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Sakthong P, Boonyanuwat W. Impact of pharmacist-led pharmaceutical care on health-related and pharmaceutical therapy-related quality of life in patients with heart failure: A randomized controlled trial. Res Social Adm Pharm 2024; 20:1058-1063. [PMID: 39152069 DOI: 10.1016/j.sapharm.2024.08.003] [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: 05/02/2024] [Revised: 06/27/2024] [Accepted: 08/11/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Data on the impact of pharmacist-led pharmaceutical care (PC) on pharmaceutical therapy-related and health-related quality of life (HRQoL) and their sensitivities to PC provision in patients with heart failure (HF) are scarce. OBJECTIVES This study aimed to assess the impact of pharmacist-led PC on HRQoL employing the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and 5-level EuroQol 5 dimension (EQ-5D-5L) and on pharmaceutical therapy-related quality of life using the Patient-Reported Outcomes Measure of Pharmaceutical Therapy (PROMPT) in HF patients and compare sensitivities to the PC provision of these three tools. METHODS A single-blinded randomized controlled trial was conducted at a tertiary public hospital in Thailand between November 2022 and May 2023. Overall, 250 patients were randomly divided into the usual care (UC) (N = 124) and PC (N = 126) groups. Mixed effects models were used to investigate the differences in the mean change scores of PROMPT, EQ-5D-5L, and MLHFQ between the UC and PC groups. The sensitivities to PC provision of the three measures were evaluated using standardized effect sizes (SESs). RESULTS Significant differences were found in five of eight domains and the total score of the PROMPT between the PC and UC groups (all p < 0.05). However, no significant differences were found in the EQ-5D-5L and MLHFQ between the two groups (both p > 0.05). The SESs of the five domains and total score of PROMPT ranged from 0.29 to 1.65, considered small-to-large effect sizes, whereas the SESs of EQ-5D-5L and MLHFQ were -0.4 to 0, considered small effect sizes. CONCLUSIONS Pharmacist-led PC can positively affect pharmaceutical therapy-related quality of life using PROMPT in HF patients. Additionally, PROMPT is more sensitive to PC provision than EQ-5D-5L and MLHFQ.
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Affiliation(s)
- Phantipa Sakthong
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Phyathai Road, Pathumwan, Bangkok, 10330, Thailand.
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Mai VQ, Van Minh H, Lindholm L, Sun S, Kim GB, Sahlén KG. Acceptability of the use of health related quality of life measurements for decision-making in healthcare science in Vietnam: a qualitative study. BMJ Open 2024; 14:e082405. [PMID: 39179276 PMCID: PMC11344514 DOI: 10.1136/bmjopen-2023-082405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 07/09/2024] [Indexed: 08/26/2024] Open
Abstract
OBJECTIVE This study was conducted with the objective of exploring the usage of health-related quality of life (HRQOL) outcomes and willingness of health technology assessment (HTA) and public health stakeholders to use the EQ-5D-5L instrument in healthcare decision-making processes in Vietnam. METHOD In this qualitative study, 11 interviews were held with key stakeholders involved in healthcare decision-making for HTA between June 2021 and June 2022. The interviewees included members of the Vietnamese pharmacoeconomic council and public-health professionals from a diverse array of regions of Vietnam. The data collection involved obtaining verbal consent, warm-up discussions and interviews conducted via Zoom, with subsequent verification by interviewees. The analysis employed a theoretical thematic approach, adopting a deductive methodology to identify and analyse underlying ideas and meanings within the empirical data. RESULTS This study highlights the general importance and viability of HRQOL measures, and more particularly the EQ-5D-5L instrument, in healthcare decision-making in Vietnam. Challenges have been identified, including insufficient recognition, interpretation, standardisation and educational initiatives relating to HRQOL measurements. This study advocates for official training programmes on HRQOL measurements, guidelines for the application of the EQ-5D-5L and an open HRQOL database in Vietnam. Concerns regarding validity and outcome variation in HRQOL measurements underline the necessity for continuous psychometric properties assessments and regular updates to national HRQOL data in the Vietnamese context. CONCLUSION HRQOL outcomes are important, and Vietnamese stakeholders express a readiness to employ the EQ-5D-5L in healthcare decision-making, especially HTA. Nevertheless, HRQOL measurements, including the EQ-5D-5L, are currently inadequately used in Vietnam, and further efforts are required to improve utilisation.
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Affiliation(s)
- Vu Quynh Mai
- Centre for Population Health Sciences, Hanoi University of Public Health, Ha Noi, Viet Nam
- Department of Epidemiology and Global Health, Umeå University, Umea, Sweden
| | | | - Lars Lindholm
- Department of Epidemiology and Global Health, Umeå University, Umea, Sweden
| | - Sun Sun
- Department of Epidemiology and Global Health, Umeå University, Umea, Sweden
- Department of Learning, Informatics Management and Ethics Karolinska Institute, Stockholm, Sweden
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Alzarea AI, Khan YH, Alzarea SI, Alanazi AS, Alsaidan OA, Alrowily MJ, Al-Shammari M, Almalki ZS, Algarni MA, Mallhi TH. Assessment of Health-Related Quality of Life Among Patients with Chronic Diseases and Its Relationship with Multimorbidity: A Cross-Sectional Study from Saudi Arabia. Patient Prefer Adherence 2024; 18:1077-1094. [PMID: 38854480 PMCID: PMC11162240 DOI: 10.2147/ppa.s448915] [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: 11/27/2023] [Accepted: 03/21/2024] [Indexed: 06/11/2024] Open
Abstract
Objective Chronic diseases hold the potential to worsen the overall health of patients by limiting their functional status, productivity, and capacity to live well, affecting their overall health-related quality of life (HRQoL). The purpose of the study was to assess the HRQoL of individuals with chronic diseases residing in the Al-Jouf region of Saudi Arabia. Furthermore, the current study also sought to ascertain the impact of multimorbidity and the duration of illness on HRQoL. Material and Methods A cross-sectional study was conducted among the residents of Al-Jouf region for a period of 6 months. A self-administered EuroQoL (EQ-5D-5L) study tool was used. Appropriate statistical analysis was conducted to ascertain the relationship between various variables and HRQoL. Results A total of 500 out of 562 participants completed the study, with a response rate of 88.97%. Participants had a mean age of 46.15 ± 16.79 years, and the majority were female (n = 299; 59.80%). A mean HRQoL score of 0.82 ± 0.20 was reported, poorest in patients with kidney failure (0.65 ± 0.26) and highest in hepatitis. However, nearly half of the participants had diabetes mellitus type II (n = 205, 39.20%). Patients aged <30 years (OR: 0.109; p = 0.002), male participants (OR: 0.053; p < 0.001), no disability (OR: 0.143; p = 0.002), and <2 comorbid diseases (0.84 ± 0.18; p < 0.001) reported better QoL. Additionally, comorbid conditions such as DM, prolong the duration of the overall illness (14.19 ± 7.67 years). Overall, imperfect health (n = 390, 78%) was reported by the study participants. Conclusion The present study provided preliminary data about the current HRQoL status of individuals with imperfect health and lower HRQoL. In the future, large-scale longitudinal studies are required to investigate the most prevalent chronic diseases, their associations, and change in HRQoL, as there is a dearth of information in the Saudi population.
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Affiliation(s)
- Abdulaziz Ibrahim Alzarea
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Sami I Alzarea
- Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Abdullah Salah Alanazi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Omar Awad Alsaidan
- Department of Pharmaceutics, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
| | - Maily J Alrowily
- Department of Radiology, Aljouf Health Cluster, Domat Al-Jandal, Al-Jouf, Saudi Arabia
| | - Monefah Al-Shammari
- Domat Al-Jandal General Hospital, Aljouf Health Cluster, Domat Al Jandal, Al-Jouf, Saudi Arabia
| | - Ziyad Saeed Almalki
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Majed A Algarni
- Department of Clinical pharmacy, College of pharmacy, Taif university, Taif, Saudi Arabia
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia
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Kangwanrattanakul K, Krägeloh CU. EQ-5D-3L and EQ-5D-5L population norms for Thailand. BMC Public Health 2024; 24:1108. [PMID: 38649833 PMCID: PMC11036570 DOI: 10.1186/s12889-024-18391-3] [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: 11/14/2023] [Accepted: 03/19/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The previous Thai norm-based scores for the EQ-5D-5L were established with Thai general population samples aged 20-70 years in 2019. Nevertheless, these values need to be updated after the COVID-19 pandemic because of its effects on both physical and mental health. This study therefore aimed to establish population norms of the Thai EQ-5D-3L, EQ-5D-5L and EQ-VAS scores as well as to estimate disutility values associated with self-reported main diseases. METHODS Individual face-to-face interviews were conducted with 2000 adult (age ≥ 18 years) members of the general Thai population to estimate norm-based scores. Each participant completed the EQ-5D-3L and EQ-5D-5L as well as questions related to their sociodemographic factors and self-reported main diseases. Responses to the two instruments were converted to health utility (HU) scores on the basis of available value sets. Descriptive statistics were used to report the norm-based scores stratified by age and sex categories. Response redistribution determining the response consistency between EQ-5D versions was investigated. The HU score agreement from those two instruments was investigated using intraclass correlation coefficient (ICC). Tobit regression models were employed to investigate the relationships between sociodemographic factors and HU and EQ-VAS scores. Moreover, it was used to estimate the disutility values associated with self-reported main diseases. RESULTS The means (percentage of ceiling effects) of EQ-5D-3L, EQ-5D-5L, and EQ-VAS scores were 0.845 (57.80%), 0.923 (49.05%), and 79.83 (3.20%), respectively. The average percentage of inconsistent response was 1.09%. A good agreement level was found between both EQ-5D versions with the ICCs of 0.789 (95% CI: 0.558-0.878). Female, older, and unemployed participants and those with BMI ≥ 30 reported lower EQ-5D-3L and EQ-5D-5L than their counterparts. Bone/Joint disorder and stroke contributed to the largest disutility value for those two instruments. CONCLUSIONS The Thai norm-based scores from those two instruments were diminished when advancing age and among female, unemployed, and obese (BMI ≥ 30) participants. It is expected to provide information to policy makers to better allocate health care resources to those with diminished norm-based scores.
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Affiliation(s)
- Krittaphas Kangwanrattanakul
- Division of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, 169 Long-Hard Bangsaen Rd.,, Chonburi, Mueang, 20131, Thailand.
| | - Christian U Krägeloh
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
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Xu RH, Dai Y, Ng SSM, Tsang HWH, Zhang S, Dong D. Assessing validity of the EQ-5D-5L proxy in children and adolescents with Duchenne muscular dystrophy or spinal muscular atrophy. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:103-115. [PMID: 36809586 DOI: 10.1007/s10198-023-01574-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To assess the psychometric properties of the EuroQol-5-Dimension five-level instrument (EQ-5D-5L) proxy in caregivers of children and adolescents with Duchenne muscular dystrophy (DMD) or spinal muscular atrophy (SMA). METHOD Data were collected using the EQ-5D-5L proxy for individuals with DMD or SMA, as reported by their caregivers. Ceiling and floor effects, reliability (Cronbach's alpha), convergent and divergent validity (Spearman's correlation coefficient and Bland-Altman plot) and known-group validity (analysis of variance) was used to assess the instrument's psychometric properties. RESULTS Totally, 855 caregivers completed the questionnaire. Significant floor effects were observed for most dimensions of the EQ-5D-5L in both SMA and DMD samples. The EQ-5D-5L was strongly correlated with the hypothesized subscales of the SF-12, which confirmed satisfactory convergent and divergent validity. The EQ-5D-5L can significantly differentiate between impaired functional groups for individuals, demonstrating satisfactory discriminative ability. The agreement between the EQ-5D-5L utility and EQ-VAS scores was poor. CONCLUSIONS Based on the measurement properties assessed in this study, the EQ-5D-5L proxy is a valid and reliable tool for measuring the health-related quality of life of individuals with DMD or SMA rated by caregivers. Further studies should examine the content validity of the EQ-5D as well as the performance of its young version in these two patient groups.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yi Dai
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong, China
| | - Shuyang Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Dong Dong
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
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Stienrut P, Pongpirul K, Phutrakool P, Savigamin C, Sermsaksasithorn P, Chanhom O, Jeamjumrus P, Pongchaichanon P, Nootim P, Soisamrong M, Chuthaputti A, Wanaratna K, Thaneerat T. Medical Cannabis Prescription Practices and Quality of Life in Thai Patients: A Nationwide Prospective Observational Cohort Study. Med Cannabis Cannabinoids 2024; 7:125-137. [PMID: 39144529 PMCID: PMC11324265 DOI: 10.1159/000540153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/25/2024] [Indexed: 08/16/2024] Open
Abstract
Introduction The legalization of cannabis in Thailand has renewed interest in its traditional medical use. This study aimed to explore the prescribing patterns of traditional practitioners and assess the impact of cannabis oil on patients' quality of life, with a specific focus on comparing outcomes between cancer and non-cancer patients. Methods We conducted a prospective observational cohort study across 30 sites in 21 Thai provinces to analyze the use of "Ganja Oil," a cannabis extract in 10% coconut oil, prescribed for symptoms like pain, anorexia, and insomnia across a diverse patient group, including cancer and migraines. Quality of life was assessed using the Edmonton Symptom Assessment Scale (ESAS) and EQ-5D-5L at baseline, 1, 2, and 3 months. The study included a predefined subgroup analysis to compare the effects on cancer versus non-cancer patients. Data management was facilitated through Research Electronic Data Capture (REDCap), with statistical analysis performed using Stata/MP. Results Among 21,284 participants, the mean age was 54.10 ± 15.32 years, with 52.49% being male. The baseline EQ-5D-5L index was 0.85 ± 0.24. Significant differences in EQ-5D-5L indices were seen between cancer patients (0.79 ± 0.32) and non-cancer patients (0.85 ± 0.23; p < 0.001). ESAS scores also differed significantly between these groups for all symptoms, except anxiety. The most frequent prescription of Ganja Oil was oral administration at bedtime (88.26%), with the predominant dosage being three drops daily, approximately 0.204 mg of tetrahydrocannabinol in total. Posttreatment, significant improvements were noted: the EQ-5D-5L index increased by 0.11 points (95% CI: 0.11, 0.11; p < 0.001) overall, 0.13 points (95% CI: 0.12, 0.14; p < 0.001) for cancer patients, and 0.11 points (95% CI: 0.10, 0.11; p < 0.001) for non-cancer patients. ESAS pain scores improved by -2.66 points (95% CI: -2.71, -2.61; p < 0.001) overall, -2.01 points (95% CI: -2.16, -1.87; p < 0.001) for cancer patients, and -2.75 points (95% CI: -2.80, -2.70; p < 0.001) for non-cancer patients, with similar significant improvements in other symptoms. Conclusion Our study indicates potential benefits of Ganja Oil for improving quality of life among Thai patients, as a complementary treatment. These findings must be viewed in light of the study's design limitations. Further controlled studies are essential to ascertain its efficacy and inform dosing guidelines.
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Affiliation(s)
- Pramote Stienrut
- Department of Thai Traditional and Alternative Medicine, Ministry of Public Health, Nonthaburi, Thailand
| | - Krit Pongpirul
- Center of Excellence in Preventive and Integrative Medicine and Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Infection Biology and Microbiomes, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
- Bumrungrad International Hospital, Bangkok, Thailand
| | - Phanupong Phutrakool
- Chula Data Management Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chatuthanai Savigamin
- Center of Excellence in Preventive and Integrative Medicine and Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pim Sermsaksasithorn
- Center of Excellence in Preventive and Integrative Medicine and Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Ornpapha Chanhom
- Department of Thai Traditional and Alternative Medicine, Ministry of Public Health, Nonthaburi, Thailand
| | - Panthakan Jeamjumrus
- Department of Thai Traditional and Alternative Medicine, Ministry of Public Health, Nonthaburi, Thailand
| | - Pimlada Pongchaichanon
- Department of Thai Traditional and Alternative Medicine, Ministry of Public Health, Nonthaburi, Thailand
| | - Preecha Nootim
- Department of Thai Traditional and Alternative Medicine, Ministry of Public Health, Nonthaburi, Thailand
| | - Mala Soisamrong
- Department of Thai Traditional and Alternative Medicine, Ministry of Public Health, Nonthaburi, Thailand
| | - Anchalee Chuthaputti
- Department of Thai Traditional and Alternative Medicine, Ministry of Public Health, Nonthaburi, Thailand
| | - Kulthanit Wanaratna
- Department of Thai Traditional and Alternative Medicine, Ministry of Public Health, Nonthaburi, Thailand
| | - Tewan Thaneerat
- Department of Thai Traditional and Alternative Medicine, Ministry of Public Health, Nonthaburi, Thailand
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Chanthana P, Atthakomol P, Manosroi W, Wongpakaran T, Kraisarin J, Sananpanich K. Comparison of patient preferences and responsiveness among common patient-reported outcome measures for hand/wrist injuries or disorders. J Orthop Traumatol 2023; 24:2. [PMID: 36622514 PMCID: PMC9829933 DOI: 10.1186/s10195-022-00681-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/28/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) were developed to examine patients' perceptions of functional health. Most studies compare the responsiveness of each type of questionnaire. However, reports of patient preferences among PROMs commonly used with patients with hand/wrist injuries or disorders are limited. This study aimed to compare patient preferences, factors associated with those preferences and responsiveness among the Disability of the Arm, Shoulder, and Hand (DASH), Michigan Hand Outcomes Questionnaire (MHQ), Patient-Rated Wrist/Hand Evaluation (PRWHE) and EQ-5D in patients with hand/wrist injuries or disorders. MATERIAL AND METHODS This retrospective cohort study collected data on 183 patients with hand/wrist injuries or diseases who had visited a hand/wrist outpatient clinic or were hospitalized for surgery between 2017 and 2020. Patients had to be at least 18 years old and able to complete the four questionnaires included in the study. The four PROMs (DASH, MHQ, PRWHE and EQ-5D) were administered to the patients prior to treatment. After completing the questionnaires, patients were asked to answer two open-ended questions regarding their preferences. Multinomial logistic regression was used to identify factors related to patient preferences. Results are presented as the relative risk ratio (RRR). The standardized response mean (SRM) was used to evaluate questionnaire responsiveness. RESULTS Of the 183 patients, most preferred the PRWHE questionnaire (n = 74, 41%), with the main reasons cited being "specific to injuries/diseases and reflects hand/wrist function (n = 23, 31%)" and "easy to complete (n = 22, 30%)." Sex was found to be associated with patient preference after adjusting for demographic data and reasons for choosing a PROM as confounders (RRR = 0.46, P value = 0.049). The PRWHE had the highest SRM, followed by DASH (0.92 and 0.88, respectively). CONCLUSIONS The PRWHE is the most preferred by patients and is the most responsive questionnaire. It is recommended for use in clinical practice in situations where a clinician would like to use only one PROM for evaluating patients with various types of hand/wrist problems. LEVEL OF EVIDENCE Prognostic III.
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Affiliation(s)
- Phongniwath Chanthana
- grid.7132.70000 0000 9039 7662Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pichitchai Atthakomol
- grid.7132.70000 0000 9039 7662Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand ,grid.7132.70000 0000 9039 7662Musculoskeletal Science and Translational Research Center, Chiang Mai University, Chiang Mai, Thailand ,grid.7132.70000 0000 9039 7662Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Worapaka Manosroi
- grid.7132.70000 0000 9039 7662Clinical Epidemiology and Clinical Statistic Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand ,grid.7132.70000 0000 9039 7662Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tinakon Wongpakaran
- grid.7132.70000 0000 9039 7662Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jirachart Kraisarin
- grid.7132.70000 0000 9039 7662Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kanit Sananpanich
- grid.7132.70000 0000 9039 7662Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Channarong P, Phongamwong C. Prevalence and risk factors of vitamin D deficiency among patients with chronic myofascial pain syndrome: a cross-sectional study. BMC Nutr 2023; 9:129. [PMID: 37964354 PMCID: PMC10647172 DOI: 10.1186/s40795-023-00792-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: 08/20/2023] [Accepted: 11/10/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Myofascial pain syndrome (MPS) is a common muscle condition characterized by painful trigger points. Vitamin D deficiency has been recognized as a precipitating factor of MPS. The present study aimed to determine the prevalence and risk factors of vitamin D deficiency in patients with chronic MPS. METHODS A cross-sectional study was conducted, using a structured face-to-face interview to collect demographic information, clinical characteristics, pain duration and location, as well as the bodily pain subscale of SF36 and EQ-5D-5 L. The Elecsys vitamin D total II assay was used to measure serum total 25-hydroxyvitamin D level. RESULTS Of 120 participants, vitamin D insufficiency (20 to 29.9 ng/ml) and deficiency (< 20 ng/ml) were 47.5% (95% CI: 38.3-56.8%) and 34.2% (95% CI: 25.8-43.4%), respectively. The adjusted odds ratios for vitamin D deficiency of participants aged < 45 years and who reported having ≤ 15 min sunlight exposure per day were 3.5 (95% CI: 1.54 to 7.98) and 2.38 (95% CI: 1.05 to 5.26), respectively. The bodily pain score (r = - 0.02, P = 0.86) and EQ-5D-5 L utility (r = 0.04, P = 0.66) did not significantly correlate with vitamin D levels. CONCLUSION Approximately one third of patients with chronic MPS had vitamin D deficiency. Age < 45 years and sunlight exposure ≤ 15 min/day were identified as potential risk factors for vitamin D deficiency in MPS patients.
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Affiliation(s)
- Pimpitcha Channarong
- Department of Rehabilitation Medicine, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Chanwit Phongamwong
- Department of Rehabilitation Medicine, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand.
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Kulthanachairojana N, Kangwanrattanakul K, Khongmee T, Pawasan N, Chityam S, Pornwattanakavee S. Health-related quality of life and willingness to pay measurement among patients on warfarin in Thailand. J Pharm Policy Pract 2023; 16:130. [PMID: 37904238 PMCID: PMC10614390 DOI: 10.1186/s40545-023-00632-2] [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: 08/11/2023] [Accepted: 10/09/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Complex dosage regimens and the high incidence of adverse events associated with warfarin therapy can affect the health-related quality of life (HRQoL) and willingness to pay (WTP) among patients on warfarin. No such previous study has been conducted to assess the HRQoL and WTP among Thai patients on warfarin; therefore, this study aimed to measure these parameters and identify some sociodemographic factors associated with those aspects among patients on warfarin in Thailand. METHODS This cross-sectional survey study involving 260 patients on warfarin between June 2022 and June 2023 used a quantitative method for data collection. Face-to-face interviews with well-trained interviewers were conducted and patients were required to complete the questionnaires of both World Health Organization Quality of Life-BREF (WHOQOL-BREF) and EQ-5D-5L to assess and measure their HRQoL levels. WTP was assessed using a bidding game technique. Descriptive statistics with mean and standard deviations were used to report HRQoL scores and WTP, whereas a generalized linear model was employed to identify factors associated with both HRQoL and WTP. RESULTS The mean EQ-5D index and mean EQ-VAS score were 0.89 ± 0.15 and 76.92 ± 15.95, respectively, whereas the mean WHOQOL-BREF domain scores were 59.18 ± 14.13, 68.56 ± 15.47, 59.13 ± 19.64, and 65.23 ± 14.04 for the physical, psychological, social, and environmental domains, respectively. Elderly participants (age > 60 years) and those with comorbidities had lower HRQoL scores than their counterparts. The mean WTP was 22.25 ± 32.19 USD for one patient's visit. The presence of comorbidities was the only factor significantly associated with WTP values. CONCLUSIONS Thai patients on warfarin have lower mean EQ-5D indexes and EQ-VAS scores than members of the general Thai population. Patients on warfarin with comorbidities have diminished HRQoL and WTP values. Therefore, all healthcare professionals should pay more attention to this group of patients on warfarin to achieve better outcomes.
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Affiliation(s)
- Nattanichcha Kulthanachairojana
- Division of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, 169 Long-Hard Bangsaen Rd., Mueang, Chonburi, 20131, Thailand
| | - Krittaphas Kangwanrattanakul
- Division of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, 169 Long-Hard Bangsaen Rd., Mueang, Chonburi, 20131, Thailand.
| | | | - Nampratai Pawasan
- Department of Pharmacy, Faculty of Medicine, Burapha University hospital, Chonburi, Thailand
| | - Sitanan Chityam
- Department of Pharmacy, Banglamung hospital, Chonburi, Thailand
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del Corral T, Fabero-Garrido R, Plaza-Manzano G, Navarro-Santana MJ, Fernández-de-las-Peñas C, López-de-Uralde-Villanueva I. Minimal Clinically Important Differences in EQ-5D-5L Index and VAS after a Respiratory Muscle Training Program in Individuals Experiencing Long-Term Post-COVID-19 Symptoms. Biomedicines 2023; 11:2522. [PMID: 37760964 PMCID: PMC10526144 DOI: 10.3390/biomedicines11092522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/21/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
The primary aim of this study was to determine the minimal clinically important difference (MCID) for the EuroQol-5D questionnaire (EQ-5D-5L) index and visual analogic scale (VAS) in individuals experiencing long-term post-COVID-19 symptoms. In addition, it was pretended to determine which variable discriminates better and to compare changes between individuals classified by the MCID. DESIGN Secondary analysis of a randomized controlled trial involving 42 individuals who underwent an 8-week intervention in a respiratory muscle training program. RESULTS A change of at least 0.262 and 7.5 for the EQ-5D-5L index and VAS represented the MCID, respectively. Only the EQ-5D-5L VAS showed acceptable discrimination between individuals who were classified as "improved" and those classified as "stable/not improved" (area under the curve = 0.78), although with a low Youden index (Youden index, 0.39; sensitivity, 46.2%; specificity, 93.1%). Those individuals who exceeded the established MCID for EQ-5D-5L VAS had significantly greater improvements in inspiratory muscle function, exercise tolerance, and peripheral muscle strength compared to participants classified as "stable/not improved". CONCLUSIONS Only the EQ-5D-5L VAS, especially when MCID was exceeded, showed an acceptable discriminative ability to evaluate the efficacy of an intervention in individuals with long-term post-COVID-19 symptoms.
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Affiliation(s)
- Tamara del Corral
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain; (T.d.C.); (R.F.-G.); (M.J.N.-S.); (I.L.-d.-U.-V.)
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Raúl Fabero-Garrido
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain; (T.d.C.); (R.F.-G.); (M.J.N.-S.); (I.L.-d.-U.-V.)
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain; (T.d.C.); (R.F.-G.); (M.J.N.-S.); (I.L.-d.-U.-V.)
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
| | - Marcos José Navarro-Santana
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain; (T.d.C.); (R.F.-G.); (M.J.N.-S.); (I.L.-d.-U.-V.)
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain;
| | - Ibai López-de-Uralde-Villanueva
- Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain; (T.d.C.); (R.F.-G.); (M.J.N.-S.); (I.L.-d.-U.-V.)
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
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Jayamaha AR, Herath NDM, Dharmarathna ND, Sandakumari HS, Ranadeva NDK, Fernando MM, Samarakoon NAW, Amarabandu PN, Senanayake B, Darshana T, Renuka N, Samarasinghe KL, Fernando N. Health-related quality of life in patients with substance use disorders enrolled to the residential treatment in Sri Lanka: a retrospective cross-sectional study. Qual Life Res 2023; 32:435-445. [PMID: 36245018 DOI: 10.1007/s11136-022-03270-4] [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: 10/03/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Substance use disorder (SUD) is a serious public health concern that requires continuum care with effective treatment modalities such as residential rehabilitation. Improvement in health-related quality of life (HRQoL) is one of the determinants of treatment and rehabilitation effectiveness. Therefore, a retrospective cross-sectional study was carried out in seven residential rehabilitation centres in Sri Lanka to determine the HRQoL of the rehabilitees with SUD. METHOD The HRQoL of 464 individuals at their enrolment and during the rehabilitation period was assessed using EuroQol five-level five-dimensional questionnaire (EQ-5D-5L). Data were analysed using IBM SPSS version 26. RESULTS The majority of the participants were Sinhala (n = 419, 90.3%) and Buddhist (n = 368, 79.3%) males (n = 461, 99.4%). Most were unmarried (n = 302, 65.1%), young adults (n = 385, 83.0%) who have pursued secondary or higher education (n = 276, 59.5%) and 87.3% were employed (n = 405). Most of the selected centres use biopsychosocial model (n = 4, 57.1%) as the rehabilitation approach while rest practice therapeutic community (n = 3, 42.9%). The average EQ-5D-5L index [range =( - 0.45)-1.00] of the rehabilitees at their enrolment was 0.52 ± 0.28 and the EQ-5D-5L Visual Analogue Scale (EQ-5D-5L VAS) score (range = 0-100%) was 47.17% ± 23.48%. The values were increased up to 0.83 ± 0.18 (EQ-5D-5L index) and 84.25% ± 16.79% (EQ-5D-5L VAS) during the rehabilitation period. Only 19.4% of the rehabilitees had a normal or upper normal HRQoL (≥ 0.75 EQ-5D-5L Index) at their enrolment and 72.2% of rehabilitees reported normal or upper normal HRQoL during the rehabilitation period. CONCLUSION A significant improvement in the HRQoL of the participants was observed during the residential treatment in comparison to the enrolment, despite the differences in the rehabilitation programs.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Nilani Renuka
- National Dangerous Drugs Control Board, Rajagiriya, Sri Lanka
| | | | - Neluka Fernando
- Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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12
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Prevolnik Rupel V, Mori Lukančič M, Ogorevc M. Costs and Quality of Life in Patients With Systemic Arterial Hypertension in Slovenia. Value Health Reg Issues 2023; 33:49-55. [PMID: 36242818 DOI: 10.1016/j.vhri.2022.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 08/02/2022] [Accepted: 09/02/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Systemic arterial hypertension (SAH) is one of the most critical risk factors for morbidity in chronic noncommunicable diseases. The aim of this study was to estimate the costs incurred by and the health-related quality of life (HRQoL) for a sample of patients with AH aged ≥ 65, in 2019. METHODS A sample of 142 patients who were taking medicines for SAH was selected from the urban and rural areas. The patients consented to participate in the study. Patients also reported their out-of-pocket expenditures connected to SAH and their HRQoL. HRQoL was measured using generic 5-level version of EQ-5D (EQ-5D-5L) and the disease-specific MINICHAL questionnaires. Descriptive analysis was used to present the results. Calculations were made using R (v4.01) software. RESULTS A sample of 141 patients filled out 17-item MINICHAL and 142 filled out the EQ-5D-5L questionnaire. Patients' MINICHAL mood and somatic domain scores were 5.5 and 3.5, respectively. EQ-5D-5L mean index utility score was 0.7 and the mean EQ VAS was 70.9. Pain/discomfort was the most affected health dimension as 60.6% of patients reported having problems. The 2 HRQoL questionnaires are moderately correlated (-0.215). The average annual costs of SAH treatment amounted to €274.3 per patient. The largest share of costs is represented by pharmacological treatment (30.5%) and out-of-pocket expenses (28.2%). CONCLUSIONS Our study is the first study in Slovenia to assess the costs incurred by and HRQoL of patients with SAH using bottom-up approach and societal perspective. It offers important input in a decision-analytic model to assess cost-effectiveness of interventions to reduce the burden of SAH.
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Affiliation(s)
| | | | - Marko Ogorevc
- Institute for Economic Research, Ljubljana, Slovenia
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13
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Moradi N, Poder TG, Safari H, Mojahedian MM, Ameri H. Psychometric properties of the EQ-5D-5L compared with EQ-5D-3L in cancer patients in Iran. Front Oncol 2022; 12:1052155. [PMID: 36568223 PMCID: PMC9782428 DOI: 10.3389/fonc.2022.1052155] [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: 10/18/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022] Open
Abstract
Background and Objective Psychometric evidence to support the validity and reliability of the EuroQol-5 Dimensions (EQ-5D) in cancer patients is limited. This study aimed to test the validity and reliability of the EQ-5D-5L (5L) in comparison with EQ-5D-3L (3L) in cancer patients. Methods Data of 650 cancer patients were collected through consecutive sampling method from three largest governmental cancer centers in Iran between June 2021 and January 2022. The data were gathered using the 3L, 5L, and the European Organization for Research and Treatment of Cancer quality of life questionnaire (QLQ-C30) instruments. The 3L and 5L were compared in terms of ceiling effect, discriminatory power, convergent and known-groups validity, relative efficiency, inconsistency, agreement, and reliability. Results Compared with the 3L, ceiling effect decreased by 27.86%. Absolute and relative informativity of discriminatory power improved by 45.93% and 22.92% in the 5L, respectively. All convergent validity coefficients with 5L were stronger than with 3L. Both 3L and 5L demonstrated good known-groups validity, and the relative efficiency was higher for 5L in 4 out of 7 patients' characteristics. The two instruments showed low overall inconsistency (1.45%) and 92.57% of the differences of observations between the 3L and 5L were within the 95% limit of agreement. The interclass correlation coefficient (ICC) for 3L and 5L indexes were 0.88 and 0.85, respectively, and kappa coefficients in the 3L dimensions (range=0.66-0.92) were higher than the 5L(range=0.64-0.79). Conclusions The 5L demonstrated to be better than the 3L in terms of ceiling effect, inconsistency, discriminatory power, convergent validity, relative efficiency.
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Affiliation(s)
- Nasrin Moradi
- Department of Health Management and Economics, School of Public Health, Iran University of Medical Science, Tehran, Iran
| | - Thomas G. Poder
- Department of Management, Evaluation and Health Policy, School of Public Health, University of Montreal, Montreal, QC, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, CIUSSS de l’Est de l’île de Montréal, Montreal, QC, Canada
| | - Hossein Safari
- Health Promotion Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad M. Mojahedian
- Department of Pharmacoeconomics, School of Pharmacy, Iran University of Medical Science, Tehran, Iran
| | - Hosein Ameri
- Health Policy and Management Research Center, Department of Health Management and Economics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Marthick-Hone D, Doyle AK, Kennedy GA, Vindigni D, Polus BI. The importance of setting and therapeutic relationships when delivering chiropractic care to those living with disadvantage. Chiropr Man Therap 2022; 30:47. [PMID: 36274135 PMCID: PMC9590208 DOI: 10.1186/s12998-022-00456-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 10/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chiropractic is a mostly privatised health profession within Australia, with people experiencing disadvantage typically having limited access due to financial barriers. However, some universities within Australia offer community outreach clinics where students provide chiropractic care to people living with disadvantage. This demographic experiences higher rates of chronic conditions including musculoskeletal complaints and requires subsidisation to access privatised care. This need also offers opportunity for the chiropractic profession to work within community healthcare teams. A mixed-methods observational study was used to investigate how the unique setting of a student chiropractic community clinic may influence the experience and outcomes of those who attend. METHODS Three patient-reported outcome measures (PROMs) investigated client outcomes: Measure Yourself Medical Outcome Profile (MYMOP); European Five Domain Five Level Quality of Life Questionnaire (EQ-5D-5L); and the Patient Enablement Instrument. The PROMs data were analysed descriptively and inferentially. Interviews were conducted with clients who had received chiropractic care, chiropractic students, clinical supervisors and staff of the centre. Interview data were coded using thematic analysis, and themes were formed using Bronfenbrenner's socio-ecological systems framework and non-participant observations. RESULTS Thirty-seven participants completed baseline PROMs and 17 completed follow-ups after four treatments. Seventy-two percent of participants nominated their primary complaint as chronic. Significant change was noted in general health and wellbeing for the MYMOP, pain and disability for the EQ-5D-5L and index scores for the EQ-5D-5L suggested improved health and wellbeing. Most clients experienced higher levels of enablement post treatment. Twelve participants were interviewed (four were clients), with five themes emerging from the interview data. Clients reported their lived experiences impacted their health problems and attending the clinic offered benefits beyond improvement of pain and disability. CONCLUSIONS Interview data suggested that these benefits were due to a combination of therapy, the setting and the relationships formed within that setting. Complementing this, PROM data suggested clients experienced better levels of health and wellbeing and decreased levels of pain and disability. Findings indicated that people who experienced disadvantage may receive broader benefits from attending community centres offering chiropractic care. Services such as chiropractic may be complementary in meeting the healthcare needs of those experiencing disadvantage.
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Affiliation(s)
- Dan Marthick-Hone
- Discipline of Chiropractic, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia.
| | - Aunty Kerrie Doyle
- grid.1029.a0000 0000 9939 5719Indigenous Health School of Medicine, University of Western Sydney, Campbelltown, Australia
| | - Gerard A. Kennedy
- grid.1040.50000 0001 1091 4859Institute of Health and Wellbeing, Federation University, Ballarat, Australia
| | - Dein Vindigni
- grid.1017.70000 0001 2163 3550Discipline of Chiropractic, School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
| | - Barbara I. Polus
- grid.1017.70000 0001 2163 3550School of Engineering, RMIT University, Bundoora, Australia
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Aung TNN, Moolphate S, Koyanagi Y, Angkurawaranon C, Supakankunti S, Yuasa M, Aung MN. Determinants of Health-Related Quality of Life Among Community-Dwelling Thai Older Adults in Chiang Mai, Northern Thailand. Risk Manag Healthc Policy 2022; 15:1761-1774. [PMID: 36164477 PMCID: PMC9508892 DOI: 10.2147/rmhp.s370353] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/02/2022] [Indexed: 11/23/2022] Open
Abstract
Background Population aging has been growing worldwide and Thailand has become an aged society with 20% of its population aged 60 and over. Age-related decline in physical and mental health impacts the health-related quality of life (HRQOL) of older adults. Purpose We aimed to describe the HRQOL of Thai older adults, residing in the community. Methods This cross-sectional survey was part of a Community-Integrated Intermediary Care project (CIIC), TCTR20190412004. A total of 1509 participants from an intervention arm of a cluster randomized controlled trial were included. A Thai version of the Euro-Qol questionnaire (EQ-5D-5L) was used to determine the HRQOL and associated sociodemographic background, health behaviors and underlying diseases of a representative sample from Maehia, Chiang Mai, Thailand. SPSS version 24 was used to analyze data via descriptive analysis and binary logistic regression. Results The mean age of the participants was 69.31±7.10 years, and nearly a quarter (23.8%) was older than 75 years. The mean EQ index score was 0.81±0.23 and older age, lower educational attainment, unemployment, lack of exercise habits, current smokers, having history of a fall in the last 6 months, diabetes, hyperlipidemia, dependency assessed using Barthel's Activity of Daily Living (ADL) Index, and depression using the Geriatric Depression Scale (GDS) were more likely to represent HRQOL-related problems. Conclusion Our findings have highlighted the factors affecting the HRQOL of community-dwelling older adults which could be of importance in preparing for active and healthy aging communities. The routine dependency assessment using the ADL index will be useful in estimating the HRQOL of the aging population. Fall prevention programs are also recommended to reduce dependency. Moreover, the association of having diabetes and hyperlipidemia with problems in HRQOL dimensions highlight the need for public health intervention not only to prevent the increasing burden of non-communicable diseases but also to improve the HRQOL of older adults.
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Affiliation(s)
- Thin Nyein Nyein Aung
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.,Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiangmai, 50300, Thailand
| | - Yuka Koyanagi
- Department of Medical and Health Science, Tokyo Ariake University, Tokyo, 135-0063, Japan
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.,Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Siripen Supakankunti
- Centre of Excellence for Health Economics, Faculty of Economics, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan, and.,Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan, and.,Faculty of International Liberal Arts, Juntendo University, Tokyo, 113-8421, Japan.,Advanced Research Institute for Health Sciences, Juntendo University, Tokyo, 113-8421, Japan
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Kangwanrattanakul K. A systematic review of health state utility values in Thai cancer patients. Expert Rev Pharmacoecon Outcomes Res 2022; 22:1171-1186. [DOI: 10.1080/14737167.2022.2123796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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17
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Blythe R, White N, Kularatna S, McPhail S, Barnett A. A Bayesian Approach for Incorporating the EQ-5D Visual Analog Scale When Estimating the Health-Related Quality of Life. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1575-1581. [PMID: 35304036 DOI: 10.1016/j.jval.2022.01.017] [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: 07/07/2021] [Revised: 11/10/2021] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The EuroQoL 3-level version of EQ-5D and 5-level version of EQ-5D questionnaires are often used to quantify health states. They include ordinal responses across 5 health dimensions (EQ-5D index) and an EQ-visual analog scale (EQ-VAS) overall health rating. We investigated the value of incorporating the EQ-VAS to update health utility estimates using a Bayesian framework. METHODS We created a joint bivariate normal EQ-VAS and EQ-5D index utility model and compared this to a univariate normal EQ-5D index utility model. We tested these models for 1026 Sri Lankan patients with chronic kidney disease and 94 Australian patients with wounds. We validated our approach by simulating EQ-VAS and EQ-5D index responses and applying our Bayesian model and then comparing the modeled estimates to our observed data. RESULTS The combined model showed a reduction in estimate uncertainty for all respondents. Compared with the EQ-5D index-only model, the mean utility for Sri Lankan respondents dropped from 0.556 (0.534-0.579) to 0.540 (0.521-0.559) in men and increased from 0.489 (0.461-0.518) to 0.528 (0.506-0.550) in women, with reduced credible interval width by 13% and 23%, respectively. The mean utility in Australian respondents moved from 0.715 (0.633-0.800) to 0.716 (0.652-0.782) in men, and 0.652 (0.581-0.723) to 0.652 (0.593-0.711) in women, with reduced credible interval width by 23% and 17%, respectively. The credible interval width for simulated data also narrowed, ranging from 8.3 to 8.5%. CONCLUSIONS Including the EQ-VAS through Bayesian methods can add value by reducing requisite sample sizes and decision uncertainty using small amounts of additional data that is often collected but rarely used.
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Affiliation(s)
- Robin Blythe
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
| | - Nicole White
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Steven McPhail
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Adrian Barnett
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
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Kuptniratsaikul V, Chaiworapuek W, Kovintaset K, Meesawang M, Chinsawangwatanakul P, Danoi A. Pain management and strength gains compared between pneumatic partial weight support treadmill and underwater treadmill in overweight patients with knee osteoarthritis: A randomized controlled trial. Clin Rehabil 2022; 36:1214-1228. [PMID: 35506932 DOI: 10.1177/02692155221097032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the efficacy of the pneumatic partial weight support treadmill compared to the underwater treadmill (UTM) for reducing pain and increasing quadriceps strength in overweight patients with knee osteoarthritis. DESIGN Non-inferiority trial with a pre-specified 1-point range. METHODS Participants (N = 109) were randomly assigned to the study (pneumatic partial weight support treadmill) (n = 55) or control (UTM) (n = 54) groups. Patients in both groups started with 50% weight support during the first week, 40% during the second week, and 30% during the third week and until the end of the study. Both groups received exercise for 30 min, 3 times per week for 8 weeks (24 sessions). Outcome measurements, including numerical pain rating scale, Western Ontario and McMaster Universities Osteoarthritis Index pain subscale, quadriceps strength, body weight, 6-min walking test, and quality of life, were evaluated at baseline, 8 weeks, and 12 weeks. RESULTS Only 74 participants completed the study. Numerical pain rating scale and the Western Ontario and McMaster Universities Osteoarthritis Index showed non-inferiority of the study to control group. Improvement in quadriceps strength was significantly greater in the study than in control group. Adverse events were not significantly different between groups. Most subjects were satisfied and rated themselves as improved or much improved. Approximately three-quarters of participants attended more than 20 sessions, and there was no significant difference in outcomes between good and poor compliance. CONCLUSION Pneumatic partial weight support treadmill can significantly decrease pain non-inferior to UTM, and can significantly increase quadriceps strength compared to UTM.
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Affiliation(s)
- V Kuptniratsaikul
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, 65106Mahidol University, Bangkok, Thailand
| | - W Chaiworapuek
- Department of Mechanical Engineering, Faculty of Engineering, 122106Kasetsart University, Bangkok, Thailand
| | - K Kovintaset
- Division of Physical Therapy, Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, 65106Mahidol University, Bangkok, Thailand
| | - M Meesawang
- Division of Physical Therapy, Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, 65106Mahidol University, Bangkok, Thailand
| | - P Chinsawangwatanakul
- Research Group and Research Network Division, Research Department, Faculty of Medicine Siriraj Hospital, 65106Mahidol University, Bangkok, Thailand
| | - A Danoi
- Division of Surgical Nursing, Department of Nursing, Siriraj Hospital, Bangkok, Thailand
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Zakershahrak M, Ribeiro Santiago PH, Sethi S, Haag D, Jamieson L, Brennan D. Psychometric properties of the EQ-5D-3L in South Australia: a multi-method non-preference-based validation study. Curr Med Res Opin 2022; 38:673-685. [PMID: 35060425 DOI: 10.1080/03007995.2022.2031941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Although HRQoL tools such as the EQ-5D-3L are significant in determining health status, these measures have not been validated in general populations in Australia. This study aims to psychometrically validate the EQ-5D-3L in a large population sample in Australia for the first time. METHODS The EQ-5D-3L was included in the Dental Care and Oral Health study (DCOHS), conducted in a South Australian population sample. The participants were 23-91 years old, and 44.1% were male. The EQ-5D-3L was responded to on a three-point rating scale ("none"/"no", "some" and "extremely"/"unable"/"confined"). We employed the area under the receiver operating characteristic curve (AUROC) to evaluate whether the EQ-5D-3L total score could identify participants with diagnosed diseases and mental health disorders. Psychometric validation of the EQ-5D-3L investigated dimensionality with Exploratory Graph Analysis, model fit, floor/ceiling effects and criterion validity. RESULTS The EQ-5D-3L comprised two dimensions, Activities and Symptoms. According to Root Mean Squared Error of Approximation (RMSEA) (<.05) and Comparative Fit Index (CFI) (>.950), the 2-dimensional structure showed excellent model fit with good reliability for the Activities subscale (Ωc = 0.80-95% CI [0.77, 0.83]), and poor reliability for the Symptom subscale (Ωc = 0.56-95% CI [0.53, 0.58]). The EQ-5D-3L showed adequate reliability (Ωc = 0.70-95% CI [0.67, 0.72]). The EQ-5D-3L showed good discrimination for diagnosed diseases (ranging from 64.3% to 86.3%). Floor/ceiling effects were observed across all items. The EQ-5D-3L total score discriminated between respondents who were experiencing health conditions (e.g. cancer, cardiovascular disease, stroke) from healthy individuals. DISCUSSION Despite the ceiling effects, the EQ-5D-3L displayed good psychometric properties as an HRQoL measure and discriminated between health states in the general South Australian population. Further research should investigate the psychometric properties of the EQ-5D-5L in South Australia and whether an increased number of response categories can mitigate the observed ceiling effects.
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Affiliation(s)
- Mehrsa Zakershahrak
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Pedro Henrique Ribeiro Santiago
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Sneha Sethi
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Dandara Haag
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - David Brennan
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
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20
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Sakthong P, Jaisue P. Impact of a drug-related patient-reported outcome measure on drug-related problem identification, physicians' acceptance, and clinical and quality of life outcomes: a randomized controlled trial. Int J Clin Pharm 2021; 44:320-329. [PMID: 34783956 DOI: 10.1007/s11096-021-01341-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/19/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Data are scarce regarding the usefulness of a pharmaceutical therapy-related quality of life measure including the Patient-Reported Outcomes Measure of Pharmaceutical Therapy for Quality of Life (PROMPT-QoL), for providing pharmaceutical care. AIM To evaluate the impact of the PROMPT-QoL on identifying drug-related problems (DRPs), physicians' acceptance of pharmacist's recommendations on the DRP resolution, and clinical and quality of life outcomes. METHOD A single-blind randomized controlled trial was conducted at a tertiary public hospital in Thailand from October 2019 to May 2020. A total of 286 outpatients with chronic diseases were randomly allocated into the control group (provided with pharmaceutical care only) (N = 146) and the intervention group (provided with pharmaceutical care together with use of the PROMPT-QoL) (N = 140). RESULTS A significantly higher mean number of DRPs could be identified in the intervention group than in the control group (p < 0.001). Moreover, there was a significantly higher proportion of physicians' acceptance of pharmacist's recommendations on the DRP resolution in the intervention than in the control group (p = 0.019). Regarding the clinical outcome, a significantly higher proportion of the DRP resolution was found in the intervention group than in the control group (p = 0.002). For quality of life outcomes, the intervention group yielded a significantly higher mean difference between posttest and pretest on the Medicine and Disease Information domain score of the PROMPT-QoL (p = 0.029) and the EuroQoL-Visual Analog Scale score (p = 0.031) than the control group. CONCLUSION This study revealed that the application of the PROMPT-QoL together with pharmaceutical care favorably influenced identification of DRPs, physicians' acceptances, and clinical outcomes. Trial registration TCTR20201208005 on December 5, 2020.
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Affiliation(s)
- Phantipa Sakthong
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Phyathai Road, Pathumwan, Bangkok, 10330, Thailand.
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21
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APTA Cross Sections and Academies Recommendations for COVID-19 Core Outcome Measures. JOURNAL OF ACUTE CARE PHYSICAL THERAPY 2021; 13:62-76. [PMID: 35340890 PMCID: PMC8939471 DOI: 10.1097/jat.0000000000000172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/29/2021] [Indexed: 12/03/2022]
Abstract
The novel coronavirus (COVID-19) emerged as a major health concern within the United States in early 2020. Because this is a novel virus, little guidance exists for best practice to evaluate this population within the field of physical therapy.
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22
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Reference data among general population and known-groups validity among hypertensive population of the EQ-5D-5L in Vietnam. Qual Life Res 2021; 31:539-550. [PMID: 34370187 PMCID: PMC8847252 DOI: 10.1007/s11136-021-02959-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 12/02/2022]
Abstract
Purpose This study aims to provide EQ-5D-5L population norms among the general population in Vietnam and to test EQ-5D-5L’ construction validity among people living with hypertension there. Methods Descriptive statistics of the five dimensions and five levels, EQ-VAS and EQ-5D-5L indexes were categorised into gender and age groups for the EQ-5D-5L population norms. Known-groups testing was set for lower EQ-5D-5L outcomes among people who were aware of their hypertensive status, females, people with more comorbidities, less education, older ages, and higher body mass indexes. Level of confident interval was 95%. Results The mean EQ-VAS and EQ-5D-5L indexes were 81.10 (SD: 13.35) and 0.94 (SD: 0.09) among the general population. The EQ-5D-5L outcomes were better among younger people, males, people with more education, employees, and single people. Respondents reported fewer problems with self-care and usual activities and tend to have problems at higher levels across older ages. The known-group testing showed statistically significant results. The mean EQ-VAS and EQ-5D-5L indexes of people in the diagnosed hypertensive group (71.48 and 0.94, respectively) were statistically significantly smaller than they were in the non-hypertensive and undiagnosed hypertensive group (76.65 and 0.97; 76.95 and 0.96 accordingly). Statistically significant associations of lower EQ-5D-5L indexes and EQ-VAS were found among people diagnosed for hypertension, people suffering from an incremental comorbidity, and obese people. Conclusion This study has provided EQ-5D-5L population norms for the general population and evidence for known-groups validity of the EQ-5D-5L instrument among hypertensive people in Vietnam. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02959-2.
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Cheng LJ, Tan RLY, Luo N. Measurement Properties of the EQ VAS Around the Globe: A Systematic Review and Meta-Regression Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1223-1233. [PMID: 34372988 DOI: 10.1016/j.jval.2021.02.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 01/21/2021] [Accepted: 02/19/2021] [Indexed: 05/26/2023]
Abstract
OBJECTIVES This study aimed to synthesize and evaluate published evidence on the measurement properties of the EQ VAS, a component of all EQ-5D questionnaires. METHODS This systematic review followed the Consensus-Based Standards for the Selection of Health Measurement Instruments guidelines. Five electronic databases were searched for EQ-5D-3L and EQ-5D-5L validation articles published from January 1, 2009, to November 5, 2019. Evidence for construct validity, test-retest reliability, and responsiveness was extracted from individual studies before being aggregated for evaluation of the populations represented by the studied samples. Multivariable logistic meta-regression was conducted to explore the effects of potential covariates on construct validity. RESULTS A total of 50 articles containing 488 studies, using samples drawn from 12 different populations, were identified. Generally, the quality of evidence was high for construct validity studies (n = 397) but only moderate for both test-retest reliability studies (n = 21) and responsiveness studies (n = 70). "Sufficient" construct validity of EQ VAS was found in 8 of 12 populations, "sufficient" test-retest reliability was found in 3 of 11 populations, and "sufficient" responsiveness was found in 5 of 12 populations. Meta-regression analyses suggested that construct validity studies from the Asian-Pacific region were more likely to show a negative rating compared with studies from Europe and North America. CONCLUSION The EQ VAS exhibits "sufficient" construct validity, "inconsistent" test-retest reliability, and "inconsistent" responsiveness across a broad range of populations. Additional studies are needed to explore the suboptimal validity of the EQ VAS in the Asian-Pacific region, whereas more high-quality validation studies are needed to assess its reliability and responsiveness.
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Affiliation(s)
- Ling Jie Cheng
- Nursing Research Unit, Department of Nursing, Khoo Teck Puat Hospital, Yishun Health Campus, National Healthcare Group, Singapore; Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Rachel Lee-Yin Tan
- Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Nan Luo
- Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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Sakthong P. Mapping World Health Organization Quality of Life-BREF Onto 5-Level EQ-5D in Thai Patients With Chronic Diseases. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1089-1094. [PMID: 34372973 DOI: 10.1016/j.jval.2021.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study aimed to map the World Health Organization Quality of Life-BREF (WHOQOL-BREF) onto the 5-level EQ-5D (EQ-5D-5L) using a real Thai valuation set of the EQ-5D-5L. The second objective was to explore the impacts of the differences between observed and predicted EQ-5D-5L index scores on the incremental cost-utility ratio (ICUR) using 5 hypothetical scenarios. METHODS This is a secondary data analysis. A total of 800 outpatients with chronic diseases were recruited from 2 university hospitals in Bangkok, Thailand, between July 2014 and March 2015. The 800 patients were randomly divided into 2 samples: estimation and validation samples. The estimation sample was used to assess the relationships between the EQ-5D-5L index score and 4 WHOQOL-BREF dimension scores and to find the best-fit model and its equation. For the validation sample, the equation of the best-fit model from the estimation sample was used to calculate predicted EQ-5D-5L index scores. RESULTS A multiple linear regression showed that only the physical domain of the WHOQOL-BREF was significantly associated with the EQ-5D-5L. Among 11 regression models, the curve estimation found that the inverse model was the best-fit model. The prediction equation of EQ-5D-5L was equal to 1.385 minus 7.572/physical domain of the WHOQOL-BREF. The impacts of the differences between the observed and predicted EQ-5D-5L index scores on ICUR were only 0.4% to 1.8% from the base case. CONCLUSIONS A nonlinear relationship between the physical domain of the WHOQOL-BREF and EQ-5D-5L utility was shown. The impacts of the differences between the observed and predicted EQ-5D-5L index scores on ICUR were minimal.
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Affiliation(s)
- Phantipa Sakthong
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand.
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25
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Feng YS, Kohlmann T, Janssen MF, Buchholz I. Psychometric properties of the EQ-5D-5L: a systematic review of the literature. Qual Life Res 2021; 30:647-673. [PMID: 33284428 PMCID: PMC7952346 DOI: 10.1007/s11136-020-02688-y] [Citation(s) in RCA: 301] [Impact Index Per Article: 100.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Although the EQ-5D has a long history of use in a wide range of populations, the newer five-level version (EQ-5D-5L) has not yet had such extensive experience. This systematic review summarizes the available published scientific evidence on the psychometric properties of the EQ-5D-5L. METHODS Pre-determined key words and exclusion criteria were used to systematically search publications from 2011 to 2019. Information on study characteristics and psychometric properties were extracted: specifically, EQ-5D-5L distribution (including ceiling and floor), missing values, reliability (test-retest), validity (convergent, known-groups, discriminate) and responsiveness (distribution, anchor-based). EQ-5D-5L index value means, ceiling and correlation coefficients (convergent validity) were pooled across the studies using random-effects models. RESULTS Of the 889 identified publications, 99 were included for review, representing 32 countries. Musculoskeletal/orthopedic problems and cancer (n = 8 each) were most often studied. Most papers found missing values (17 of 17 papers) and floor effects (43 of 48 papers) to be unproblematic. While the index was found to be reliable (9 of 9 papers), individual dimensions exhibited instability over time. Index values and dimensions demonstrated moderate to strong correlations with global health measures, other multi-attribute utility instruments, physical/functional health, pain, activities of daily living, and clinical/biological measures. The instrument was not correlated with life satisfaction and cognition/communication measures. Responsiveness was addressed by 15 studies, finding moderate effect sizes when confined to studied subgroups with improvements in health. CONCLUSIONS The EQ-5D-5L exhibits excellent psychometric properties across a broad range of populations, conditions and settings. Rigorous exploration of its responsiveness is needed.
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Affiliation(s)
- You-Shan Feng
- Institute for Community Medicine, Medical University Greifswald, Greifswald, Germany.
- Institute for Clinical Epidemiology and Applied Biometrics, Medical University of Tübingen, Silcherstraße 5, 72076, Tübingen, Germany.
| | - Thomas Kohlmann
- Institute for Community Medicine, Medical University Greifswald, Greifswald, Germany
| | - Mathieu F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Erasmus University, Rotterdam, The Netherlands
| | - Ines Buchholz
- Institute for Community Medicine, Medical University Greifswald, Greifswald, Germany
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Bilbao A, Martín-Fernández J, García-Pérez L, Mendezona JI, Arrasate M, Candela R, Acosta FJ, Estebanez S, Retolaza A. Psychometric properties of the EQ-5D-5L in patients with major depression: factor analysis and Rasch analysis. J Ment Health 2021; 31:506-516. [PMID: 33522336 DOI: 10.1080/09638237.2021.1875422] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The EQ-5D is one of the most recommended questionnaires for cost-effectiveness studies. AIMS To study the psychometric properties of the EQ-5D-5L in patients with major depression. METHODS This prospective observational study included 433 patients with major depression who completed the EQ-5D-5L and Patient Health Questionnaire-9 (PHQ-9) questionnaires at baseline, of whom 310 also did six months later. The structural validity was assessed by confirmatory factor analysis, the item functioning by item response analysis, and reliability by Cronbach's alpha. Convergent validity and known-groups validity was studied using the PHQ-9 and a general health question. To assess responsiveness effect sizes were calculated. RESULTS The results supported the unidimensionality and showed adequate item functioning, with somewhat age-related item differential functioning for the mobility dimension. Cronbach's alpha was 0.77. The EQ-5D-5L showed a high correlation with the PHQ-9 and general health. The more severe the depression level and the poorer the general health, the lower the EQ-5D-5L scores (p < 0.001). Responsiveness parameters showed moderate changes among "improved" patients. CONCLUSIONS These findings support the adequate psychometric properties of the EQ-5D-5L in patients with major depression. It could be very useful for clinicians and researchers as an outcome measure and for use in economic evaluation.
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Affiliation(s)
- Amaia Bilbao
- Osakidetza Basque Health Service, Basurto University Hospital, Research Unit, Bilbao, Spain.,Health Service Research Network on Chronic Diseases (REDISSEC), Spain.,Kronikgune Institute for Health Services Research, Barakaldo, Spain
| | - Jesús Martín-Fernández
- Health Service Research Network on Chronic Diseases (REDISSEC), Spain.,Oeste Multiprofessional Teaching Unit of Primary and Community Care, Primary Healthcare Management, Madrid Health Service, Madrid, Spain.,Health Sciences Faculty, Rey Juan Carlos University, Madrid, Spain
| | - Lidia García-Pérez
- Health Service Research Network on Chronic Diseases (REDISSEC), Spain.,Fundación Canaria de Investigación Sanitaria (FUNCANIS), Santa Cruz de Tenerife, Spain
| | - José Ignacio Mendezona
- Osakidetza Basque Health Service, Bizkaia Mental Health Network, Derio Mental Health Centre, Derio, Spain
| | - Marta Arrasate
- Osakidetza Basque Health Service, Bizkaia Mental Health Network, Derio Mental Health Centre, Derio, Spain.,Osakidetza Basque Health Service, Bizkaia Mental Health Network, Uribe Mental Health Centre, Getxo, Spain
| | - Ruth Candela
- Psychiatry Department, Fuenlabrada University Hospital, Madrid, Spain
| | - Francisco Javier Acosta
- Health Service Research Network on Chronic Diseases (REDISSEC), Spain.,Service of Mental Health, General Management of Healthcare Programs, Canary Islands Health Service, Canary Islands, Spain.,Insular University Hospital of Gran Canaria, Canary Islands, Spain
| | - Soraya Estebanez
- Osakidetza Basque Health Service, Basurto University Hospital, Research Unit, Bilbao, Spain
| | - Ander Retolaza
- Health Service Research Network on Chronic Diseases (REDISSEC), Spain.,Osakidetza Basque Health Service, Bizkaia Mental Health Network, Basauri Mental Health Centre, Basauri, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
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27
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Atthakomol P, Manosroi W, Mongkonkamthon A, Buranaworathitikul P, Wongcharoen W, Tongprasert S, Wongpakaran T. Cross‑cultural adaptation, construct validity, reliability, and responsiveness of the Thai version of the Patient-Rated Wrist/Hand Evaluation (Thai PRWHE). Qual Life Res 2021; 30:1793-1802. [PMID: 33506434 DOI: 10.1007/s11136-021-02760-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE To translate the Patient-Rated Wrist/Hand Evaluation (PRWHE) which is widely used as the evaluation in healthcare and research system in wrist/hand disorder patients into Thai (Thai PRWHE) and to examine its psychometric properties. METHODS The PRWHE was translated to Thai, including cross-cultural adaptations, following standard guidelines. Psychometric properties were evaluated with 292 wrist/hand musculoskeletal disorder patients. Internal consistency was assessed using Cronbach's alpha. Intraclass correlation coefficient (ICC) was used to determine test-retest reliability over a 7-day interval. Construct validity was evaluated using two methods: Spearman's rank correlation of related and unrelated subscales and confirmatory factor analysis (CFA). Responsiveness was analyzed using the standardized response mean (SRM). RESULTS All subscales had high Cronbach's alpha (0.91-0.96). Evaluation of the Pain subscale found good correlations with the Thai PRWHE and the Thai version of disabilities of the arm, shoulder, and hand (Thai DASH) questionnaire (r = 0.55, P < 0.0001) in related dimensions. Unrelated dimensions, the Total Function subscale of the Thai PRWHE, and the Mobility subscale of the Thai EQ-5D-5L had a weak correlation (r = 0.09, P < 0.12). Comparison of the one-factor solution and the bifactor model found the first-order three-factor solution fitted the data better than other models. The test-retest reliability with 61 patients in each subscale revealed excellent reliability (ICC = 0.94-0.96). In the assessment of responsiveness, the SRM with 54 patients was large (0.94). CONCLUSIONS The Thai PRWHE has excellent internal consistency in all modules and good construct validity and reliability for Thai patients and provides a large standardized response mean after treatment.
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Affiliation(s)
- Pichitchai Atthakomol
- Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. .,Musculoskeletal Science and Translational Research Center, Chiang Mai University, Chiang Mai, Thailand.
| | - Worapaka Manosroi
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Aphiwij Mongkonkamthon
- Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Wilailak Wongcharoen
- Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Siam Tongprasert
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Kangwanrattanakul K. A comparison of measurement properties between UK SF-6D and English EQ-5D-5L and Thai EQ-5D-5L value sets in general Thai population. Expert Rev Pharmacoecon Outcomes Res 2020; 21:765-774. [PMID: 32981380 DOI: 10.1080/14737167.2021.1829479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Evidence is limited for comparative psychometric properties between EQ-5D-5L and SF-6D. Therefore, this study compared psychometric properties between those instruments using value sets from Thailand, England, and the UK in the general Thai population. METHODS A total of 1,200 participants were recruited. The agreement level was evaluated using intraclass correlation coefficients (ICCs) and Bland-Altman plots. Convergent validity with SF-12v2 was assessed by Spearman's rho correlations. Known-group validity compared discriminant activity and sensitivity between groups. Responsiveness was assessed using standardized effect sizes (SES) and standardized response mean (SRM). RESULTS Agreement between SF-6D and Thai (ICCs = 0.51) and English (ICCs = 0.52) EQ-5D-5L index scores was good. The physical functioning demonstrated moderate to strong and moderate correlations with Thai (r = 0.50) and English (r = 0.46) EQ-5D-5L index scores, whereas SF-6D index scores strongly correlated with role emotion (r = 0.81). EQ-5D-5L was better than SF-6D at discrimination and sensitivity for gender, age, education level, household income, and number of diseases. The SF-6D was more responsive than the EQ-5D-5L for the worsened group. CONCLUSION Both SF-6D and EQ-5D-5L are valid among the general Thai population. Further studies should reinvestigate responsiveness and determine their impacts on economic analyses among patient groups.
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Affiliation(s)
- Krittaphas Kangwanrattanakul
- Division of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, Thailand
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Prevolnik Rupel V, Ogorevc M. EQ-5D-5L Slovenian population norms. Health Qual Life Outcomes 2020; 18:333. [PMID: 33028345 PMCID: PMC7542912 DOI: 10.1186/s12955-020-01584-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 09/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The study aims to present Slovenian EQ-5D-5L population norms for different age and gender subgroups that can be used as reference values in future studies concerning health status. The secondary aim is to compare those norms with population norms from some other countries in Europe and elsewhere. METHODS The cross-sectional survey was conducted between November 2019 and February 2020 via online panel. 1071 adults aged 18+ were included in the survey. The general population was sampled using quota sampling in terms of age, gender, and NUTS2 region. In the study, the EQ-5D-5L Slovenian online version was used. Descriptive statistics was used to present health status by age groups and genders for the EQ-5D-5L descriptive system, EQ VAS and the EQ-5D-5L index score. The latter was derived from Slovenian EQ-3D-3L tariff, transformed to five levels using the crosswalk methodology. RESULTS The mean EQ VAS score in the Slovenian population was 79.9, mean utility index was 0.808. 28.2% of the population did not have problems on any dimension and 3.9% of the population had problems on all dimensions. Persons residing in Western Slovenia had, on average, 0.016 higher utility score, compared to Eastern Slovenia. Effect of gender was not significant. Age was negatively associated with both utility index and EQ VAS score. Education was positively correlated to health status. Problems on dimensions were generally increasing with age, except for anxiety/depression dimension, where youngest group (ages 18-29) reported more anxiety/depression compared to older counterparts. Self-reported anxiety/depression was more pronounced in women. CONCLUSIONS Similarly to other countries, the health generally deteriorates with age, except for the anxiety/depression dimension where the share of respondents reporting no problems was lowest in the youngest age group. The open question for the future remains, whether population norms from this online sample differ significantly from the actual EQ-5D-5L health status data of the Slovenian general population.
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Affiliation(s)
| | - Marko Ogorevc
- Institute for Economic Research, Kardeljeva ploščad 17, 1000, Ljubljana, Slovenia
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Hu X, Jing M, Zhang M, Yang P, Yan X. Responsiveness and minimal clinically important difference of the EQ-5D-5L in cervical intraepithelial neoplasia: a longitudinal study. Health Qual Life Outcomes 2020; 18:324. [PMID: 33008423 PMCID: PMC7531135 DOI: 10.1186/s12955-020-01578-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 09/24/2020] [Indexed: 12/18/2022] Open
Abstract
Background With the widespread clinical application of the five-level version of the EuroQol five-dimensional questionnaire (EQ-5D-5L), whether the questionnaire scores are responsive to changes in patients’ health and how much changes in questionnaire scores represent patients’ real health changes require consideration. Consequently, we assessed responsiveness and estimated the minimal clinically important difference (MCID) of the EQ-5D-5L in surgically treated patients with cervical intraepithelial neoplasia (CIN) to determine the relationship between MCID and minimal detectable change (MDC). Methods We conducted a longitudinal, observational study. Participants were patients with CIN from the gynecology inpatient department of a grade-A tertiary hospital in Shihezi, Xinjiang, China. Participants completed the EQ-5D-5L and the Global Rating of Change Questionnaire (GRCQ) at baseline and one month post-surgery. The Wilcoxon signed-rank test was used to compare EQ-5D-5L scores pre- and post-treatment. We calculated the effect size (ES) and the standardized response mean (SRM) to quantitatively assess responsiveness. Distribution-based, anchor-based, and instrument-defined methods were used to estimate MCID. MCID to MDC ratios at individual- and group-levels were also calculated. Results Fifty patients with CIN completed the follow-up investigation (mean age 44.76 ± 8.72 years; mean follow-up time 32.28 ± 1.43 days). The index value and EQ visual analogue scale (EQ VAS) of the EQ-5D-5L improved by 0.025 and 6.92 (all p < 0.05) at follow-up as compared to baseline respectively. The ES and the SRM of the index value were 0.47 and 0.42 respectively, indicating small responsiveness; while the ES and the SRM of EQ VAS were 0.50 and 0.49 respectively, indicating small to moderate responsiveness. The average (range) of MCIDs for index value and EQ VAS were 0.039 (0.023–0.064) and 5.35 (3.12–6.99) respectively. These values can only be used to determine whether patients have experienced clinically meaningful health improvements at the group level. Conclusions The EQ-5D-5L has only small to moderate responsiveness in post-surgical patients with CIN, and the MCIDs developed in this study can be used for group-level health assessment. However, further study is needed concerning health changes at the individual level.
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Affiliation(s)
- Xin Hu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Mingxia Jing
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China.
| | - Mei Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Ping Yang
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Xiaolong Yan
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
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Almasri DM, Noor AO, Ghoneim RH, Bagalagel AA, Almetwazi M, Baghlaf NA, Hamdi EA. The impact of diabetes mellitus on health-related quality of life in Saudi Arabia. Saudi Pharm J 2020; 28:1514-1519. [PMID: 33424245 PMCID: PMC7783106 DOI: 10.1016/j.jsps.2020.09.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/21/2020] [Indexed: 11/13/2022] Open
Abstract
Objective To evaluate the effect of different demographic, clinical and social factors on diabetic patients' quality of life (QOL). Research design and methods A cross sectional study conducted on patients with type 2 diabetes who attended King Abdulaziz University Hospital outpatient clinics between February and March 2017. The patients were asked about sociodemographic data including age, sex, educational level, exercise history and marital status in addition to clinical data such as duration of diabetes, presence of comorbidities as well as medication history. The patients' QOL were assessed using EQ-5D-5L Arabic version. Results 131 participants were included in the study with a median age 55 years old. Forty five percent of participants were male. Regarding EQ-5D scores, there were significant correlation with gender, exercise, hypertension, heart disease, marital status, educational level and duration of diabetes while there was a significant difference in EQ-VAS scores with respect to heart disease, level of education and duration of diabetes. Conclusion More attention needs to be given to the assessment of the QOL of diabetic patients and assessing the effect of different treatment modalities on improvement of patients’ QOL.
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Affiliation(s)
- Diena M Almasri
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmad O Noor
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ragia H Ghoneim
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alaa A Bagalagel
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mansour Almetwazi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Nujud A Baghlaf
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Esraa A Hamdi
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
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Atthakomol P, Manosroi W, Sanguanrungsirikul S, Punoppamas S, Benjachaya S, Tongprasert S, Wongpakaran T. A Thai version of the Michigan hand questionnaire (Thai MHQ): an investigation of the psychometric properties. Health Qual Life Outcomes 2020; 18:313. [PMID: 32962701 PMCID: PMC7510100 DOI: 10.1186/s12955-020-01548-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 08/28/2020] [Indexed: 12/26/2022] Open
Abstract
Background The Michigan Hand Questionnaire (MHQ) is widely used to assess the hand/wrist conditions. We translated the original version into Thai (Thai MHQ) and evaluated its psychometric properties. Methods After receiving permission, the original MHQ was translated and cross-culturally adapted to Thai following standard guidelines. Two hundred and seventeen patients who had hand/wrist injuries or disorders were included in the study. Internal consistency was evaluated using Cronbach’s alpha. Test-retest reliability was analyzed using the intraclass correlation coefficient (ICC). Spearman’s rank correlation among the subscales of Thai MHQ, Thai DASH and Thai EQ-5D-5L and also confirmatory factor analysis (CFA) were used to explore construct validity. The standardized response mean (SRM) was used to evaluate the responsiveness of the Thai MHQ. Results All subscales showed an acceptable Cronbach’s alpha (0.79–0.98). The test-retest reliability of each subscale was good (ICC = 0.83–0.95). In related dimensions, strong correlation was demonstrated between the Activities of daily living subscale of the Thai MHQ and the Common activities subscale in the Thai DASH (r = 0.77, P < 0.0001). For unrelated dimensions, a weak correlation was found between the Aesthetics subscale in the Thai MHQ and the Mobility subscale in the Thai EQ-5D-5L (r = − 0.13, P = 0.05). The Thai MHQ had strong correlation with Thai DASH (r = − 0.79, P < 0.0001) and Thai EQ-5D-5L (r = 0.63, P < 0.0001). CFA showed that the 6-factor model demonstrated an acceptable fit to the data. The SRM of the Thai MHQ was 0.78, indicating relatively large responsiveness. The MIC of Thai MHQ using distribution methods (SEM) was 5.2. Conclusions The Thai MHQ provides adequate internal consistency in all subscales as well as good construct validity and reliability for Thai patients and a relatively large standardized response mean at 2 months after treatment.
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Affiliation(s)
- Pichitchai Atthakomol
- Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. .,Musculoskeletal Science and Translational Research Center, Chiang Mai University, Chiang Mai, Thailand.
| | - Worapaka Manosroi
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Siraphop Punoppamas
- Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sirapat Benjachaya
- Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Siam Tongprasert
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tinakon Wongpakaran
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Zhu J, Yan XX, Liu CC, Wang H, Wang L, Cao SM, Liao XZ, Xi YF, Ji Y, Lei L, Xiao HF, Guan HJ, Wei WQ, Dai M, Chen W, Shi JF. Comparing EQ-5D-3L and EQ-5D-5L performance in common cancers: suggestions for instrument choosing. Qual Life Res 2020; 30:841-854. [PMID: 32930993 DOI: 10.1007/s11136-020-02636-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 01/03/2023]
Abstract
PURPOSE To compare the performance of three-level EuroQol five-dimensions (EQ-5D-3L) and five-level EuroQol five-dimensions (EQ-5D-5L) among common cancer patients in urban China. METHODS A hospital-based cross-sectional survey was conducted in three provinces from 2016 to 2018 in urban China. Patients with breast cancer, colorectal cancer, or lung cancer were recruited to complete the EQ-5D-3L and EQ-5D-5L questionnaires. Response distribution, discriminatory power (indicator: Shannon index [H'] and Shannon evenness index [J']), ceiling effect (the proportion of full health state), convergent validity, and health-related quality of life (HRQoL) were compared between the two instruments. RESULTS A total of 1802 cancer patients (breast cancer: 601, colorectal cancer: 601, lung cancer: 600) were included, with the mean age of 55.6 years. The average inconsistency rate was 4.4%. Compared with EQ-5D-3L (average: H' = 1.100, J' = 0.696), an improved discriminatory power was observed in EQ-5D-5L (H' = 1.473, J' = 0.932), especially contributing to anxiety/depression dimensions. The ceiling effect was diminished in EQ-5D-5L (26.5%) in comparison with EQ-5D-3L (34.5%) (p < 0.001), mainly reflected in the pain/discomfort and anxiety/depression dimensions. The overall utility score was 0.790 (95% CI 0.778-0.801) for EQ-5D-3L and 0.803 (0.790-0.816) for EQ-5D-5L (p < 0.001). A similar pattern was also observed in the detailed cancer-specific analysis. CONCLUSIONS With greater discriminatory power, convergent validity and lower ceiling, EQ-5D-5L may be preferable to EQ-5D-3L for the assessment of HRQoL among cancer patients. However, higher utility scores derived form EQ-5D-5L may also lead to lower QALY gains than those of 3L potentially in cost-utility studies and underestimation in the burden of disease.
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Affiliation(s)
- Juan Zhu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China.,Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Xin-Xin Yan
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Cheng-Cheng Liu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Hong Wang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Le Wang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China
| | - Su-Mei Cao
- Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China
| | - Xian-Zhen Liao
- Hunan Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha, People's Republic of China
| | - Yun-Feng Xi
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, People's Republic of China
| | - Yong Ji
- Cancer Hospital, Shenzhen Center, Chinese Academy of Medical Sciences, Shenzhen, People's Republic of China
| | - Lin Lei
- Shenzhen Center for Chronic Disease Control, Shenzhen, People's Republic of China
| | - Hai-Fan Xiao
- Hunan Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha, People's Republic of China
| | - Hai-Jing Guan
- China Center for Health Economic Research, Peking University, Beijing, People's Republic of China
| | - Wen-Qiang Wei
- Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Min Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China.
| | - Wanqing Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China.
| | - Ju-Fang Shi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People's Republic of China.
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Prevolnik Rupel V, Ogorevc M. Crosswalk EQ-5D-5L Value Set for Slovenia. Zdr Varst 2020; 59:189-194. [PMID: 32952720 PMCID: PMC7478094 DOI: 10.2478/sjph-2020-0024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 06/09/2020] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Due to the availability of the EQ-5D-5L instrument official translation into Slovenian its use is widespread in Slovenia. However, the health profiles obtained in many studies cannot be ascribed their appropriate values as the EQ-5D-5L value set does not yet exist in Slovenia. Our aim was to estimate an interim EQ-5D-5L value set for Slovenia using the crosswalk methodology developed by the EuroQol Group on the basis of the EQ-5D-3L Slovenian TTO value set. Our secondary aim was to compare the interim values obtained with the EQ-5D-3L Slovenian values. METHODS To obtain a Slovenian interim EQ-5D-5L value set, we applied the crosswalk methodology developed by the EuroQol Group to the Slovenian EQ-5D-3L TTO value set. We examined the differences between values by comparing the mean 3L and 5L value scores and the distribution of values across all respondents. RESULTS By definition, 3-level and 5-level versions have the same range (from 1 to -0.495) and a health state coded 22222 in the 3-level version corresponds to 33333 in the 5-level version. While the addition of a "slight" severity level (22222) in the 5-level version has a low informational value, the addition of a "severe" health state (44444) covers larger range of the scale. The 5-level version results in fewer health states being valued below 0 and above 0.8. CONCLUSION The EQ-5D-5L value set, based on the crosswalk methodology, should be used until a value set for the EQ-5D-5L is derived from preferences elicited directly from a representative sample of the Slovenian general population.
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Affiliation(s)
| | - Marko Ogorevc
- Institute for Economic Research, Kardeljeva ploščad 17, 1000Ljubljana, Slovenia
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Comparing Quality of Life of General Population and Orthopedic Patients in Slovenia. Value Health Reg Issues 2020; 22:93-98. [PMID: 32823061 DOI: 10.1016/j.vhri.2020.07.575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 07/11/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To our knowledge this is the first study presenting descriptive EQ-5D health profile and VAS scores for orthopedic patients in Slovenia. Furthermore, EQ-5D-3L population norms for Slovenia are presented. The aims of this study are (1) to provide population norms for EQ-5D-3L in Slovenia according to age and sex and (2) to compare different groups of orthopaedic patients' health state among themselves as well as to the general population. METHODS Data on orthopedic patients' preoperative health status assessment were recorded (n = 1118). The health status of 4 groups of orthopedic patients was analyzed and compared using EQ VAS and the EQ-5D descriptive profile. The results were compared with Slovenian population norms, which were calculated using the EQ-5D valuation set database from year 2000 (n = 708). RESULTS As expected, a higher proportion of patients than the general population report problems on all dimensions. The opposite is true only for mobility and anxiety/depression dimension for shoulder surgery patients. Hip endoscopy patients have the lowest health-related quality of life (HRQoL) out of all patient groups using EQ VAS and EQ-5D descriptive profiles. CONCLUSION The population norms presented will be useful for many researchers trying to compare HRQoL among various patient groups or the general population. Separate use of the descriptive profile of the EQ-5D is informative when assessing HRQoL in orthopedic patients and is in line with VAS values. The results can support further studies on health needs assessment as well as decisions on funds allocation among groups of orthopedic patients.
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Kangwanrattanakul K, Parmontree P. Psychometric properties comparison between EQ-5D-5L and EQ-5D-3L in the general Thai population. Qual Life Res 2020; 29:3407-3417. [PMID: 32780315 DOI: 10.1007/s11136-020-02595-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Evidence for the EQ-5D-5L's psychometric properties in the general Thai population is limited. This study aimed to compare ceiling effect, discriminatory power, response redistribution, validity, reliability between the EQ-5D-5L (5L) and the EQ-5D-3L (3L) in the general Thai population. METHODS 1200 participants were randomly selected. The Shannon index ([Formula: see text] and Shannon evenness index ([Formula: see text] determining discriminatory power of both EQ-5D versions in each dimension were compared. Test-retest reliability was evaluated using weighted kappa (k) and intraclass correlation coefficients (ICCs). Validity was evaluated by correlations between similar dimensions of the EQ-5D, WHOQOL-BREF, and SF-12v2 and known-groups validity. The ceiling effects for the 3L and for the 5L were compared. RESULTS The 5L had lower ceiling effects than the 3L (49.08% vs 57.17%, p < 0.01). [Formula: see text] was higher for the 5L than for the 3L, but [Formula: see text] showed otherwise. Moderate correlations were detected between similar dimensions of the EQ-5D and the WHOQOL-BREF and SF-12v2. ICCs and k of the 3L were slightly higher than those of the 5L (ICCs: 0.78 vs 0.71) and (k: 0.42-0.63 vs 0.48-0.61), respectively. Older, female participants and those with comorbidities reported a lower utility index for both versions. CONCLUSION Evidence supported use of both EQ-5D versions in the general Thai population. The 5L had better ceiling effects and discriminant activity, while it showed comparable known-groups validity with the 3L. Nevertheless, evidence is limited for the superiority of reliability between these two versions, so more future research is required to investigate it.
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Affiliation(s)
- Krittaphas Kangwanrattanakul
- Division of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, 169 Long-Hard Bangsaen Rd., Mueang, Chonburi, 20131, Thailand.
| | - Porntip Parmontree
- Division of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, 169 Long-Hard Bangsaen Rd., Mueang, Chonburi, 20131, Thailand
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Hashimoto Y, Sakai R, Ikeda K, Fukui M. Association between sleep disorder and quality of life in patients with type 2 diabetes: a cross-sectional study. BMC Endocr Disord 2020; 20:98. [PMID: 32605640 PMCID: PMC7325681 DOI: 10.1186/s12902-020-00579-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 06/16/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND We investigated the association between sleep symptoms, which cause sleep disorder, and quality of life (QoL) among people with type 2 diabetes (T2D). METHODS In this cross-sectional study of 342 people with T2D, the Japan National Health and Wellness Survey (NHWS) database 2016 were used. We treated the respondents who reported experiencing any of the sleep symptoms as having sleep disorders. To examine health-related QoL (HRQoL), we used the physical component summary (PCS) and the mental component summary (MCS) from the 36-Item short-form and the EuroQol 5 Dimension (EQ-5D) survey instruments. Overall activity impairment was used for assessment of the effect on the individual's ability to perform regular daily activities. We used t-test and one-way ANOVA test for comparison QoL scores between the participants with and without sleep disorders. RESULTS 66.4% of the participants with T2D reported having a sleep disorder. The PCS, MCS, EQ-5D, and overall activity impairment of people with sleep disorder was significantly poorer than those of the people without. Specific sleep symptoms, such as waking up to go to the bathroom, daytime sleepiness, and waking up too early (before the alarm clock), had high prevalence (35.4, 27.8 and 20.2%). The participants who experienced waking up to go to the bathroom or daytime sleepiness demonstrated significantly poorer QoL on all scores related to QoL, but those who experienced waking up too early only demonstrated significantly poorer QoL on the EQ-5D. CONCLUSIONS Two-thirds of people with T2D in this study suffer from sleep disorders. The people who experience waking up to go to the bathroom or daytime sleepiness had significantly poorer QoL than those without these symptoms. Thus, sleep disorders, especially the symptoms of waking up to go to the bathroom or daytime sleepiness, might be the treatment targets for QOL of people with T2DM.
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Affiliation(s)
- Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Ryosuke Sakai
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Kenichiro Ikeda
- Product Branding, Product Marketing Department, Kowa Company, Ltd., Tokyo, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
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Sakthong P. Relationships Between Pharmaceutical Therapy-Related Quality of Life and Health Utility Scores in Thai Patients With Chronic Diseases. Value Health Reg Issues 2020; 21:222-225. [PMID: 32325325 DOI: 10.1016/j.vhri.2019.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 09/30/2019] [Accepted: 12/17/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The purpose of this study was to assess the relationships between pharmaceutical therapy-related quality of life (PTRQoL) and health utility (HU) scores since such data was not available. METHODS The dataset of 1156 outpatients with chronic diseases from 3 public university hospitals in Bangkok, Thailand, were applied. The Patient-Reported Outcomes Measure of Pharmaceutical Therapy for Quality of Life (PROMPT-QoL) was utilized to assess PTRQoL. HU measures included EQ-5D-5L and EuroQoL-Visual Analog Scale (EQ-VAS). Multiple linear regressions using a stepwise approach were applied to evaluate the relationships between the PROMPT-QoL and the HU scores. RESULTS The results found that the EQ-5D-5L was mostly correlated with the impacts of medicines and side-effects followed by the medicine effectiveness, psychologic impacts of medication use, and availability and accessibility domains of the PROMPT-QoL, respectively (actual R2 about 18%). The EQ-VAS was mostly associated with the impacts of medicines and side-effects, followed by the medicine effectiveness and overall quality of life domains, respectively (actual R2 about 14%). CONCLUSIONS The PROMPT-QoL had medium correlations with the EQ-5D-5L and EQ-VAS scores. Their relationships depended on HU approaches used. More research is needed to examine the relationships between the PROMPT-QoL or other PTRQoL instruments and other HU scores in other settings and populations.
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Affiliation(s)
- Phantipa Sakthong
- Department of Pharmacy Practice, Chulalongkorn University, Bangkok, Thailand.
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Qian X, Tan RLY, Chuang LH, Luo N. Measurement Properties of Commonly Used Generic Preference-Based Measures in East and South-East Asia: A Systematic Review. PHARMACOECONOMICS 2020; 38:159-170. [PMID: 31761995 PMCID: PMC7081654 DOI: 10.1007/s40273-019-00854-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVES Our aim was to systematically review published evidence on the construct validity, test-retest reliability and responsiveness of generic preference-based measures (PBMs) used in East and South-East Asia. METHODS This systematic review was guided by the COSMIN guideline. A literature search on the MEDLINE, EMBASE, PsycINFO and PubMed databases up to August 2019 was conducted for measurement properties validation papers of the EuroQol-5 Dimensions (EQ-5D), Short Form-6 Dimensions (SF-6D), Health Utilities Index (HUI), Quality of Well-Being (QWB), 15-Dimensional (15D) and Assessment of Quality of Life (AQOL) in East and South-East Asian countries. Included papers were disaggregated into individual studies whose results and quality of design were rated separately. The population-specific measurement properties (construct validity, test-retest reliability and responsiveness) of each PBM were assessed separately using relevant studies. The overall methodological quality of the studies used in each of the assessments was also rated. RESULTS A total of 79 papers containing 1504 studies were included in this systematic review. The methodological quality was 'very good' or 'adequate' for the majority of the construct validity studies (99%) and responsiveness studies (61%), but for only a small portion of the test-retest reliability studies (23%). EQ-5D was most widely assessed and was found to have 'sufficient' construct validity and responsiveness in many populations, while the SF-6D and EuroQol-Visual Analog Scale (EQ-VAS) exhibited 'inconsistent' construct validity in some populations. Scarce evidence was available on HUI and QWB, but current evidence supported the use of HUI. CONCLUSIONS This systematic review provides a summary of the quality of existing generic PBMs in Asian populations. The current evidence supports the use of EQ-5D as the preferred choice when a generic PBM is needed, and continuous testing of all PBMs in the region.
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Affiliation(s)
- Xinyu Qian
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Sciene Drive 2, Singapore, 117549, Singapore
| | - Rachel Lee-Yin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Sciene Drive 2, Singapore, 117549, Singapore
| | - Ling-Hsiang Chuang
- Pharmerit International, Marten Meesweg 107, 3068 AV, Rotterdam, The Netherlands
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Sciene Drive 2, Singapore, 117549, Singapore.
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Schmitz S, Makovski TT, Adams R, van den Akker M, Stranges S, Zeegers MP. Bayesian Hierarchical Models for Meta-Analysis of Quality-of-Life Outcomes: An Application in Multimorbidity. PHARMACOECONOMICS 2020; 38:85-95. [PMID: 31583600 DOI: 10.1007/s40273-019-00843-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Health-related quality of life (HRQoL) is a key outcome in cost-utility analyses, which are commonly used to inform healthcare decisions. Different instruments exist to evaluate HRQoL, however while some jurisdictions have a preferred system, no gold standard exists. Standard meta-analysis struggles with the variety of outcome measures, which may result in the exclusion of potentially relevant evidence. OBJECTIVE Using a case study in multimorbidity, the objective of this analysis is to illustrate how a Bayesian hierarchical model can be used to combine data across different instruments. The outcome of interest is the slope relating HRQoL to the number of coexisting conditions. METHODS We propose a three-level Bayesian hierarchical model to systematically include a large number of studies evaluating HRQoL using multiple instruments. Random effects assumptions yield instrument-level estimates benefitting from borrowing strength across the evidence base. This is particularly useful where little evidence is available for the outcome of choice for further evaluation. RESULTS Our analysis estimated a reduction in quality of life of 3.8-4.1% per additional condition depending on HRQoL instrument. Uncertainty was reduced by approximately 80% for the instrument with the least evidence. CONCLUSION Bayesian hierarchical models may provide a useful modelling approach to systematically synthesize data from HRQoL studies.
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Affiliation(s)
- Susanne Schmitz
- Competence Center for Methodology and Statistics, Department of Population Health, Luxembourg Institute of Health, 1 A-B, rue Thomas Edison, 1445, Strassen, Luxembourg.
| | - Tatjana T Makovski
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Chairgroup of Complex Genetics and Epidemiology, Nutrition and Metabolism in Translational Research (NUTRIM), Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Roisin Adams
- National Centre for Pharmacoeconomics, St James's Hospital, Dublin, Ireland
| | - Marjan van den Akker
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Institute of General Practice, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
- Academic Centre of General Practice, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Saverio Stranges
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Maurice P Zeegers
- Chairgroup of Complex Genetics and Epidemiology, Nutrition and Metabolism in Translational Research (NUTRIM), Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Relationship Between Health-Related Quality of Life and Patient Acceptable Symptom State With Disease Activity and Functional Status in Patients With Ankylosing Spondylitis in Thailand. J Clin Rheumatol 2019; 25:16-23. [PMID: 29509563 DOI: 10.1097/rhu.0000000000000750] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to identify factors associated with EuroQoL-5 Dimensions, 5 Levels and Patient Acceptable Symptom State (PASS) and health utility (HU) in Thai patients with ankylosing spondylitis (AS). METHODS This was a cross-sectional study of consecutive AS patients visiting Siriraj Hospital between May 31, 2012, and March 31, 2016. Demographic data and outcomes related to HU (Thai version of EuroQoL-5 Dimensions, 5 Levels), disease activity (Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity Score-erythrocyte sedimentation rate or Ankylosing Spondylitis Disease Activity Score-C-reactive protein, number of tender and swollen joints, and enthesitis), and functional status (Bath Ankylosing Spondylitis Functional Index and Health Assessment Questionnaire) were collected. Regression analysis was used to explore factors associated with each EuroQOL-5 Dimensions (EQ-5D) domain, HU, and PASS. RESULTS Among 119 AS patients, the mean age was 40.4 years; 61.3% were male. The mean EQ-5D was 0.75. In univariate analysis, lower disease activity and less impaired function were significantly associated with higher HU and not to mild problems in each EQ-5D domain. In multivariate regression analysis, Bath Ankylosing Spondylitis Disease Activity Index, C-reactive protein, and Health Assessment Questionnaire adjusting for age explained 77.4% of the HU variance. Patients answering yes to PASS were significantly older, had higher HU, and lower disease activity compared with those answering no to PASS. Usual activity and pain problems were importantly related to PASS after adjusting for other domains and age. CONCLUSIONS Disease activity and functional status in AS patients were significant factors related to HU and PASS. To improve quality of life, treatment goals should be achieving remission, improving function, and controlling pain.
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Makovski TT, Schmitz S, Zeegers MP, Stranges S, van den Akker M. Multimorbidity and quality of life: Systematic literature review and meta-analysis. Ageing Res Rev 2019; 53:100903. [PMID: 31048032 DOI: 10.1016/j.arr.2019.04.005] [Citation(s) in RCA: 282] [Impact Index Per Article: 56.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/14/2019] [Accepted: 04/15/2019] [Indexed: 02/08/2023]
Abstract
Multimorbidity is typically defined as the co-existence of two or more chronic diseases within an individual. Its prevalence is highest among the elderly, with poor quality of life (QoL) being one of the major consequences. This study aims to: (1) understand the relationship between multimorbidity and QoL or health-related quality of life (HRQoL) through systematic literature review; (2) explore the strength of this association by conducting the first meta-analysis on the subject. Following PRISMA, Medline/PubMed, Embase, CINAHL and PsycINFO were searched for studies published through September 1st, 2018. Original studies with clear operationalization of multimorbidity and validated QoL (or HRQoL) measurement were retained. For random-effect meta-analysis, a minimum of three studies with the same multimorbidity tool (e.g. number of diseases or equal comorbidity index) and the same QoL tool were required. Number of diseases was most common and the only measure on which meta-analysis was carried out. The outcome of interest was the linear regression slope between increasing number of diseases and QoL. Heterogeneity was explored with meta-regression. Out of 25,890 studies initially identified, 74 studies were retained for systematic review (total of 2,500,772 participants), of which 39 were included in the meta-analysis. The mean decrease in HRQoL per each added disease, depending on the scale, ranged from: -1.55% (95%CI: -2.97%, -0.13%) for the mental component summary score of pooled SF-36, -12 and -8 scales to -4.37% (95%CI: -7.13%, -1.61%) for WHOQoL-BREF physical health domain. Additional studies considering severity, duration and patterns of diseases are required to further clarify this association.
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Affiliation(s)
- Tatjana T Makovski
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg; Department of Family medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Chairgroup of Complex Genetics and Epidemiology, Nutrition and Metabolism in Translational Research (NUTRIM), Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
| | - Susanne Schmitz
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
| | - Maurice P Zeegers
- Chairgroup of Complex Genetics and Epidemiology, Nutrition and Metabolism in Translational Research (NUTRIM), Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Saverio Stranges
- Epidemiology and Public Health Research Unit, Department of Population Health, Luxembourg Institute of Health (LIH), Strassen, Luxembourg; Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada; Department of Family Medicine, Western University, London, Ontario, Canada
| | - Marjan van den Akker
- Department of Family medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Academic Centre for General Practice/Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium; Institute of General Practice, Johann Wolfgang Goethe University, Frankfurt am Main, Germany
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Raaijmakers CP, Lohle PN, Lodder P, de Vries J. Quality of Life and Clinical Outcome After Traumatic Spleen Injury (SPLENIQ Study): Protocol for an Observational Retrospective and Prospective Cohort Study. JMIR Res Protoc 2019; 8:e12391. [PMID: 31066709 PMCID: PMC6533045 DOI: 10.2196/12391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 03/15/2019] [Accepted: 03/24/2019] [Indexed: 12/19/2022] Open
Abstract
Background Little is known about the effect of a splenic rupture on the quality of life (QOL) of patients, although the spleen is one of the most frequently injured organs in blunt abdominal trauma. It is essential to obtain more knowledge about QOL after traumatic spleen injury so that this can be taken into account when choosing treatment. Objective The primary objective of the SPLENic Injury and Quality of life (SPLENIQ) study is to determine QOL after treatment for traumatic spleen injury. The secondary objective is to investigate clinical and imaging outcome in relation to QOL. Methods A combination of a retrospective single-center and a prospective multicenter observational cohort study will be conducted. Patients in the retrospective study have had a splenic injury after blunt abdominal trauma and were admitted for treatment to the ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis) in Tilburg between January 2005 and February 2017. Concerning the prospective cohort study, patients with splenic injury admitted to 1 of the 10 participating hospitals between March 2017 and December 2018 will be asked to participate. The follow-up period will be 1 year regarding QOL, clinical symptoms, and imaging. Patients in the retrospective study will complete 2 questionnaires: World Health Organization QOL assessment instrument-Bref (WHOQOL-Bref) and 12-Item Short-Form Health Survey (SF-12). Patients in the prospective study will complete 5 questionnaires at 1 week, 1 month, 3 months, 6 months, and 12 months after treatment: WHOQOL-Bref, SF-12, Euroqol 5-Dimensional 5-Level (EQ-5D-5L) questionnaire, Institute for Medical Technology Assessment (iMTA) Productivity Cost Questionnaire (iPCQ), and iMTA Medical Consumption Questionnaire (iMCQ). In both the retrospective and prospective study, patients treated with splenic artery embolization will undergo magnetic resonance imaging (MRI). The retrospective group will undergo MRI once, and the prospective group will undergo MRI 1 month and 1 year after treatment. Treatment of splenic injury depends on the severity of the splenic injury, the hemodynamic condition of the patient, and the hospital’s or doctor’s preference. This study is observational in nature without randomization. Concerning the retrospective data, multivariate analysis of covariance will be done. With regard to the prospective data, mixed linear modeling will be performed. Results This project was funded in April 2015 by ZonMw. The results of the retrospective study will be expected in March 2019. With regard to the prospective study, inclusion of patients was completed in December 2018 and data collection will be completed in December 2019. The first results will be expected in 2019. Conclusions To our knowledge, this is the first study that examines QOL in patients with a traumatic spleen injury. The SPLENIQ study responds to the shortage of information about QOL after treatment for traumatic spleen injury and may result in the development of a patient-oriented protocol. Trial Registration ClinicalTrials.gov NCT03099798; https://clinicaltrials.gov/ct2/show/NCT03099798 (Archived by WebCite at http://www.webcitation.org/714ZKV6A0). International Registered Report Identifier (IRRID) DERR1-10.2196/12391
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Affiliation(s)
- Claudia Pam Raaijmakers
- ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Trauma TopCare, Tilburg, Netherlands.,ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Department of Radiology, Tilburg, Netherlands
| | - Paul Nm Lohle
- ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Department of Radiology, Tilburg, Netherlands
| | - Paul Lodder
- Tilburg University, Department of Medical and Clinical Psychology, Tilburg, Netherlands.,Tilburg University, Department of Methodology and Statistics, Tilburg, Netherlands
| | - Jolanda de Vries
- ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Trauma TopCare, Tilburg, Netherlands.,Tilburg University, Department of Medical and Clinical Psychology, Tilburg, Netherlands.,ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Department of Medical Psychology, Tilburg, Netherlands
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Arrospide A, Machón M, Ramos-Goñi JM, Ibarrondo O, Mar J. Inequalities in health-related quality of life according to age, gender, educational level, social class, body mass index and chronic diseases using the Spanish value set for Euroquol 5D-5L questionnaire. Health Qual Life Outcomes 2019; 17:69. [PMID: 30999899 PMCID: PMC6472013 DOI: 10.1186/s12955-019-1134-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 04/01/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reducing health inequalities on the basis of social factors has been a key driver in the development of Public Health policies. Health-related quality of life is a global indicator useful to assess health inequalities within a society. The objective of this study was to identify inequalities on health by analysing the interactive effects of gender, age, educational level, social class, body mass index and chronic diseases on health-related quality of life in a Spanish population sample. METHODS We used data from the Spanish National Health Survey 2011-2012. Health-related quality of life was measured by the EQ-5D-5L instrument applying the Spanish value set. Probability of being in perfect health was ascertained by logistic regression models including gender, age, educational level, body mass index and social class and the corresponding terms of interaction. A two-part model combining logistic regression analysis and generalized linear models was applied to calculate the adjusted utility loss associated with chronic conditions (disutility values). RESULTS The sample used for analysis contained 18,450 individuals. The mean age was 50 years, 51.3% were women, 55% were overweight or obese and 46.7% had low social status. The mean utility was 0.94 in men and 0.89 in women. Elderly women, obese people, those of low social class and those with chronic conditions had significant lower utility values. Within the regression analysis, interaction assessment revealed that the detrimental effect of obesity disappeared in higher social classes. Utility values for all chronic conditions considered were lower in women than in men and were on a gradient within social class, the lowest for individuals declaring stroke. The greatest decrease on health-related quality of life was determined by declaration of stroke (17.6%) or mental diseases (18.6%). CONCLUSIONS The interactive effects of gender, age, educational level, social class, body mass index and chronic diseases on health-related quality of life in the Spanish population revealed important inequalities in health. Social class acted as a modulator of the stigma associated with obesity. Chronic conditions producing loss of autonomy had the greatest impact on reduction of health-related quality of life. This is the first study using the Spanish EQ-5D-5L value set to estimate utilities.
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Affiliation(s)
- Arantzazu Arrospide
- Unidad de Investigación AP-OSIs Gipuzkoa, Hospital Alto Deba, Avda Navarra 16, Arrasate-Mondragón, 20500 Gipuzkoa Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain
- Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain
| | - Mónica Machón
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain
- Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain
- Unidad de Investigación AP-OSIs Gipuzkoa, Osakidetza, San Sebastián, Spain
- Centro de Investigación en Cronicidad Kronikgune, Barakaldo, Spain
| | - Juan M. Ramos-Goñi
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain
- Axentiva Solutions, Tacoronte, Spain
| | - Oliver Ibarrondo
- Unidad de Investigación AP-OSIs Gipuzkoa, Hospital Alto Deba, Avda Navarra 16, Arrasate-Mondragón, 20500 Gipuzkoa Spain
- Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain
| | - Javier Mar
- Unidad de Investigación AP-OSIs Gipuzkoa, Hospital Alto Deba, Avda Navarra 16, Arrasate-Mondragón, 20500 Gipuzkoa Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain
- Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain
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Wu X, Liu Q, Li Q, Tian Z, Tan H. Health-Related Quality of Life and Its Determinants among Criminal Police Officers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081398. [PMID: 31003430 PMCID: PMC6518095 DOI: 10.3390/ijerph16081398] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/08/2019] [Accepted: 04/13/2019] [Indexed: 01/02/2023]
Abstract
Criminal police officers are viewed as having a very tiring and stressful job, one that is closely correlated with work disability and other factors that might impair quality of life. Few studies have addressed the issue of health-related quality of life (HRQoL) in this population. Thus, this study aimed to assess the HRQoL of criminal police officers compared with the general adult population and identify determinants associated with HRQoL. Based on a cross-sectional study of 281 criminal police officers in China, we used the EuroQol five-dimension three-level (EQ-5D-3L) scale, the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS) to collect data. Tobit regression models and logistic regression models were used to investigate factors associated with HRQoL. The average EQ-5D-3L index score and EQ-5D visual analogue set (EQ-5D VAS) score were 0.919 and 77.22, respectively (total comparable population 0.958 and 80.12, respectively). Anxiety/depression and pain/discomfort were the most frequently-reported problems. Lower HRQoL was associated with age, drinking alcohol, physical activity, injury on duty, and symptoms of anxiety or depression. These findings indicated that criminal police officers have poorer quality of life than the general adult population and that risk-oriented interventions should be implemented to improve the HRQoL of criminal police officers.
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Affiliation(s)
- Xinrui Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China.
| | - Qian Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China.
| | - Qi Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China.
| | - Zhengwen Tian
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China.
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China.
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Chiowchanwisawakit P, Srinonprasert V, Thaweeratthakul P, Katchamart W. Disease activity and functional status associated with health-related quality of life and patient-acceptable symptom state in patients with psoriatic arthritis in Thailand: A cross-sectional study. Int J Rheum Dis 2019; 22:700-707. [PMID: 30666824 DOI: 10.1111/1756-185x.13473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 12/19/2018] [Accepted: 12/22/2018] [Indexed: 01/02/2023]
Abstract
AIM To identify factors associated with the EuroQol-5 Dimensions-5 levels (EQ-5D-5L) and patient acceptable symptom state (PASS) and to estimate health utility (HU) in Thai patients with psoriatic arthritis (PsA). METHODS A cross-sectional study of consecutive PsA patients visiting Siriraj Hospital was performed between 31 May, 2012 and 31 March, 2016. Data of patient demographics, HU outcomes (Thai EQ-5D-5L), disease activity (Disease Activity Index for Psoriatic Arthritis [DAPSA], the Clinical DAPSA [cDAPSA], the minimal disease activity [MDA]), and the Health Assessment Questionnaire (HAQ) were collected. Regression analyses were used to explore factors associated with each EQ-5D domain, HU, and PASS. RESULTS Of 129 PsA patients, the mean age was 47.6 years; 53.5% were male. The mean HU was 0.76. Univariable analysis showed lower disease activity and less impaired function were significantly associated with higher HU and no to mild problem in each EQ-5D domain. Multivariable analysis showed HAQ and disease activity indices (cDAPSA, DAPSA, MDA) adjusting for age, had good goodness-of-fit to HU (adjusted R2 : 0.63-0.65). Patients answering "yes" to PASS had significantly longer disease duration of PsA, higher HU, lower disease activity, less disability, and were more often married than those answering "no" to PASS. Pain problem was the most important association to PASS adjusting for other domains and age. CONCLUSIONS Disease activity and functional status in PsA patients were significant factors related to HU and PASS. To improve quality of life, the goal of treatment should be achieving remission, improving function, and controlling pain.
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Affiliation(s)
- Praveena Chiowchanwisawakit
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Varalak Srinonprasert
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Phakhamon Thaweeratthakul
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wanruchada Katchamart
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Kangwanrattanakul K, Gross CR, Sunantiwat M, Thavorncharoensap M. Exploration of a cultural-adaptation of the EQ-5D for Thai population: A “bolt-on” experiment. Qual Life Res 2018; 28:1207-1215. [DOI: 10.1007/s11136-018-2072-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2018] [Indexed: 10/27/2022]
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Kangwanrattanakul K, Gross CR, Sunantiwat M, Thavorncharoensap M. Adding two culture-specific 'bolt-on' dimensions on the Thai version of EQ-5D-5L: an exploratory study in patients with diabetes. Expert Rev Pharmacoecon Outcomes Res 2018; 19:321-329. [PMID: 30221564 DOI: 10.1080/14737167.2019.1525294] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND This study explored whether addition of culture-specific bolt-on dimensions, 'interpersonal relationships (IR)' and 'activities related to bending knees (AK)' improves the relevance and validity of the EQ-5D among Thai patients with diabetes. METHODS A cross-sectional study was conducted among 200 diabetic patients. Ceiling/floor effects, known-groups validity and test-retest reliability were evaluated. Hierarchical multiple regressions was performed to evaluate the incremental value of the EQ-5D+AK+IR over the EQ-5D-5L in predicting utility measured by visual analog scale (VAS). RESULTS The EQ-5D+AK+IR reduced ceiling effects by 34%. For known-groups validity, women and lower educated patients reported more AK problems (p-value< 0.05); however, none of the IR dimension hypotheses were supported. Both IR and AK had the weighted kappa coefficients of 0.49, indicating good reliability. Hierarchical multiple regression found that adding AK (adjusted r2: 0.182 vs 0.156), but not IR (adjusted r2: 0.157 vs 0.156) significantly increased the explained variance in VAS score. CONCLUSION Preliminary findings suggest that AK, but not IR, may be a useful addition to the EQ-5D questionnaire for use with Thai patients. Further studies in diverse populations are needed to examine the impacts of the proposed new dimensions and determine if these cultural adaptations are justified.
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Affiliation(s)
- Krittaphas Kangwanrattanakul
- a Department of Pharmacy, Faculty of Pharmacy , Mahidol University , Bangkok , Thailand.,b Faculty of Pharmaceutical Sciences , Burapha University , Chonburi , Thailand
| | - Cynthia R Gross
- c Department of Experimental and Clinical Pharmacology , College of Pharmacy, University of Minnesota , Minneapolis , USA
| | - Montaya Sunantiwat
- a Department of Pharmacy, Faculty of Pharmacy , Mahidol University , Bangkok , Thailand
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Purba FD, Hunfeld JAM, Timman R, Iskandarsyah A, Fitriana TS, Sadarjoen SS, Passchier J, Busschbach JJV. Test-Retest Reliability of EQ-5D-5L Valuation Techniques: The Composite Time Trade-Off and Discrete Choice Experiments. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2018; 21:1243-1249. [PMID: 30314626 DOI: 10.1016/j.jval.2018.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/18/2018] [Accepted: 02/15/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To explore the test-retest reliability of the composite time trade-off (C-TTO) and discrete choice experiment (DCE) used in the Indonesian five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) valuation study. METHODS A representative sample aged 17 years and older was recruited from the Indonesian general population by stratified quota sampling with respect to residence, sex, and age. Trained interviewers conducted computer-assisted face-to-face interviews using the EuroQol valuation technology. Each respondent valued 10 health states using C-TTO and 7 pairs of health states in a DCE exercise. The retest interview was conducted after 2 weeks by the same interviewer. The Wilcoxon matched-pairs signed-rank test, intraclass correlation coefficient, and multilevel regression were applied in comparing the C-TTO test and retest data. For DCE, the analysis of proportions was used. RESULTS A total of 226 respondents with characteristics similar to the Indonesian population completed the retest interview. For C-TTO, 82 (95.3%) of 86 health states had no significant mean value differences between test and retest. The mean value of the second test was statistically significantly higher than that of the first test by 0.042. For DCE, 72.5% of responses were identical. DCE retest showed a different pattern concerning the relative importance of the dimensions, whereas the C-TTO remained the same. CONCLUSIONS C-TTO is stable over time, whereas in DCE the relative values of the dimensions shift. The results support the use of the C-TTO, in particular the Indonesian EQ-5D-5L value set, and suggest a critical examination of the reliability of DCE results over time.
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Affiliation(s)
- Fredrick Dermawan Purba
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Department of Developmental Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia.
| | - Joke A M Hunfeld
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Reinier Timman
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Aulia Iskandarsyah
- Department of Clinical Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Titi Sahidah Fitriana
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, The Netherlands; Faculty of Psychology, YARSI University, Jakarta, Indonesia
| | - Sawitri S Sadarjoen
- Department of Clinical Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Jan Passchier
- Department of Clinical, Neuro and Developmental Psychology, VU University, Amsterdam, The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Bilbao A, García-Pérez L, Arenaza JC, García I, Ariza-Cardiel G, Trujillo-Martín E, Forjaz MJ, Martín-Fernández J. Psychometric properties of the EQ-5D-5L in patients with hip or knee osteoarthritis: reliability, validity and responsiveness. Qual Life Res 2018; 27:2897-2908. [PMID: 29978346 DOI: 10.1007/s11136-018-1929-x] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To study the psychometric properties, including reliability, validity and responsiveness, of the Spanish EQ-5D-5L questionnaire for patients with hip or knee osteoarthritis (OA). METHODS We included 758 patients with hip or knee OA who completed the EQ-5D-5L and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline, of whom 644 also did 6 months later. The EQ-5D-5L contains five questions from which a utility index is derived. The WOMAC covers three dimensions: pain, stiffness and physical function. Floor and ceiling effects were calculated. Reliability was assessed using Cronbach's alpha. Convergent validity was tested using the Spearman correlation coefficient between EQ-5D-5L and WOMAC. We examined known-groups validity by comparing the EQ-5D-5L between subgroups defined by WOMAC scores using ANOVA or the Kruskal-Wallis test. Effect sizes were calculated to assess responsiveness, and minimal clinically important difference (MCID) was estimated. RESULTS The EQ-5D-5L showed minimal floor and ceiling effects (< 3%). Cronbach's alpha was 0.86. The EQ-5D-5L index was strongly correlated with WOMAC pain and function scores (- 0.688 and - 0.782). Patients with higher WOMAC scores had significantly (p < 0.0001) lower EQ-5D-5L index. The 20.19% had hip or knee replacement during the follow-up. Effect sizes were small among non-surgical patients, but > 0.80 among "improved" surgical patients, being the MCID for improvement 0.32 points. CONCLUSIONS The results support the reliability, validity and responsiveness of the EQ-5D-5L, overcoming the limitations of the EQ-5D-3L in these patients. Therefore, the EQ-5D-5L could be very useful as an outcome measure, at least in patients with hip or knee OA.
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Affiliation(s)
- Amaia Bilbao
- Research Unit, Basurto University Hospital (Osakidetza), Avda. Montevideo, 18, 48013, Bilbao, Bizkaia, Spain. .,Health Service Research Network on Chronic Diseases (REDISSEC), Bilbao, Spain.
| | - Lidia García-Pérez
- Health Service Research Network on Chronic Diseases (REDISSEC), Bilbao, Spain.,Canary Foundation for Health Research (FUNCANIS), La Laguna, Tenerife, Spain
| | - Juan Carlos Arenaza
- Health Service Research Network on Chronic Diseases (REDISSEC), Bilbao, Spain.,Traumatology and Orthopedic Surgery Service, Basurto University Hospital (Osakidetza), Bilbao, Bizkaia, Spain
| | - Isidoro García
- Traumatology and Orthopedic Surgery Service, Galdakao-Usansolo Hospital (Osakidetza), Galdakao, Bizkaia, Spain
| | - Gloria Ariza-Cardiel
- Health Service Research Network on Chronic Diseases (REDISSEC), Bilbao, Spain.,Multiprofessional Teaching Unit of Primary and Community Care, Primary Healthcare Management, Madrid Health Service, Madrid, Spain
| | | | - Maria João Forjaz
- Health Service Research Network on Chronic Diseases (REDISSEC), Bilbao, Spain.,Carlos III Health Institute, National School of Public Health, Madrid, Spain
| | - Jesús Martín-Fernández
- Health Service Research Network on Chronic Diseases (REDISSEC), Bilbao, Spain.,Villamanta Clinic, Navalcarnero Health Centre, Madrid Health Service, Madrid, Spain.,Health Sciences Faculty, Rey Juan Carlos University, Madrid, Spain
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