments. The selected PRO needs to be translated in several languages using a systematic process ensuring its validity and equivalence for use in multicenter clinical trials. The main objectives were to translate the SWAL-QOL and the Sydney Swallow Questionnaire (SSQ) into French Canadian (SWAL-QOL-FC and SSQ-FC) and to assess their appropriateness for patients with oculopharyngeal muscular dystrophy (OPMD). METHODS A forward- and back-translation process was followed including independent mother-tongue translators followed by committee review. Known-groups validity was assessed by comparing scores of OPMD French-Canadian participants (n = 21) known to differ in dysphagia severity according to the 80-ml drinking test score. A Mann-Whitney test was used to compare the mean scores. Cognitive interviews were conducted later on to ensure a posteriori cultural equivalence among French-Canadian participants (n = 28). RESULTS Evidences of adequate known-groups validity was shown for the SSQ-FC. Only two domains out of 10 of the SWAL-QOL-FC (burden and eating duration) showed adequate known-groups validity. In addition, the difference in the mean composite score was not significant. Several conceptual equivalence issues were found in both questionnaires as a result of the cognitive interviews. CONCLUSION This study provided evidence that the SSQ-FC presents better validity than the SWAL-QOL-FC in a small sample size of OPMD participants. The findings of the cognitive interviews suggest the need to develop an OPMD-specific questionnaire to capture better the whole spectrum of disease severity.
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Affiliation(s)
- Claudia Côté
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Québec, Canada. .,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada. .,Centre de recherche Charles-Le Moyne-Saguenay-Lac-St-Jean sur les innovations en santé, University of Sherbrooke, Sherbrooke, Québec, Canada.
| | - Julie Fortin
- Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada
| | - Bernard Brais
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Québec, Canada
| | - Sarah Youssof
- Department of Neurology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Cynthia Gagnon
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Québec, Canada.,Groupe de recherche interdisciplinaire sur les maladies neuromusculaires, Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-St-Jean, Saguenay, Québec, Canada.,Centre de recherche Charles-Le Moyne-Saguenay-Lac-St-Jean sur les innovations en santé, University of Sherbrooke, Sherbrooke, Québec, Canada
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Argov Z, de Visser M. Dysphagia in adult myopathies. Neuromuscul Disord 2020; 31:5-20. [PMID: 33334661 DOI: 10.1016/j.nmd.2020.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/30/2020] [Accepted: 11/02/2020] [Indexed: 12/11/2022]
Abstract
Dysphagia (impaired swallowing) is not a rare problem in various neuromuscular disorders, both in the pediatric and the adult patient population. On many occasions such patients are first presented to other medical specialists or health professionals. Disorders of deglutition are probably underrecognized in patients with a neuromuscular disease as a result of patient's and doctor's delay. This review will focus on dysphagia in adults suffering from a myopathy. Dysphagia in myopathies usually affects the oropharyngeal phases which rely mostly on voluntary muscle activity of the mouth, pharynx and upper esophageal sphincter. Dysphagia is known to contribute to a reduction of quality of life and may also lead to increased morbidity and mortality. The review includes an overview on symptomatology and tools of assessments, and elaborates on dysphagia in specific hereditary and acquired myopathies.
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Affiliation(s)
- Zohar Argov
- Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Marianne de Visser
- Department of Neurology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands.
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