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Ibáñez-Davó M, Balanza-Galindo S, Gómez-Díaz M, Morales-Moreno I. Quality of life of patients and caregivers in southern Spain: Living with the Obstructive pulmonary disease and after a stroke. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2631-e2637. [PMID: 34997793 DOI: 10.1111/hsc.13706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/22/2020] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
Chronic diseases show a significant limitation on the quality of life and functional status, as patients as also their caregivers. The objective of this study is to analyse the quality of life of patients diagnosed with chronic obstructive pulmonary disease and stroke and their caregivers, and to find out if there is a relationship between the caregiver's overload and the quality of life of the patient, as well as to determine whether the functional status of the patients is related to the quality of life of the caregiver. Quantitative, observational, descriptive, cross-sectional and prospective study, performed at Primary Health Care Centres of the northwest Area of Murcia Region (Spain), between January and May 2018, with 131 patients, 79 with stroke, 48 with chronic obstructive pulmonary disease (4 of them with both diseases), and 110 caregivers. The EuroQol scale, Zarit's questionnaire and Barthel's index and an ad hoc questionnaire of sociodemographic variables developed for this study were used. We found a positive and significant correlation between the scores of the caregiver's overload scale and those of the caregiver's health status (r = -0.425; p = 0.001), and a negative and also significant correlation between the overload and quality of life of the patients (r = -0.297; p = 0.002) and their inability (r = 0.189; p = 0.048). The more the overload we find the worse quality of life of the caregiver, but better quality of life of the patient. The physical inability of the patients also influences on the caregiver's level of overload, but not in his health status. Intervention programmes are needed to improve the quality of life of family members as they are the best patient support and the best help for healthcare professionals.
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Affiliation(s)
- María Ibáñez-Davó
- Faculty of Nursing, Catholic University of Murcia (UCAM), Murcia, Spain
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Ayora AF, Soler LM, Gasch AC. Analysis of two questionnaires on quality of life of Chronic Obstructive Pulmonary Disease patients. Rev Lat Am Enfermagem 2019; 27:e3148. [PMID: 31340341 PMCID: PMC6687364 DOI: 10.1590/1518-8345.2624.3148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 02/07/2019] [Indexed: 01/10/2023] Open
Abstract
Objective: to evaluate the efficacy of quality of life questionnaires St. George
Respiratory Questionnaire and Chronic Obstructive
Pulmonary Disease Assessment Test in patients with chronic
obstructive pulmonary disease based on correlation and agreement analyses,
and identify the most effective tool to assess their quality of life. Method: cross-sectional cohort study with patients hospitalized in a Spanish hospital
for exacerbation of chronic obstructive pulmonary disease. Health-related
quality of life was assessed with both questionnaires. The correlation and
the agreement between the questionnaires were analyzed, as well as the
internal consistency. Associations were established between the clinical
variables and the results of the questionnaire. Results: one hundred and fifty-six patients participated in the study. The scales had
a correlation and agreement between them and high internal consistency. A
higher sensitivity of the Chronic Obstructive Pulmonary Disease
Assessment Test was observed for the presence of cough and
expectoration. Conclusion: the questionnaires have similar reliability and validity to measure the
quality of life in patients with acute chronic obstructive pulmonary
disease, and the Chronic Obstructive Pulmonary Disease
Assessment Test is more sensitive to detect cough and
expectoration and requires a shorter time to be completed.
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Affiliation(s)
- Ana Folch Ayora
- Universitat Jaume I, Facultad de Ciencias de la Salud, Castellón de la Plana, Comunidad Valenciana, Espanha
| | - Loreto Macia Soler
- Universidad de Alicante, Facultad de Ciencias de la Salud, Alicante, Comunidad Valenciana, Espanha
| | - Agueda Cervera Gasch
- Universitat Jaume I, Facultad de Ciencias de la Salud, Castellón de la Plana, Comunidad Valenciana, Espanha
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Folch-Ayora A, Orts-Cortés MI, Macia-Soler L, Andreu-Guillamon MV, Moncho J. Patient education during hospital admission due to exacerbation of chronic obstructive pulmonary disease: Effects on quality of life-Controlled and randomized experimental study. PATIENT EDUCATION AND COUNSELING 2019; 102:511-519. [PMID: 30279028 DOI: 10.1016/j.pec.2018.09.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 09/05/2018] [Accepted: 09/14/2018] [Indexed: 06/08/2023]
Abstract
UNLABELLED The objective of this study was to assess the effectiveness of an education program and telephone call follow-up at improving the health related quality of life (HRQL) of patients with chronic obstructive pulmonary disease (COPD). METHOD Experimental, controlled, randomized, single blind study, masked data analysis. Duration of 2 years and 3 months. Patients hospitalised for exacerbation. The effectiveness was evaluated by calculating the absolute and relative change (%) of the St. George questionnaire scores (total and by dimensions) before and after the intervention program. Calculation of the effect of the group variable on the absolute and relative changes of the variables, Multiple Analysis of Variance (MANOVA). RESULTS Completed study of 116 patients. Greater effects on their HRQL reported at admission (48.3 ± SD 20.0 years). Patients in the intervention group improved significantly in their total SGRQ scores (-6.83) in absolute and relative terms and more significantly in their activity dimension (-16.05). CONCLUSIONS The education program was effective at improving global HRQL, especially the activity dimension, in exacerbated COPD patients. PRACTICE IMPLICATIONS This research contributes to clarifying the benefits and contents of education programs for patients with COPD; hospital admission is the suitable moment to contact these patients.
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Affiliation(s)
- A Folch-Ayora
- Department of Nursing, University Jaume I, Castellón de la Plana, Spain
| | - M I Orts-Cortés
- Department of Nursing, Universidad de Alicante, Nursing and Healthcare Research Unit (Investén-isciii), Instituto de Salud Carlos III, CIBERFES, Grupo Balmis, ISABIAL, Alicante, Spain.
| | - L Macia-Soler
- Department of Nursing, Universidad de Alicante, Alicante, Spain
| | | | - J Moncho
- Research Unit for the Analysis of Mortality and Health Statistics, Universidad de Alicante, Alicante, Spain
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Carratalá-Munuera C, Arriero-Marin JM, Orozco-Beltrán D, Cuneo Amat B, Lopez-Pineda A, Soler-Cataluña JJ, Gil-Guillén VF, Quesada Rico JA. Percepción de calidad de vida en pacientes con enfermedad pulmonar obstructiva crónica en España. OPEN RESPIRATORY ARCHIVES 2019. [DOI: 10.1016/j.opresp.2019.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Folch Ayora A, Macia-Soler L, Orts-Cortés MI, Hernández C, Seijas-Babot N. Comparative analysis of the psychometric parameters of two quality-of-life questionnaires, the SGRQ and CAT, in the assessment of patients with COPD exacerbations during hospitalization: A multicenter study. Chron Respir Dis 2018. [PMID: 29529879 PMCID: PMC6234566 DOI: 10.1177/1479972318761645] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The aim of this study was to assess health-related quality of life (HRQL) in patients with chronic obstructive pulmonary disease (COPD) and to discuss the different tools available for its assessment. The most widely used assessments are the St. George respiratory questionnaire (SGRQ) and the COPD assessment test (CAT) questionnaire. Both have a different difficulty in exam completion, calculation, and scoring. No studies exist that analyze the validity and internal consistency of using both questionnaires on patients admitted to the hospital for a COPD exacerbation. A multicenter, cross-sectional analytic observational study of patients admitted to the hospital due to a COPD exacerbation (CIE 491.2). During their hospital stay, they were administered the SGRQ and the CAT questionnaire within the framework of a therapeutic education program (APRENDEPOC). Descriptive and comparative analysis, correlations between the scales (Pearson’s correlation index), consistency and reliability calculations (Cronbach’s α), and a forward stepwise multiple linear regression were performed, with significant correlations in both questionnaires considered p < 0.01 with the total scores. A statistical significance of p < 0.05 was assumed. Altogether, 231 patients were admitted for a COPD exacerbation (n = 77) at Hospital Clínic of Barcelona (HCB) and (n = 154) at Hospital Universitario General of Castellón (HUGC). The sample profile was not homogeneous between both centers, with significant differences in HRQL between hospitals. Correlation were noted between both scales (p < 0.01), along with high levels of internal consistency and reliability (CAT 0.836 vs. SGRQ 0.827). The HRQL is related to dyspnea, wheezing, daytime drowsiness, and edema, as well as to the need to sleep in a sitting position, anxiety, depression, and dependence on others in the execution of daily activities. Our regression analysis showed that the SGRQ questionnaire could predict more changes in HRQL with a higher number of variables.
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Hoogendoorn M, Feenstra TL, Asukai Y, Briggs AH, Borg S, Dal Negro RW, Hansen RN, Jansson SA, Leidl R, Risebrough N, Samyshkin Y, Wacker ME, Rutten-van Mölken MPMH. Patient Heterogeneity in Health Economic Decision Models for Chronic Obstructive Pulmonary Disease: Are Current Models Suitable to Evaluate Personalized Medicine? VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2016; 19:800-810. [PMID: 27712708 DOI: 10.1016/j.jval.2016.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 02/18/2016] [Accepted: 04/03/2016] [Indexed: 05/26/2023]
Abstract
OBJECTIVES To assess how suitable current chronic obstructive pulmonary disease (COPD) cost-effectiveness models are to evaluate personalized treatment options for COPD by exploring the type of heterogeneity included in current models and by validating outcomes for subgroups of patients. METHODS A consortium of COPD modeling groups completed three tasks. First, they reported all patient characteristics included in the model and provided the level of detail in which the input parameters were specified. Second, groups simulated disease progression, mortality, quality-adjusted life-years (QALYs), and costs for hypothetical subgroups of patients that differed in terms of sex, age, smoking status, and lung function (forced expiratory volume in 1 second [FEV1] % predicted). Finally, model outcomes for exacerbations and mortality for subgroups of patients were validated against published subgroup results of two large COPD trials. RESULTS Nine COPD modeling groups participated. Most models included sex (seven), age (nine), smoking status (six), and FEV1% predicted (nine), mainly to specify disease progression and mortality. Trial results showed higher exacerbation rates for women (found in one model), higher mortality rates for men (two models), lower mortality for younger patients (four models), and higher exacerbation and mortality rates in patients with severe COPD (four models). CONCLUSIONS Most currently available COPD cost-effectiveness models are able to evaluate the cost-effectiveness of personalized treatment on the basis of sex, age, smoking, and FEV1% predicted. Treatment in COPD is, however, more likely to be personalized on the basis of clinical parameters. Two models include several clinical patient characteristics and are therefore most suitable to evaluate personalized treatment, although some important clinical parameters are still missing.
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Affiliation(s)
- Martine Hoogendoorn
- Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Talitha L Feenstra
- Department for Prevention and Health Services Research, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands; Department of Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Yumi Asukai
- IMS Health, Health Economics and Outcomes Research and Real-World Evidence Solutions, London, UK
| | - Andrew H Briggs
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Sixten Borg
- The Swedish Institute for Health Economics, Lund, Sweden; Health Economics Unit, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden; Evidera, London, UK
| | - Roberto W Dal Negro
- National Center for Respiratory Pharmacoeconomics and Pharmacoepidemiology (CESFAR), Verona, Italy
| | - Ryan N Hansen
- Pharmaceutical Outcomes Research and Policy Program, School of Pharmacy, University of Washington, Seattle, WA, USA
| | - Sven-Arne Jansson
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Reiner Leidl
- Helmholtz Zentrum München, Institute of Health Economics and Health Care Management, Member of the German Center for Lung Research, Comprehensive Pneumology Center Munich, Neuherberg, Germany
| | | | - Yevgeniy Samyshkin
- IMS Health, Health Economics and Outcomes Research and Real-World Evidence Solutions, London, UK
| | - Margarethe E Wacker
- Helmholtz Zentrum München, Institute of Health Economics and Health Care Management, Member of the German Center for Lung Research, Comprehensive Pneumology Center Munich, Neuherberg, Germany
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Cano Gutiérrez C, Arciniegas Rubio A, Germán Borda M, Samper-Ternent R, Gil Laverde F, Londoño Trujillo D. Perception of health-related quality of life using the EURO-QOL in older adults in Bogotá, Colombia. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2016.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Miravitlles M, Huerta A, Valle M, García-Sidro P, Forné C, Crespo C, López-Campos JL. Clinical variables impacting on the estimation of utilities in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2015; 10:367-77. [PMID: 25733826 PMCID: PMC4337593 DOI: 10.2147/copd.s76397] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Health utilities are widely used in health economics as a measurement of an individual's preference and show the value placed on different health states over a specific period. Thus, health utilities are used as a measure of the benefits of health interventions in terms of quality-adjusted life years. This study aimed to determine the demographic and clinical variables significantly associated with health utilities for chronic obstructive pulmonary disease (COPD) patients. PATIENTS AND METHODS This was a multicenter, observational, cross-sectional study conducted between October 2012 and April 2013. Patients were aged ≥40 years, with spirometrically confirmed COPD. Utility values were derived from the preference-based generic questionnaire EQ-5D-3L applying weighted Spanish societal preferences. Demographic and clinical variables associated with utilities were assessed by univariate and multivariate linear regression models. RESULTS Three hundred and forty-six patients were included, of whom 85.5% were male. The mean age was 67.9 (standard deviation [SD] =9.7) years and the mean forced expiratory volume in 1 second (%) was 46.2% (SD =15.5%); 80.3% were former smokers, and the mean smoking history was 54.2 (SD =33.2) pack-years. Median utilities (interquartile range) were 0.81 (0.26) with a mean value of 0.73 (SD =0.29); 22% of patients had a utility value of 1 (ceiling effect) and 3.2% had a utility value lower than 0. The factors associated with utilities in the multivariate analysis were sex (beta =-0.084, 95% confidence interval [CI]: -0.154; -0.013 for females), number of exacerbations the previous year (-0.027, 95% CI: -0.044; -0.010), and modified Medical Research Council Dyspnea Scale (mMRC) score (-0.123 [95% CI: -0.185; -0.061], -0.231 [95% CI: -0.301; -0.161], and -0.559 [95% CI: -0.660; -0.458] for mMRC scores 2, 3, and 4 versus 1), all P<0.05. CONCLUSION Multivariate analysis showed that female sex, frequent exacerbations, and an increased level of dyspnea were the main factors associated with reduced utility values in patients with COPD.
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Affiliation(s)
- Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain ; CIBER de Enfermedades Respiratorias (CIBERES), Tres Cantos, Madrid, Spain
| | - Alicia Huerta
- Market Access Department, GlaxoSmithKline, Tres Cantos, Madrid, Spain
| | - Manuel Valle
- Pneumology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Patricia García-Sidro
- Pneumology Department, Hospital Universitario de la Plana, Vila-real, Castellón, Spain
| | - Carles Forné
- Health Economics and Outcome Strategies Department, Oblikue Consulting, Barcelona, Spain
| | - Carlos Crespo
- Health Economics and Outcome Strategies Department, Oblikue Consulting, Barcelona, Spain ; Statistics Department, University of Barcelona, Barcelona, Spain
| | - José Luis López-Campos
- CIBER de Enfermedades Respiratorias (CIBERES), Tres Cantos, Madrid, Spain ; Unidad Médico Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
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Miravitlles M, Huerta A, Fernández-Villar JA, Alcázar B, Villa G, Forné C, Cuesta M, Crespo C, García-Río F. Generic utilities in chronic obstructive pulmonary disease patients stratified according to different staging systems. Health Qual Life Outcomes 2014; 12:120. [PMID: 25189786 PMCID: PMC4173058 DOI: 10.1186/s12955-014-0120-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 07/22/2014] [Indexed: 11/10/2022] Open
Abstract
Background To determine generic utilities for Spanish chronic obstructive pulmonary disease (COPD) patients stratified by different classifications: GOLD 2007, GOLD 2013, GesEPOC 2012 and BODEx index. Methods Multicentre, observational, cross-sectional study. Patients were aged ≥40 years, with spirometrically confirmed COPD. Utility values were derived from EQ-5D-3 L. Means, standard deviations (SD), medians and interquartile ranges (IQR) were computed based on the different classifications. Differences in median utilities between groups were assessed by non-parametric tests. Results 346 patients were included, of which 85.5% were male with a mean age of 67.9 (SD = 9.7) years and a mean duration of COPD of 7.6 (SD = 5.8) years; 80.3% were ex-smokers and the mean smoking history was 54.2 (SD = 33.2) pack-years. Median utilities (IQR) by GOLD 2007 were 0.87 (0.22) for moderate; 0.80 (0.26) for severe and 0.67 (0.42) for very-severe patients (p < 0.001 for all comparisons). Median utilities by GOLD 2013 were group A: 1.0 (0.09); group B: 0.87 (0.13); group C: 1.0 (0.16); group D: 0.74 (0.29); comparisons were statistically significant (p < 0.001) except A vs C. Median utilities by GesEPOC phenotypes were 0.84 (0.33) for non exacerbator; 0.80 (0.26) for COPD-asthma overlap; 0.71 (0.62) for exacerbator with emphysema; 0.72 (0.57) for exacerbator with chronic bronchitis (p < 0.001). Comparisons between patients with or without exacerbations and between patients with COPD-asthma overlap and exacerbator with chronic bronchitis were statistically-significant (p < 0.001). Median utilities by BODEx index were: group 0–2: 0.89 (0.20); group 3–4: 0.80 (0.27); group 5–6: 0.67 (0.29); group 7–9: 0.41 (0.31). All comparisons were significant (p < 0.001) except between groups 3–4 and 5–6. Conclusion Irrespective of the classification used utilities were associated to disease severity. Some clinical phenotypes were associated with worse utilities, probably related to a higher frequency of exacerbations. GOLD 2007 guidelines and BODEx index better discriminated patients with a worse health status than GOLD 2013 guidelines, while GOLD 2013 guidelines were better able to identify a smaller group of patients with the best health.
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