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Clemmesen MER, Gren ST, Frøstrup AG, Thomsen SF, Egeberg A, Thein D. Psychosocial and mental impact of alopecia areata: Analysis of the Danish Skin Cohort. J Eur Acad Dermatol Venereol 2024. [PMID: 38940661 DOI: 10.1111/jdv.20211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 05/24/2024] [Indexed: 06/29/2024]
Abstract
IMPORTANCE Alopecia areata (AA) carries a psychological burden for patients beyond hair loss. However, quality-of-life measurement tools such as EQ-5D used in clinical trials may not adequately capture the burden of AA, the perceived stigmatization or the psychosocial impact of AA. OBJECTIVE To investigate the potential association between disease severity and the degree of social isolation, perceived stigmatization, anxiety and depression, alcohol consumption and work absenteeism using multiple PRO measures in patients with AA. DESIGN, SETTING AND PARTICIPANTS Using the Danish Skin Cohort, the study included adult patients diagnosed with AA. The study included multiple PRO measures, including Skindex-16, EQ-5D-5L, Work Productivity and Activity Impairment (WPAI), Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and the Alopecia Areata Symptom Impact Scale (AASIS). The questionnaires were dispatched to the patients in January 2023. The severity of AA was determined based on scalp involvement using a modified Alopecia Areata Scale. Multiple multivariate linear regressions were conducted using Skindex-16, AASIS and WPAI, while multivariate logistic regressions were applied to HADS, AUDIT-C and EQ-5D-5L. RESULTS A total of 376 patients were included, of which 177 (47%) had severe disease, 41 (11%) had moderate disease, 94 (25%) had mild disease, and 64 (17%) were in remission. The median age of patients was 55 (IQR, 47-66 years) and most were female (70%). Skindex-16 and AASIS were the only PRO measures able to distinguish between severity. For these scores, moderate and severe diseases, female sex, and involvement of eyebrows increased the score and negatively impacted patient quality of life. CONCLUSION AND RELEVANCE The results indicate the importance of using the proper tool for the intended measurement of quality of life and that factors such as the severity of AA, as well as female sex and involvement of the eyebrows, may potentially increase the psychosocial burden of AA.
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Affiliation(s)
| | | | | | - Simon Francis Thomsen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Alexander Egeberg
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - David Thein
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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Cha EJ, Moon Y, Ryu SH, Jeon HJ. Central features in health-related quality of life in older adults: network analysis using nationwide survey data. BJPsych Open 2023; 9:e145. [PMID: 37550873 PMCID: PMC10617500 DOI: 10.1192/bjo.2023.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Population ageing is a global phenomenon that necessitates consideration of health-related quality of life (HRQoL) in older adults. Previous studies have investigated related factors including mobility, social support and living situations. AIMS This study aimed to provide a network perspective on factors related to HRQoL. METHOD Cross-sectional nationwide data were obtained from the Korean National Health and Nutrition Examination Survey conducted from 2018 to 2020 for network analyses. Data for participants aged 65 years or above were analysed, resulting in a total of 4317 eligible cases. The variables included were EQ-5D (a measure of HRQoL), household income, education, living situation, subjective perceived health, Charlson Comorbidity Index (a measure of medical comorbidities), stress, exercise per week, alcohol consumption and smoking. Three networks were produced: (a) EQ-5D dimensions network, (2) EQ-5D dimensions, lifestyle and psychosocial factors network, and (3) overall EQ-5D index, lifestyle and psychosocial factors network. Node centralities, bridge centralities and edges of the networks were examined. RESULTS The most central EQ-5D dimension was the ability to carry out usual activities. In the second network, subjective health, stress and anxiety/depression were revealed as nodes with high bridge centralities. Subjective health, exercise, and Charlson Comorbidity Index were nodes closely linked to the overall EQ-5D index. CONCLUSIONS The results emphasise the importance of enhancing functional independence and subjective health cognition, increasing routine exercise and reducing stress as targets for interventions to improve HRQoL in older adults.
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Affiliation(s)
- Eun Jung Cha
- Department of Psychiatry, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Yeonsil Moon
- Department of Neurology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hong Jun Jeon
- Department of Psychiatry, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
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Engel L, Whitehurst DGT, Haagsma J, Janssen MF, Mulhern B. What is measured by the composite, single-item pain/discomfort dimension of the EQ-5D-5L? An exploratory analysis. Qual Life Res 2022; 32:1175-1186. [PMID: 36469212 DOI: 10.1007/s11136-022-03312-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE This study examines the EQ-5D-5L pain/discomfort dimension by drawing comparisons with five other pain and discomfort items (pain severity, discomfort severity, pain frequency, discomfort frequency and pain interference) collected in the Australian psychometric study for the EQ Health and Wellbeing instrument. METHODS Participants, recruited via a market research company, completed an online survey. Methods of analyses included the assessment of descriptive statistics, variation in reporting patterns using chi-square tests and cross-tabulations, correlation analyses, ordered univariate logistic regression, and discriminatory power analyses (Shannon index (H') and Shannon Evenness index (J')). RESULTS Survey data from 514 participants were used. Compared with EQ-5D-5L pain/discomfort, there was a higher proportion of respondents reporting some level of impairment on at least one of the pain severity and discomfort severity items (74% versus 81%). Correlation with EQ-5D-5L pain/discomfort was strongest for pain severity (r = 0.83) and weakest for discomfort frequency (r = 0.41); the same inferences were drawn for predictive ability. Adding any additional pain or discomfort items to the EQ-5D-5L increased the absolute informativity (H') but not the relative informativity (J'). When replacing EQ-5D-5L pain/discomfort with separate pain and/or discomfort items - i.e., adding items to a modified 'EQ-4D-5L'-absolute informativity increased, while relative informativity increased only when pain interference and frequency-related items (independently or in combination) were added. CONCLUSION The EQ-5D-5L pain/discomfort dimension captures aspects of pain more than aspects of discomfort. Potential reasons include the absence of descriptors or because pain is mentioned first in the composite item.
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Affiliation(s)
- Lidia Engel
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St. Kilda Road, Melbourne, VIC, 3004, Australia.
| | - David G T Whitehurst
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
| | - Juanita Haagsma
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
| | - M F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
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Lau CLL, Hor CY, Ong ST, Roslan MF, Beh XY, Permal D, Rama S. Home medication management problems and associated factors among psychiatric patients using home care pharmacy services at government hospitals in western Malaysia. BMC Health Serv Res 2022; 22:726. [PMID: 35650614 PMCID: PMC9157038 DOI: 10.1186/s12913-022-08069-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
Background Proper home medication management plays a role in improving medication adherence, preserving drug efficacy and ensuring safe medication practices, which is crucial to establish positive treatment outcomes. However, no published studies are available on home medication management among psychiatric patients. The study aimed to identify home medication management problems among psychiatric patients in Malaysia and to examine the associations of inappropriate medication storage and lack of a medication administration schedule with sociodemographic factors, disease insight, number of medications and type of home care pharmacy services (HCPS). Methods This multicentre cross-sectional study was conducted among psychiatric patients using HCPS in six government hospitals in western Malaysia. Data were extracted from the HCPS form used for each visit as per the protocol published by the Pharmaceutical Services Division, Ministry of Health Malaysia. A minimum sample size of 169 was needed. Proportional random sampling was applied. The associations of inappropriate medication storage and lack of medication administration schedule with study parameters were analysed using multiple logistic regressions. Results A total of 205 home visits were conducted with 229 home medication management problems identified; inappropriate medication storage and lack of medication administration schedule topped the list. Inappropriate medication storage was significantly associated with low income [AOR = 4.34 (95% CI 1.17:15.98), p = 0.027], alcohol consumption [AOR = 14.26 (95% CI 1.82:111.38), p = 0.011], poor insight [AOR = 2.34 (95% CI 1.08:5.06), p = 0.030] and part-time HCPS [AOR = 2.60 (95% CI 1.20:5.67), p = 0.016]. Lack of administration schedule was significantly associated with low income [AOR = 6.90 (95% CI 1.46:32.48), p = 0.014], smoking [AOR = 2.43 (95% CI 1.20:4.92), p = 0.013], poor insight [AOR = 5.32 (95% CI 2.45:11.56), p < 0.05] and part-time HCPS [AOR = 2.96 (95% CI 1.42:6.15), p = 0.004]. Conclusions Inappropriate medication storage and a lack of a medication administration schedule are common among psychiatric patients. The study also highlighted the potential of HCPS to improve disease insight and home medication management among psychiatric patients if the service is utilized fully.
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Affiliation(s)
- Christine Li Ling Lau
- Pharmacy Department, Bahagia Ulu Kinta Hospital, Ministry of Health Malaysia, Jalan Besar, 31250, Tanjung Rambutan, Perak, Malaysia.
| | - Cheah Yen Hor
- Pharmacy Department, Seri Manjung Hospital, Ministry of Health Malaysia, Seri Manjung, Perak, Malaysia
| | - Siew Ting Ong
- Pharmacy Department, Teluk Intan Hospital, Ministry of Health Malaysia, Teluk Intan, Perak, Malaysia
| | - Muhammad Fadhlullah Roslan
- Pharmacy Department, Raja Permaisuri Bainun Hospital, Ministry of Health Malaysia, Ipoh, Perak, Malaysia
| | - Xin Yi Beh
- Pharmacy Department, Taiping Hospital, Ministry of Health Malaysia, Taiping, Perak, Malaysia
| | - Dashnilatha Permal
- Pharmacy Department, Slim River Hospital, Ministry of Health Malaysia, Slim River, Perak, Malaysia
| | - Shamini Rama
- Pharmacy Department, Raja Permaisuri Bainun Hospital, Ministry of Health Malaysia, Ipoh, Perak, Malaysia
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Cabrero-García J, Rico-Juan JR, Oliver-Roig A. Does the global activity limitation indicator measure participation restriction? Data from the European Health and Social Integration Survey in Spain. Qual Life Res 2022; 31:1335-1344. [PMID: 34882281 PMCID: PMC9023392 DOI: 10.1007/s11136-021-03057-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE The global activity limitation indicator (GALI) is the only internationally agreed and harmonised participation restriction measure. We examine if GALI, as intended, is a reflective measure of the domains of participation; furthermore, we determine the relative importance of these domains. Also, we investigated the consistency of response to GALI by age and gender and compared the performance of GALI with that of self-rated health (SRH). METHODS We used Spanish data from the European Health and Social Integration Survey and selected adults aged 18 and over (N = 13,568). Data analysis, based on logistic regression models and Shapley value decomposition, were also stratified by age. The predictors of the models were demographic variables and restrictions in participation domains: studies, work, mobility, leisure and social activities, domestic life, and self-care. The GALI and SRH were the response variables. RESULTS GALI was strongly associated with all participation domains (e.g. for domestic life, adjusted OR 24.34 (95% CI 18.53-31.97) in adult under 65) and performed differentially with age (e.g. for domestic life, adjusted OR 13.33 (95% CI 10.42-17.03) in adults over 64), but not with gender. The relative importance of domains varied with age (e.g. work was the most important domain for younger and domestic life for older adults). The results with SRH were parallel to those of GALI, but the association of SRH with participation domains was lowest. CONCLUSIONS GALI reflects well restrictions in multiple participation domains and performs differently with age, probably because older people lower their standard of good functioning.
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Affiliation(s)
- Julio Cabrero-García
- Department of Nursing, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig-Alicante, Spain
| | - Juan Ramón Rico-Juan
- Department of Software and Computing Systems, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig-Alicante, Spain
| | - Antonio Oliver-Roig
- Department of Nursing, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig-Alicante, Spain
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Noto S, Wake M, Mishiro I, Hammer-Helmich L, Ren H, Moriguchi Y, Fujikawa K, Fernandez J. Health-Related Quality of Life Over 6 Months in Patients With Major Depressive Disorder Who Started Antidepressant Monotherapy. Value Health Reg Issues 2022; 30:127-133. [PMID: 35405582 DOI: 10.1016/j.vhri.2021.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/03/2021] [Accepted: 12/30/2021] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Major depressive disorder (MDD) is increasing worldwide and is associated with impaired quality of life (QOL). This study aimed to assess the QOL and its association with cognitive symptoms in patients with MDD who started antidepressant monotherapy. METHODS Data from the PERFORM (Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder) study were analyzed. A descriptive epidemiological analysis on EQ-5D-5L utility score, the level of each dimension, and the EuroQoL visual analog scale value was conducted at 4 visits during 6 months' follow-up. The association between cognitive complaints and changes in QOL measures was analyzed using multivariate linear regression analysis. RESULTS The median EQ-5D-5L utility score improved from 0.67 at baseline to 0.82 at month 6. Although the proportion of patients reporting level 1 (no problem) in every dimension of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression increased over time, less than half of the patients achieved level 1 in pain/discomfort and depression/anxiety, which were closely related to depression and usual activities at month 6. Patients with no cognitive complaints or no history of MDD at baseline showed greater improvement in EQ-5D-5L utility scores and EuroQoL visual analog scale value for measuring QOL than those with these characteristics. CONCLUSIONS Treatment over 6 months improved QOL in patients with MDD although there remained room for improvement in dimensions of usual activities, pain/discomfort, and depression/anxiety. Cognitive complaints or history of MDD at baseline predicted less improvement in QOL at 6 months. Any history of MDD might delay improvement in QOL after treatment.
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Affiliation(s)
- Shinichi Noto
- Department of Rehabilitation, Niigata University of Health and Welfare, Niigata, Japan.
| | - Mayumi Wake
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Izumi Mishiro
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | | | | | | | - Keita Fujikawa
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Jovelle Fernandez
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
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Purba FD, Anggriani Y, Murtini T. EQ-5D-5L in Schizophrenia: differences between patients and nurses' reports. Health Qual Life Outcomes 2021; 19:240. [PMID: 34641911 PMCID: PMC8513280 DOI: 10.1186/s12955-021-01873-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: 06/01/2021] [Accepted: 09/30/2021] [Indexed: 11/12/2022] Open
Abstract
Purpose To examine the differences between patient-reports and proxy-reports by nurses of EQ-5D-5L responses among patients with schizophrenia. Methods This study was conducted in June–September 2019 in Duren Sawit Regional Public Hospital in Jakarta, Indonesia. The self-report data were obtained by interviewing the patients and the proxy-report data were obtained from the psychiatric nurses. The patients’ Positive and Negative Syndrome Scale (PANSS) scores were obtained from their medical records. The data were collected in two time points: (1) when the patients moved from the acute to the quiet rooms (first-test) and (2) when they were discharged from the hospital (second-test). The self and proxy report scores were analysed by the Wilcoxon matched-pairs signed-ranks test and their relationship with the PANSS scores using Spearman's rank correlation coefficient. Results There were 206 patients in the final sample. The majority are male (56.8%) with a mean age of 37.5 years (SD = 12.05). Significant differences between the two reports were found in three domains (i.e., self-care, usual activities, and pain/discomfort) in the first-test and two domains (i.e., usual activities and pain/discomfort) in the second-test. Concerning the relationship with the PANSS scores, only three significant correlations were found, all in the proxy-version and in the second-test: mobility (r = 0.139), anxiety/depression (r = 0.2523), and utility scores (r = − 0.176). Conclusions The poor-to-fair agreement between patients and nurses reports and the poor correlation with the PANSS scores suggested that it is difficult to decide which report best represents the patients’ health status.
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Affiliation(s)
- Fredrick Dermawan Purba
- Department of Developmental Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia. .,Center for Health Technology Assessment, Universitas Padjadjaran, Jatinangor, Indonesia. .,Center for Psychological Innovation and Research, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia.
| | - Yusi Anggriani
- Faculty of Pharmacy, University of Pancasila, Jakarta, Indonesia
| | - Tri Murtini
- Faculty of Pharmacy, University of Pancasila, Jakarta, Indonesia
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