Health-related quality of life among patients with hypertension: population-based survey using EQ-5D-5L in Hong Kong SAR, China

Health-related quality of life and its predictors among hypertensive patients on follow up at public hospitals in Addis Ababa, Ethiopia: application of Tobit regression model

BACKGROUND

Health-related quality of life and its associated factors among hypertensive patients living in Ethiopia are not well studied. Therefore, this study aims to assess the level of health-related quality of life and its associated factors in hypertensive patients on follow-up in Public Hospitals in Addis Ababa, Ethiopia.

METHODS

A facility-based cross-sectional study was conducted among 339 hypertensive patients on follow-up at Yekatit 12 &Zewditu Hospitals. Data were collected through face-to-face interviews using Euro Quality of Life Groups 5 Dimensions 5 Levels (EQ-5D-5L) in combination with Euro Quality of Life Groups Visual Analog Scale (EQ-VAS). A multivariable Tobit regression model was employed to assess the association between EQ-5D-5L index, EQ-VAS, and potential predicting factors.

RESULTS

The median index value and EQ-VAS Scales score was 0.86 (IQR = 0.74, 0.94) and 69 (IQR = 55, 80) respectively. The proportion of participants reporting anxiety/depression and pain/discomfort problems was highest, while the fewest patients reported problems in the self-care dimension. Older, rural residents, low income, higher stages of hypertension, increased use of antihypertensive medications, and patients with an increased hospitalization rate scored lower on health-related quality of life than others.

CONCLUSION

Health-related quality of life among hypertensive patients attending public health hospitals in Addis Ababa is unacceptably poor. Emphasis should be given to patients with higher stages of hypertension, increased use of antihypertensive medications, and an increased hospitalization rate giving due focus to older, rural residents, and low-income patients to promote their health-related quality of life.

Evaluation of the health-related quality of life of patients with type 2 diabetes in relation to macrovascular and microvascular complications

PURPOSE

The complications of type 2 diabetes (T2DM) have a negative impact on health-related quality of life (HRQoL) and could lead to increased healthcare costs. However, there is a lack of evidence regarding how and to what extent T2DM complications, particularly macrovascular and microvascular complications, affect the patients' HRQoL. This study aimed to evaluate the HRQoL in relation to diabetes complications and identify associated factors among patients with T2DM.

METHODS

A cross-sectional study was conducted over six months on T2DM patients at a National University Hospital, Malaysia. Since Malaysia is a multiethnic country with majority Malay-speaking and English widely used, the Malay and English versions of the revised version Diabetes Quality of life (DQoL) questionnaire was used to measure HRQoL. Multiple Linear Regression was applied to estimate association of individual DQoL domains with T2DM-related complications, sociodemographic and clinical characteristics.

RESULTS

A total of 513 patients were recruited in the study. Sociodemographic (age, gender, ethnicity, employment, education) and body mass index affected satisfaction, impact and worry domains while complications affected the impact domain. Poorer HRQoL were demonstrated for severe stages heart failure (p = 0.001), nephropathy (p = 0.029), retinopathy (p < 0.001). The presence of neuropathy (p = 0.004) and foot ulcer (p = 0.039) showed poor HRQoL regardless of severity stage. Increase frequencies of hypoglycaemia (p < 0.001) showed poorer HRQoL compared to those with lesser frequencies.

CONCLUSION

The complications, sociodemographic and clinical characteristics of patients with T2DM affect the HRQoL domains differently. Understanding the point of which complication types and stages impact HRQoL the most can provide insights to clinicians to prioritise on effective interventions. The study findings may assist researchers and policymakers in selecting appropriate health state values when conducting cost-effectiveness studies to aid decision making.

Real-World Experience of People with Hemophilia A Receiving Turoctocog Alfa Pegol (N8-GP): Results from a Patient Experience Survey

Purpose

Turoctocog alfa pegol (N8-GP) is an extended half-life recombinant factor VIII molecule used for the treatment of hemophilia A (HA). The purpose of this study was to investigate real-world experiences of patients with HA treated with N8-GP.

Patients and Methods

A 25-minute online survey was completed by adults (≥18 years) and caregivers of adolescents (12-16 years) with HA receiving N8-GP across six countries (Germany, Italy, Portugal, Spain, UK and US). Patients were recruited using a multichannel approach through recruitment panels, referrals from healthcare professionals and patient associations. The survey comprised a questionnaire with metrics including satisfaction and preferences for N8-GP, quality of life (QoL) and long-term impact.

Results

A total of 62 participants (98% male [n=61], mean age 29 years) comprising 46 patients and 16 caregivers completed the survey. Patients (60% non-severe [n=37] and 40% severe [25]) were on N8-GP for a mean period of 1.4 years. Patients expressed satisfaction (95% vs 42%, p<0.001) and preference (91% vs 9%, p<0.001) for N8-GP vs their previous treatments. Most patients with severe HA (87%, p=0.038) and patients on prophylaxis (84%, p<0.001) stated lower frequency of injections as their main reason for satisfaction, while improved QoL drove satisfaction for non-severe patients (81%, p=0.053). Overall, patients perceived that QoL score improved (74.8 vs 65.9, p=0.01) with N8-GP treatment compared with previous treatments. Flexibility to store at room temperature was one of the key convenience factors driving satisfaction. Patients believed that N8-GP can offer a long-term impact in areas such as ability to perform day-to-day activities (68%), independence to live like a person without hemophilia (63%), ability to travel (60%) with a feeling of optimism and hopefulness (82%).

Conclusion

Lower frequency of injections, storage flexibility and improved QoL drove satisfaction and preference for N8-GP over previous treatments among patients with HA.

Measurement of Health-Related Quality of Life in Individuals With Rare Diseases in China: Nation-Wide Online Survey

BACKGROUND

Rare diseases (RDs) affect millions of people worldwide, and these diseases can severely impact the health-related quality of life (HRQoL) of those affected. Despite this, there is a lack of research measuring HRQoL using the EQ-5D-5L, which is one of the most widely used generic preference-based instruments to measure HRQoL in populations living with RDs.

OBJECTIVE

This study aimed to measure HRQoL using the EQ-5D-5L in a large number of patients with various types of RDs in China, and to examine the relationship between respondents' socioeconomic characteristics and preference-based health utility scores.

METHODS

The data used in this study were obtained from a web-based survey conducted in China. The survey aimed to explore and understand the health and socioeconomic status of patients with RDs in China. We recruited registered and eligible members, including patients or their primary caregivers, from 33 RD patient associations to complete the questionnaires via their internal social networks. HRQoL was measured using the EQ-5D-5L utility score, which was calculated based on an established Chinese value set. Utility scores have been presented based on demographics and disease-related information. Univariate linear regression analysis was used to assess the differences in the EQ-5D-5L utility scores between subgroups.

RESULTS

A total of 12,502 respondents completed the questionnaire and provided valid responses, including 6919 self-completed respondents and 5583 proxy-completed respondents. Data from 10,102 participants over the age of 12 years were elicited for analysis. Among patients with RDs, 65.3% (6599/10,102), 47.5% (4799/10,102), 47.0% (4746/10,102), 24.8% (2506/10,102), and 18.4% (1855/10,102) reported no problems for "self-care," "usual activities," "mobility," "pain/discomfort," and "anxiety/depression," respectively. A full health state was reported by 6.0% (413/6902) and 9.2% (295/3200) of self- and proxy-completed patients, respectively. Among self-completed patients, 69.9% (4826/6902) and 50.4% (3478/6902) reported no problems for "self-care" and "usual activities," respectively, whereas only 17.7% (1223/6902) reported problems for "anxiety/depression." Proxy-completed respondents showed a higher proportion of reporting extreme problems than self-completed respondents in all 5 dimensions. The mean utility scores reported by self- and proxy-completed respondents were 0.691 and 0.590, respectively. Different types of caregivers reported different utility scores, and among them, proxy-completed (mother) respondents reported the highest mean utility score.

CONCLUSIONS

The establishment of a normative profile for RD patients can facilitate patients' adaptation and assess the effectiveness of interventions to improve the HRQoL and well-being of this population. Differences between self- and proxy-completed HRQoL assessed by the EQ-5D-5L have been identified in this study. This finding highlights the importance of incorporating perspectives from both patients and their proxies in clinical practice. Further development of the patient cohort is necessary to assess long-term changes in HRQoL in the RD population.

Development and Psychometric Evaluation of a Lifestyle Evaluation Instrument for Older Adults

Brazil is experiencing an accelerated period of population aging, with important implications for individuals, families, and the society at large. Lifestyles for the elderly can have both positive and negative health effects and are characterized by behaviors that individuals constantly reproduce in day-to-day life. However, few assessment instruments are aimed at evaluating lifestyles, and this has hampered research development. Thus, our aim in this study was to develop and evaluate the psychometric qualities of a new instrument to assess older adults' lifestyles. We developed this single scale to assess the lifestyles of older men and women using the sequential mixed method. Individuals over 60 years old of both sexes participated in this study of several phases. In Phase 1, we produced a 96-item single scale instrument, based on a literature review, previous scales, and qualitative research. In Phase 2, we verified the scale's content validity with help from 12 experts and 20 members of a target audience, aged between 60-84 years, deleting some items and reworking others. In Phase 3, we analyzed the psychometric qualities of the new scale in a sample of 700 older adults, aged 60 and above, from the five regions of Brazil, using both exploratory and confirmatory factor analysis. Our completed "Older Adult Lifestyle Scale" (OALS) is composed of 19 items divided into four subscales. The OALS has shown good psychometric qualities for Brazilian older adults over 60 years of age, and we can now recommend its use in this population.

Implementing a package of essential non-communicable diseases interventions in low- and middle-income countries: a realist review protocol

INTRODUCTION

The burden of non-communicable diseases (NCDs) is increasing rapidly, particularly in low- and middle-income countries (LMIC), accounting for 85% of premature deaths in the region. LMICs have been facing an increasing trend of a double burden of disease (infectious diseases and NCDs) that has led to multiple challenges in prioritising strategies for NCDs control amidst limited resources. Evidence indicates that measures such as the WHO's package of essential non-communicable (PEN) diseases interventions can prevent and control NCDs. However, because of the complexity of such health interventions, there is limited evidence that explains how the intervention works, for whom and in what context. We aim to unpack the causal mechanisms explaining how, why, for whom and in what context PEN prevents and controls NCDs.

METHODS AND ANALYSIS

We propose a realist review to understand how, why, for whom and under what circumstances PEN works or does not work. The review process includes five steps applied iteratively throughout the study: clarification of review scope, searching for evidence, appraising and extracting data, synthesising evidence and drawing conclusions, and disseminating the findings. Programme theories will be developed using the realist logic for theory formulation-Retroductive Theorising. The context-mechanism-outcome (CMO) heuristic tool will be used to develop the programme theories. Portions of the reviewed documents describing constructs of context, mechanism and outcomes will be coded inductively and extracted. These extracted constructs will then be linked abductively to formulate CMO configurations.

ETHICS AND DISSEMINATION

Formal ethical approval is not required for this review. Study findings will be disseminated through publications in peer-reviewed journals, conference presentations and formal and informal reports.

Determinants of health-related quality of life in people with Human Immunodeficiency Virus, failing first-line treatment in Africa

BACKGROUND

Antiretroviral treatment improves health related quality of life (HRQoL) of people with human immunodeficiency virus (PWH). However, one third initiating first-line treatment experience virological failure and the determinants of HRQoL in this key population are unknown. Our study aims to identify determinants of among PWH failing antiretroviral treatment in sub-Saharan Africa.

METHODS

We analysed data from a cohort of PWH having virological failure (> 1,000 copies/mL) on first-line ART in South Africa and Uganda. We measured HRQoL using the EuroQOL EQ-5D-3L and used a two-part regression model to obtain by-country analyses for South Africa and Uganda. The first part identifies risk factors that were associated with the likelihood of participants reporting perfect health (utility = 1) versus non-perfect health (utility < 1). The second part identifies risk factors that were associated with the EQ-5 L-3L utility scores for participants reporting non-perfect health. We performed sensitivity analyses to compare the results between the two-part model using tobit models and ordinary least squares regression.

RESULTS

In both countries, males were more likely to report perfect health and participants with at least one comorbidity were less likely to report perfect health. In South Africa, participants with side effects and in Uganda those with opportunistic infections were also less likely to report perfect health. In Uganda, participants with 100% ART adherence were more likely to report perfect health. In South Africa, high HIV viral load, experiencing ART side effects, and the presence of opportunistic infections were each associated with lower HRQoL, whereas participants with 100% ART adherence reported higher HRQoL. In Uganda participants with lower CD4 count had lower HRQoL.

CONCLUSION

Markers of advanced disease (opportunistic infection, high viral load, low CD4), side effects, comorbidities and lack of ART adherence negatively impacted HRQoL for PWH experiencing virological failure.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT02787499.

Mental Health and the COVID-19 Pandemic: Observational Evidence from Malaysia

The interplay of physical, social, and economic factors during the pandemic adversely affected the mental health of healthy people and exacerbated pre-existing mental disorders. This study aimed to determine the impact of the COVID-19 pandemic on the mental health of the general population in Malaysia. A cross-sectional study involving 1246 participants was conducted. A validated questionnaire consisting of the level of knowledge and practice of precautionary behaviors, the Depression, Anxiety, and Stress Scales (DASS), and the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) was used as an instrument to assess the impacts of the COVID-19 pandemic. Results revealed that most participants possessed a high level of knowledge about COVID-19 and practiced wearing face masks daily as a precautionary measure. The average DASS scores were beyond the mild to moderate cut-off point for all three domains. The present study found that prolonged lockdowns had significantly impacted (p < 0.05), the mental health of the general population in Malaysia, reducing quality of life during the pandemic. Employment status, financial instability, and low annual incomes appeared to be risk factors (p < 0.05) contributing to mental distress, while older age played a protective role (p < 0.05). This is the first large-scale study in Malaysia to assess the impacts of the COVID-19 pandemic on the general population.

An observational study on health-related quality of life and persistent symptoms in COVID-19 patients after hospitalization at a tertiary care centre

Aim

The study aims to determine persistent symptoms and effects of COVID-19 infection on the quality of life (QOL) at 1 and 3 months after the acute phase of the disease in mild, moderate and severe cases.

Methods

The prospective observational study was conducted among patients with confirmed COVID-19 who had been treated and discharged after hospitalization from February 2021 to June 2021. All patients were interviewed at 1 and 3 months post discharge to assess persisting symptoms and health-related QOL. QOL was assessed using European Quality Of Life 5-Dimensions 3-Levels (EQ-5D-3L) and EuroQol-visual analogue scales (EQ-VAS).

Results

In total, 388 out of 479 discharged following COVID-19 infection were included. The median age of patients was 48 years, with 62.6% male predominance. Most of the COVID-19 cases were mild (67.01%). Most common presenting symptom was fever (69.8%). EQ-5D-3L showed that the problems reported at 3-month follow-up were significantly less when compared to 1-month follow-up (p < 0.001), and QOL significantly improved after 3 months in non-intensive care unit (ICU) patients when compared to ICU patients (p = 0.007). The mean EQ-VAS score significantly improved at 3 months when compared to 1 month (80.34 ± 12.77 vs. 91.69 ± 12.34; P < 0.001). The severity of illness was correlated with QOL (p < 0.007).

Conclusion

The study results demonstrate ongoing improvement in the QOL and persistent symptoms, while a minority still were symptomatic after 3 months post-COVID-19 illness.

Costs and Quality of Life in Patients With Systemic Arterial Hypertension in Slovenia

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.

The association between personal social capital and health-related quality of life among Chinese older people: A cross-sectional study

Background

Lower health-related quality of life (HRQoL) can result in adverse effects on the health of older people. This study aims to explore the relationship between personal social capital (PSC) and HRQoL among Chinese elderly people from rural-and-urban perspective.

Materials and methods

4,802 samples were included from China's health-related quality of life Survey for Older Adults 2018 (CHRQLS-OA 2018). The PSC, including bonding and bridging social capital (BOC and BRC), was measured by the Chinese version of the Personal Social Capital Scale (PSCS-16). The HRQoL was evaluated by the European Five Dimensions Questionnaire (EQ-5D-3L). Linear and Tobit regression models were conducted to examine the relationship between PSC and HRQoL.

Results

The BOC and BRC of rural older people were significantly lower than those of urban older people. Pain/discomfort and anxiety/depression were the most significant health problems affecting the older samples. In the five dimensions, the proportion of rural older people with problems was higher than that of urban older people. Among rural older people, BOC was significantly related to self-rated health and EQ-5D utility index (p < 0.05); while BRC was insignificantly associated with self-rated health (p > 0.05) but related to EQ-5D utility index (p < 0.05). Both BOC and BRC were significantly correlated with self-rated health and EQ-5D utility index (p < 0.05) among urban older people.

Conclusion

Our study reveals older people's worrying PSC and HRQoL status. The relationship between PSC and HRQoL suggested that more social support and care of intimates should be encouraged to increase the PSC of older people, especially rural older people.

Health-related quality of life and treatment satisfaction of patients with cardiovascular disease in Ethiopia

Purpose

Cardiovascular disease is the most prevalent health problem associated with poorer health-related quality of life (HRQoL). We aimed to assess HRQoL and treatment satisfaction of cardiovascular disease patients in Ethiopia.

Methods

A cross-sectional survey was conducted among adults attending the outpatient cardiac clinic at Tikur Anbessa Specialized Hospital from July to September 2021. Patients were recruited consecutively during follow-up visits. Treatment Satisfaction Questionnaire for Medication and European Quality of life questionnaires were used to evaluate treatment satisfaction and HRQoL, respectively. Kruskal-Wallis and Mann-Whitney U-tests were used to compare utility weights between patient subgroups. Utility values were computed using disutility weights of the Ethiopian general population derived using a hybrid regression model. Tobit regression modeling was used to explore factors associated with poor HRQoL. Statistical significance was determined at p < 0.05.

Results

A total of 357 patients participated in the study with a mean age of 49.3 ± 17.8 years. The most frequently reported health problems were pain/discomfort (75.4%), followed by mobility (73.4%). The median (interquartile range) European Quality questionnaires five dimensions with five levels utility (EQ-5D-5L) and European Quality of life Visual Analog Scale scores were 0.84 (0.55-0.92) and 70.0 (50.0-85.0), respectively. The highest and lowest mean (standard deviation) treatment satisfaction scores were for the convenience and safety satisfaction dimensions: 87.7 (17.9) and 53.1 (33.5), respectively. Unemployment, older age, previous hospital admission, non-adherence to lifestyle modification, and presence of three or more cardiovascular disease factors were significantly negatively associated with HRQoL.

Conclusions

Overall, the study found that cardiovascular disease had a profound negative effect on HRQoL and patient treatment satisfaction. We suggest that interventions to enhance HRQoL and treatment satisfactions should focus on modifiable associated factors including lifestyle changes and controlling disease progression.

Vulnerable populations during COVID-19 response: Health-related quality of life among Chinese population and its influence due to socio-demographic factors and loneliness

Background

Infection control policy affected people's wellbeing during the COVID-19 pandemic, especially those vulnerable populations. This study aimed to compare the health-related quality of life (HRQoL) of the Hong Kong (HK) Chinese population under the pandemic with the normative profiles and explore its influencing factors, including socio-demographic characteristics, loneliness, and the interaction between them.

Methods

A cross-sectional questionnaire survey (301 online and 202 in-person) was conducted between June and December 2020 among the adult Chinese population during the 2nd wave of COVID-19 in HK. HRQoL was measured by a Hong Kong validated EQ-5D-5L instrument (EQ-5D-5L HK). Loneliness was measured by a single-item question regarding the frequency of the participants reporting feeling lonely and their subjective social status was measured by the MacArthur Scale of Subjective Social Status. A series of Tobit regressions was conducted. The interaction terms between socio-demographics and loneliness were also examined to decide their association with HRQoL.

Results

A total of 503 responses were collected. The level of HRQoL of the respondents was significantly lower than the referred norms profile among the local general population. The findings identified that younger age, single, a higher subjective social status, and a lower level of loneliness were significantly associated with better HRQoL. Moreover, age and marital status were significant moderators in the relationship between loneliness and HRQoL.

Conclusion

The present study found that some population groups face additional vulnerabilities during the pandemic in terms of declined HRQoL. In addition, reducing loneliness can protect the HRQoL during the pandemic, especially among older people. This article provides useful information for policy-makers to design and promote effective services or provide education to improve the connection of people and recover from the global pandemic.

Chronic diseases and emotional disorders are associated with low perception of quality of life in food insecurity/security

Understanding individual perception of Quality of Life (QoL) can help combat social and health inequalities. We aimed to identify factors associated with Low Perceived Quality of Life (LPQoL) in 295 adults and older adults with food security and food insecurity, in the city of Natal, Brazil. A cross-sectional study was conducted from June to December 2019, with collection of data on socioeconomic demographic status, lifestyle information, non-communicable diseases (NCDs) and risk factors, emotional disorders, food (in) security and quality of life. To assess food insecurity, the Brazilian Scale of Food Insecurity—EBIA was used, and the WHOQOL-Bref questionnaire was used to assess quality of life. Poisson's Regression was used to verify associations between variables and LPQoL, stratifying the sample into food secure (FS) and food insecure (FI) groups. In the FI group, being overweight, older adult, having no partner, drinking alcoholic beverages twice a week or more, and not having daily availability of water were associated with LPQoL, and in the FS group, having diabetes, monthly family income in the 1st and 2nd tertiles, and never having studied was associated with LPQoL. Reporting emotional disorders and sleeping &lt; 7 h/day were associated with LPQoL in both FI and FS groups. LPQoL was associated with the occurrence of NCDs and risk factors, and emotional disorders, regardless of the food security measure. However, the lack of adequate access to water highlights the social vulnerability of the FI group.

Evaluating the socio-demographic, economic and clinical (SDEC) factors on health related quality of life (HRQoL) of hypertensive patients using EQ-5D-5L scoring algorithm

This study was conducted to determine the various socio-demographic, economic, and clinical variables (SDECVs) which influence the health-related quality of life (HRQoL) of hypertensive patients. Three hundred and fifty hypertensive patients participated in this study through a structured questionnaire and EQ 5D 5L. 211(60.28%) participants had stage 1, and 139 (39.7%) had stage 2 hypertension. No participants reported severe problems in any domain on EQ 5D 5L. Generalize Linear Model (GLM) was used to assess the association between HRQoL and SDECVs. The mean utility and VAS score was 0.64 (±0.15) and 63.17 (±11.01) respectively. The participants of the stage 1 hypertension group had a significantly better score on each domain of EQ 5D 5L as compared to stage 1 (0.027, 0.010, 0.00, 0.00, 0.048). No participant in either group reported extreme problems in any domain. Among socio-demographic factors, the males, non-smokers, income sharing, and healthy normal hypertensive patients had better HRQoL (0.009, 0.016, 0.019, and 0.003). A lower cost of treatment was also associated with better HRQoL (0.017). Among clinical variables, stage 1 hypertension had better HRQoL than stage 2(0.035). The number of prescribed antihypertensive drugs had no effect on the quality of life (0.253), however, the non-pharmacologic interventions such as reduction in salt and oil consumption (0.035), reduction in beverages consumption (0.0014) and increased water intake (0.010) had resulted in better QoL. The patients who reported dizziness had poor HRQoL while patients who had cardiac problems and diabetes reported a significantly lower EQ-VAS score. The effect of gender on the HRQoL of hypertensive patients who had comorbid conditions was significant in the case of renal, respiratory, visual problems, and dizziness where females had a lesser utility score than males. The study reports on significant determinants which should be taken into account in an attempt to improve the health-related quality of life of hypertensive patients.

Chronic Pain and Its Association with Depressive Symptoms and Renal Function in Hypertensive Patients

Chronic pain is a common concern and is considered to be one of the major problems in patients with chronic physical disorders. We studied the effect of pain in patients with hypertension with or without chronic kidney disease (CKD) and the association between pain and symptoms of depression. The study involved 158 hypertensive individuals (59.5% male, mean age 55 years), of whom 47 (29.8%) had CKD (estimated glomerular filtration rate < 60 mL/min/1.73 m²). Pain was assessed with the pain/discomfort domain of the EuroQol-5 D, while depressive symptoms were assessed with the depression module of the Patient health questionnaire (PHQ-9). The prevalence of chronic pain in our sample was 44.3%. Women exhibited chronic pain more often compared to men (57.1% vs. 42.9%, p < 0.001). The presence of CKD was not significantly associated with a higher prevalence of chronic pain among hypertensive patients. Depressive symptoms were significantly associated with the presence of chronic pain. These findings were confirmed in the logistic regression analysis. Chronic pain is common in hypertensive individuals and the association with depression warrants further investigation and may have practical implications in managing these patients.

Health-related quality of life of patients with haemophilia: a cross-sectional survey in the Northeast of China

INTRODUCTION

Haemophilia is a hereditary, chronic and haemorrhagic disorder caused by a deficiency in coagulation factors. Long-term spontaneous bleeding of joints and soft tissues can seriously affect the quality of life of patients.

OBJECTIVE

The study aimed to assess the health-related quality of life (HRQoL) of patients with haemophilia and associated factors.

METHODS

A snowball sampling strategy was adopted to select study participants. Eligible participants were those who were 18 years or older and had mild, moderate or severe haemophilia. They were asked to self-complete a questionnaire, collecting data regarding their sociodemographic characteristics, target joint status and HRQoL measured by the EQ-5D-5L(a tool developed by the European quality of life (EuroQol) Group).

RESULTS

The respondents reported a mean EQ-5D_utility(country-specific valuesets for the EQ-5D-5L) score of 0.51 (SD=0.34). Those with severe haemophilia had a lower utility score than those with mild/moderate haemophilia (0.46±0.37 vs 0.56±0.30, p=0.737). The linear regression analyses showed that older age (>25 years), two or more target joints, not working, low levels of knowledge of the disease and borrowing money to pay for medical treatments were associated with lower EQ-5D_utility scores.

CONCLUSION

Low HRQoL of patients with haemophilia is evident in China. Social support needs to be strengthened to address this issue.

Association between comorbidity and health-related quality of life in a hypertensive population: a hospital-based study in Bangladesh

Background

Hypertension is a known risk factor for several chronic conditions including diabetes and cardiovascular diseases. However, little is known about its impact on Health-related quality of life (HRQoL) in the context of Bangladesh. This study aimed to evaluate the association of hypertension on HRQoL among Bangladeshi patients corresponding to the socio-demographic condition, comorbid conditions, treatment, and health outcomes.

Methods

A hospital based cross-sectional study was conducted using a pre-tested structured questionnaire among patients with hypertension in 22 tertiary medical college hospitals in Bangladesh. The study recruited male and female hypertensive patients of age ≥18 years between July 2020 to February 2021 using consecutive sampling methods. Health related quality of life was measured using the widely-used index of EQ-5D that considers 243 different health-related attributes and uses a scale in which 0 indicates a health state equivalent to death and 1 indicates perfect health status. The five dimensions of the quality index included mobility, self-care, usual activities, pain or discomfort, and anxiety or depression. Ordered logit regression and linear regression models were used to estimate the predictors of comorbidity and HRQoL.

Results

Of the 1,912 hypertensive patients, 56.2% were female, 86.5% were married, 70.7% were either overweight or obese, 67.6% had a family history of hypertension, and 85.5% were on anti-hypertensive medication. Among the individuals with comorbidities, 47.6% had diabetes, 32.3% were obese, 16.2% had heart disease, 15% were visually impaired, and 13.8% were suffering from psychological diseases. HRQoL was found to be inversely proportional to the number of comorbidities. The most frequent comorbidities of diabetes and obesity showed the highest EQ- 5D mean utilities of 0.59 and 0.64, respectively.

Conclusions

Prevalent comorbidities, diabetes and obesity were found to be the significant underlying causes of declining HRQoL. It is recommended that the comorbidities should be adequately addressed for better HRQoL. Special attention should be given to address mental health issues of patients with hypertension.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12562-w.

The Impact of Risk Factor Control on Health-Related Quality of Life in Individuals with High Cardiovascular Disease Risk: A Cross-sectional Study Based on EQ-5D Utility Scores in Inner Mongolia, China

Objectives

To assess the impact of cardiovascular disease (CVD) risk factor control on health-related quality of life (HRQoL), as well as the other influencing factors of HRQoL among high CVD risk individuals.

Methods

From 2015 to 2017, residents of six villages or communities in Inner Mongolia, selected using a multi-stage stratified cluster random sampling method, were invited to complete a questionnaire and undergo physical examination and laboratory testing. We selected participants whose predicted 10-year risk for CVD exceeded 10% as those with high CVD risk. HRQoL in individuals with high CVD risk was investigated based on the EuroQol-5 Dimension (EQ-5D) scale. The Chinese utility value integral system was used to calculate EQ-5D utility scores, and the Tobit regression model was used to analyze the influencing factors of HRQoL among individuals with high CVD risk.

Results

Of 13,359 participants with high CVD risk, 65.63% reported no problems in any of the five dimensions; the most frequently reported difficulty was pain/discomfort. The median utility score was 1.000 (0.869, 1.000). Participants with hypertension, and uncontrolled glycemic and blood lipids had lower HRQoL. In addition, sex, age, living environment, education level, household income, and medical insurance were influencing factors of HRQoL.

Conclusion

Sex, age, living environment, education level, household income, medical insurance, hypertension, and whether glycemic and blood lipids control or not are related to HRQoL of high CVD risk individuals.

Health-Related Quality of Life and Utility Scores of Lung Cancer Patients Treated with Traditional Chinese Medicine in China

PURPOSE

To assess health-related quality of life (HRQoL) and utility scores of lung cancer patients treated with traditional Chinese medicine (TCM) in China.

METHODS

This cross-sectional study included lung cancer patients treated with TCM in seven tertiary hospitals in Shanghai, China. The HRQoL and utility scores of these patients were measured using the five-level EQ-5D (EQ-5D-5L). The EQ-5D-5L utility scores were derived from the Chinese EQ-5D-5L Value Set. The relationships between HRQoL and the socio-demographic and clinical characteristics of these patients were further explored by Tobit regression.

RESULTS

This study included a total of 347 patients. Their mean ± SD and median EQ-5D-5L utility scores were 0.851 ± 0.198 and 0.893, respectively. The highest proportion of participants reporting problems was observed in pain/discomfort dimension (57.9%) and anxiety/depression (45.5%). Lung cancer patients treated with TCM had poor HRQoL, influenced by cancer clinical stage.

CONCLUSION

Lung cancer patients treated with TCM have poor HRQoL, with many patients reporting problems in the pain/discomfort and anxiety/depression dimensions. The information on health utility scores and HRQoL of lung cancer patients treated with TCM could be useful for future supportive care, economic evaluations and decision-making in China.

Association between antihypertensive drugs and the elderly's oral health- related quality of life: Results of Amirkola cohort study

Background:

Prerequisite for achieving the goals of the registration program is the existence of valid and accurate data, and the usability of this data is possible if they are coded correctly. This study assets the quality of pathological data of the population-based cancer registration centers based on ICD-O-3.

Methods:

This applied study was performed descriptively and retrospectively. The study population included 20129 pathology reports sent to the population-based cancer registration center of Mazandaran Province during 2018-2020. A total of 2015 out of, 2050 samples of the received reports were examined according to stratified random sampling method. A researcher checklist was made to collect the data, and STATA 13 and Cohen's Kappa agreement coefficient were used to analyze the data.

Results:

Among the 2015 reports of pathology, 1114 (55.3%) pathology reports were related to government centers, (42.9%) 865 cases were registered with their topographic code, morphology and behavior. Based on the registration of the exact topographic code, the kappa coefficient and the total agreement were 0.266 and 27.70%, respectively. Kappa coefficient in all received reports and reports with topographic code was 0.346 and 0.906, respectively. In the reports with topographic code, the most reports of cancers were related to cancers of the gastrointestinal organs (97.6%) 246.

Conclusion:

The accuracy of the codes given in the pathology centers in terms of topographic, morphological, behavioral and grade codes based on the percentage of agreement with the coding was above average, which were higher in governmental centers and also in some cancers.

Disability and Comorbidity of Mood Disorders and Anxiety Disorders With Diabetes and Hypertension: Evidences From the China Mental Health Survey and Chronic Disease Surveillance in China

BACKGROUND

The China Mental Health Survey was carried out using the same sampling frame with the China Chronic Diseases and Risk Factors Surveillance. This paper explores the relationship between the disability and the comorbidity of mood disorders and anxiety disorders with diabetes and hypertension.

METHODS

A large-scale nationally representative sample with both mental disorders and chronic diseases was collected from 157 Disease Surveillance Points in 31 provinces across China. Face-to-face interviews were conducted by trained lay interviewers to make diagnoses of mood disorders and anxiety disorders using the Composite International Diagnostic Interview. Diabetes and hypertension were diagnosed from self-report and blood examination or body measurement. Sampling design weights, non-response adjustment weights, and post-stratification adjustment weights were applied during the analyses of comorbidity and disability.

RESULTS

Totally 15,000 respondents had information of mental disorders and physical diseases. In the patients with mood disorders or anxiety disorders, the weighted prevalence rates of diabetes or hypertension were not higher than those in persons without the above mental disorders, but the weighed disability rates increased when having the comorbidity of hypertension (P < 0.05). The severity of disability was higher among patients with comorbidity of diabetes and anxiety disorders, or hypertension and mood disorders, compared with that among patients without the physical comorbidity (P < 0.05). After adjusted by age, gender and education, patients with comorbidity of mental disorders and physical disorders had the highest disability, followed by the patients with mental disorders only, and physical diseases only.

CONCLUSIONS

The disability of mood disorders and anxiety disorders comorbid with diabetes and hypertension are more serious than that of any single disease. The relationship of mental and physical diseases is worth exploring in depth for comprehensive and integrated intervention to decrease the disability.

A pilot study on the validity and psychometric properties of the electronic EQ-5D-5L in routine clinical practice

Background

Electronic measurement of health-related quality of life (HRQOL) may facilitate timely and regular assessments in routine clinical practice. This study evaluated the validity and psychometric properties of an electronic version of the EQ-5D-5L (e-EQ-5D-5L) in Chinese patients with chronic knee and/or back problems.

Methods

151 Chinese subjects completed an electronic version of the Chinese (Hong Kong) EQ-5D-5L when they attended a primary care or orthopedics specialist out-patient clinic in Hong Kong. They also completed the Chinese Western Ontario and McMaster University Osteoarthritis Index (WOMAC), a Pain Rating Scale, and a structured questionnaire on socio-demographics, co-morbidities and health service utilization. 32 subjects repeated the e-EQ-5D-5L two weeks after the baseline. 102 subjects completed e-EQ-5D-5L and 99 completed the Global Rating on Change Scale at three-month clinic follow up. Construct validity was assessed by the association of EQ-5D-5L scores with external criterion of WOMAC scores. We tested mean differences of WOMAC scores between adjacent response levels of the EQ-5D-5L dimensions by one-way ANOVA, test–retest reliability by intra-class correlation, sensitivity by known group comparisons and responsiveness by changes in EQ-5D-5L scores over 3 months.

Results

There was an association between EQ-5D-5L and WOMAC scores. Mean WOMAC scores increased with the increase in adjacent response levels of EQ-5D-5L dimensions. Test–retest intraclass correlation coefficient (ICC) of EQ-5D-5L utility and EQ-VAS scores were 0.76 and 0.83, respectively, indicating good reliability. There were significant differences in the proportions reporting limitations in the EQ-5D-5L dimensions, the utility and VAS scores between the mild and severe pain groups (utility = 0.28, p = 0.001; VAS = 11.46, p < 0.001), and between primary care and specialist out-patient clinic patients (utility = 0.15, p = 0.001; VAS = 10.21, p < 0.001), supporting sensitivity. Among those reporting ‘better’ global health at three-months, their EQ-5D-5L utility and EQ-VAS scores were significantly increased from baseline (utility = 0.18, p < 0.001; VAS = 10.75, p = 0.005).

Conclusions

The electronic version of the EQ-5D-5L is valid, reliable, sensitive and responsive in the measurement of HRQOL in Chinese patients with chronic knee or back pain in routine clinical practice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-021-01898-3.

The influencing factors of health-related quality of life among rural hypertensive individuals: a cross-sectional study

Background

Previous reports regarding health-related quality of life (HRQoL) of hypertensive individuals commonly concentrated on urban population. This study focused on rural population and aimed to explore the influencing factors of HRQoL.

Methods

Date were derived from Henan Rural Cohort study. The HRQoL of participants were assessed via European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) instrument. Tobit regression model and generalized linear model were employed to explore the influencing factors of HRQoL. Another binary logistic regression was utilized to examine the robustness of our results.

Results

Among 23,485 rural population, 8128 participants were identified with hypertension. The mean (SD) utility index and VAS score of non-hypertension group were 0.96 (0.09) and 79.66 (14.20), respectively, while in hypertension group were 0.94 (0.14) and 75.88 (15.50), respectively. Pain/discomfort was the most common self-reported problem (23.05%) for patients. Aging and suffering with other diseases were negatively associated with HRQoL among rural patients, while high socioeconomic status and healthy lifestyles corresponded with high HRQoL.

Conclusions

Hypertension did push considerable pressures on patients’ HRQoL. Maintaining healthy lifestyles and improving the socioeconomic status of patients were advisable ways to reduce this burden.

Trial registration The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). http://www.chictr.org.cn/showproj.aspx?proj=11375

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-021-01879-6.

A cost-effectiveness analysis of the Chronic Disease Management Program in patients with hypertension in Korea

BACKGROUND

The Chronic Disease Management Program (CDMP) of Korea has been introduced to improve care continuity in patients with hypertension and diabetes.

OBJECTIVE

This study evaluated the cost effectiveness of the CDMP in patients with hypertension from the perspective of the healthcare payer.

METHODS

A cost-effectiveness analysis was performed based on a Markov simulation model. The cost and effect of the CDMP versus usual care was compared in individuals aged 40 years or above. The two strategies were presumed to result in a difference in the incidence of myocardial infarction, stroke, and chronic kidney disease. The model was analyzed over the lifetime of the cohort. Incremental cost-effectiveness ratio (ICER) was calculated by dividing the difference in lifetime costs by the difference in lifetime effects (quality adjusted life years, QALYs) between the two strategies. Costs were expressed in Korean Won (KRW).

RESULTS

The ICER value of the CDMP participation strategy was -5 761 088 KRW/QALY compared to usual care. Similar tendencies were found when limiting the population to only clinic users (-3 843 355 KRW/QALY) and national health examination participants (-5 595 185 KRW/QALY).

CONCLUSION

The CDMP was highly cost-effective in patients with hypertension aged 40 years or above. Implementing efficient policies that enhance care coordination and improve outcomes in patients with hypertension is important.

Psychometric Evaluation of the Chinese Recovering Quality of Life (ReQoL) Outcome Measure and Assessment of Health-Related Quality of Life During the COVID-19 Pandemic

Objective

The primary objective was to translate the Recovering Quality of Life (ReQoL) measures from English to traditional Chinese and assess their psychometric properties in Hong Kong (HK) Chinese population. The secondary objective was to investigate the mental health-related quality of life (HRQoL) of this sample during the coronavirus disease 2019 (COVID-19) pandemic.

Method

Recovering Quality of Life was translated to Traditional Chinese adhering to standard guideline recommended by the official distributors. Five hundred members of the general population were successfully recruited to participate in a telephone-based survey. The following psychometric properties of the ReQoL were evaluated: construct, convergent, and known-group validity and internal consistency and test-retest reliability. The item measurement invariance was assessed on the basis of differential item functioning (DIF). Multiple regression analysis was used to assess the relationship between respondents' characteristics and mental HRQoL.

Results

Results of confirmatory factor analysis (CFA) supported a two-factor structure of the ReQoL. The ReQoL showed significant correlations with the other mental health, quality of life, and well-being measures, which indicated a satisfactory convergent validity. Known-group validity confirmed that ReQoL is able to differentiate between people with different mental health status. The (Cronbach's alpha = 0.91 and 0.76 for positive [PF] and negative [NF] factor), and McDonald's omega of 0.89 (PF = 0.94, NF = 0.82) indicated the ReQoL has good reliability as well as test-retest reliability with an intraclass correlation coefficient of 0.75. Four items showed negligible DIF with respect to age. Respondents who were highly educated and without psychological problems reported a high ReQoL score.

Conclusion

Traditional Chinese ReQoL was shown to be a valid and reliable instrument to assess the recovery-focused quality of life in HK general population. Future studies are needed to appraise its psychometric properties in local people experiencing mental disorders.

Health-related quality of life in different trimesters during pregnancy

Background

Pregnant women experience physical, physiological, and mental changes. Health-related quality of life (HRQoL) is a relevant indicator of psychological and physical behaviours, changing over the course of pregnancy. This study aims to assess HRQoL of pregnant women during different stages of pregnancy.

Methods

This cross-sectional study was performed using the The EuroQoL Group’s five-dimension five-level questionnaire (EQ-5D-5L) to assess the HRQoL of pregnant women, and demographic data were collected. This study was conducted in a regional university hospital in Guangzhou, China.

Results

A total of 908 pregnant women were included in this study. Pregnant women in the early 2^nd trimester had the highest HRQoL. The HRQoL of pregnant women rose from the 1st trimester to the early 2nd trimester, and dropped to the bottom at the late 3rd trimester due to some physical and mental changes. Reports of pain/discomfort problem were the most common (46.0%) while self-care were the least concern. More than 10% of pregnant women in the 1st trimester had health-related problems in at least one dimension of whole five dimensions. In the whole sample, the EuroQoL Group’s visual analog scale (EQ-VAS) was 87.86 ± 9.16. Across the gestational stages, the HRQoL remained stable during the pregnancy but the highest value was observed in the 1st trimester (89.65 ± 10.13) while the lowest was in the late 3rd trimester (87.28 ± 9.13).

Conclusions

During pregnancy, HRQoL were associated with gestational trimesters in a certain degree. HRQoL was the highest in the early 2nd trimester and then decreased to the lowest in the late 3rd trimester due to a series of physical and psychological changes. Therefore, obstetric doctors and medical institutions should give more attention and care to pregnant women in the late 3rd trimester.

How important is current physical fitness for future quality of life? Results from an 8-year longitudinal study on older adults

INTRODUCTION

A vast amount of research has focused on the effects of physical fitness (PF) on mortality, with little research evaluating the effects of PF on future expected health related quality of life (HRQoL).

AIM

To evaluate how current PF influences future HRQoL measured in a prospective 8-year study in older adults.

METHODS

A total of 617 (157 males) older adults (>65y) participated in the study. PF was assessed with the EXERNET battery in 2008-2009 (baseline) and 2016-2017 (follow-up). HRQoL was assessed using the EQ-5D-3L questionnaire in both evaluations. PF tertiles were developed from baseline PF variables: FIT (highest PF values), REGULAR and UNFIT (lowest PF values) taking into account age and sex. Follow-up HRQoL values were compared to sex and age-specific expected values. Logistic regressions were performed to test differences between PF tertiles regarding future expected quality of life. Linear regressions were developed to test whether baseline PF could predict future HRQoL scores.

RESULTS

The FIT group showed higher probabilities of an improved HRQoL when compared to the UNFIT group. All PF variables seemed to be important at some point of the study except upper extremities flexibility. Aerobic endurance was the variable that showed to be significant for most of the HRQoL predictions.

CONCLUSION

PF influences future HRQoL in older adults who accordingly should try to remain fit to maintain an increased age-adjusted HRQoL.

Estimation of minimally important difference of the EQ-5D-5L utility scores among patients with either hypertension or diabetes or both: a cross-sectional study in Hong Kong

OBJECTIVE

To estimate and report the minimally important difference (MID) of the EuroQol five-dimensional five-level questionnaire (EQ-5D-5L) using the Hong Kong (HK) utility score among patients with either hypertension or diabetes or both.

DESIGN

Data were analysed using secondary data analysis based on a cross-sectional study assessing patients' experiences in HK.

SETTING

A representative sample was recruited from 26 specialist outpatient clinics in HK.

PARTICIPANTS

We analysed data from 2231 and 662 patients who reported having hypertension or diabetes alone, respectively, and 874 patients had these two diseases.

INTERVENTION

An instrument-defined approach was applied to estimate MID stratified according to sex and age for the three subpopulations.

RESULTS

The overall MID (oMID) estimates were 0.089, 0.086 and 0.089 for patients with hypertension or diabetes alone and with these two diseases, respectively. The adjusted MID (aMID) estimate was smaller than the oMID, and the improved MID was larger than the deteriorated MID. Women had larger oMID but smaller aMID than men. Younger respondents had larger aMID than older respondents. Effect sizes ranged from 0.30 to 0.503, which fit our preset criteria.

CONCLUSION

Four types of MID of the EQ-5D utility score for patients with hypertension or diabetes alone and with these two diseases were reported. Variations in the MID estimates should be further explored in other populations or using different statistical methods.

Health-related quality of life measured using EQ-5D in patients with lymphomas

PURPOSE

This study aimed to estimate the health preference-based index scores of the population of patients with lymphoma using the EQ-5D in China.

METHODS

A cross-sectional online survey was conducted to examine the health and well-being of patients with lymphoma in China. Their health-related quality of life (HRQoL; using the EQ-5D), demographic and socioeconomic characteristics, and health conditions were assessed. The data were analyzed using Pearson's χ² test, analysis of variance, and binary logistic and Tobit regression models.

RESULTS

A total of 3261 patients (sex: men = 58.5%, age: < 30 years = 9.5% and > 60 years = 24.6%) participated in the study. The mean EQ-5D-5L index and EQ-VAS scores were 0.83 and 68.8, respectively. Binary logistic regression analysis revealed that women reported more pain-related problems than men did. Unemployed participants were substantially more likely to report health problems on all the five dimensions of the EQ-5D than their employed counterparts. The Tobit regression model revealed that respondents who were older, unemployed, with low income, received chemotherapy, and with short durations reported a low index score.

CONCLUSION

Using the EQ-5D, the preference-based scores of different subpopulations of patients with lymphoma may support economic evaluation by promoting the simultaneous consideration of both the reasonable use of resources and satisfactory achievement of health outcomes.

Relationship between health-related quality of life and blood pressure control in patients with uncontrolled hypertension

We sought to investigate the psychosocial characteristics of patients with uncontrolled hypertension and examine factors that influence blood pressure (BP) control. A total of 1011 patients with uncontrolled hypertension were enrolled in 13 tertiary hospitals. Uncontrolled hypertension was defined as systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg despite on antihypertensive therapy. Socio-demographics, anthropometrics, behavioral risk factors, medication pattern, adherence, and measures of health-related quality of life (HRQoL; EuroQol 5D visual analog scale [EQ-5D VAS]) were assessed at baseline and during follow-up visits (3 and 6 months). Patients were divided into 2 groups based on BP control status at 6 months (controlled group [n = 532] vs uncontrolled group [n = 367]). There were no differences in clinical characteristics except the proportion of smokers and baseline BP between patients with controlled BP and uncontrolled BP. At 6 months, the adherence of antihypertensive medication did not differ between the groups but the proportion of combination therapy with ≥3 antihypertensives was significantly higher in patients with uncontrolled BP. EQ-5D VAS at follow-up was significantly lower in patients with uncontrolled BP despite similar baseline values. Multivariate logistic regression analysis revealed that EQ-5D VAS at follow-up significantly correlated with BP control. Patients with worse HRQoL had higher Charlson Comorbidity Index and higher proportion of taking ≥3 antihypertensives, but medication adherence was similar to those with better HRQoL. These findings suggest that along with pharmacologic intervention of hypertension, management of comorbid conditions or psychological support might be helpful for optimizing BP control in patients with uncontrolled hypertension.

Evaluation of health-related quality of life using EQ-5D in China during the COVID-19 pandemic

Objective

Since December 2019, an increasing number of cases of the 2019 novel coronavirus disease (COVID-19) infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been identified in Wuhan, Hubei Province, China. Now, more cases have been reported in 200 other countries and regions. The pandemic disease not only affects physical health who suffered it, but also affects the mental health of the general population. This study aims to know about the impact of the COVID-19 epidemic on the health-related quality of life (HRQOL) of living using EQ-5D in general population in China.

Methods

An online-based survey was developed and participants were recruited via social media. The questionnaires included demographic and socioeconomic data, health status, the condition epidemic situation and EQ-5D scale. The relationships of all factors and the scores of EQ-5D were analyzed. Logistic regression model were used to the five health dimensions.

Results

The respondents obtained a mean EQ-5D index score of 0.949 and a mean VAS score of 85.52.The most frequently reported problem were pain/discomfort (19.0%) and anxiety/depression (17.6%). Logistic regression models showed that the risk of pain/discomfort and anxiety/depression among people with aging, with chronic disease, lower income, epidemic effects, worry about get COVID-19 raised significantly.

Conclusion

The article provides important evidence on HRQOL during the COVID-19 pandemic. The risk of pain/discomfort and anxiety/depression in general population in China raised significantly with aging, with chronic disease, lower income, epidemic effects, worried about get COVID-19 during the COVID-19 pandemic. The results from each categorical data can be used for future healthcare measures among general population.

Validation of the Chinese EORTC chronic lymphocytic leukaemia module - application of classical test theory and item response theory

Purpose

The association of chronic lymphocytic leukemia (CLL) with health-related quality of life (HRQoL) is rarely studied globally. This study evaluated the psychometric properties of the EORTC-Chronic Lymphocytic Leukaemia (CLL17 [phase III]) module, a newly developed assessment on CLL patients’ HRQoL, among Chinese CLL patients.

Methods

The Chinese CLL17, comprised of three subscales (symptom burden [SB], physical condition [PC] and worries/fears [WF]), was provided by the developer team through EORTC. A cross-sectional online survey was conducted to collect data. The classical traditional theory (CTT) and the item response theory (IRT) were used to evaluate the psychometric properties of CLL17. Internal consistency reliability was determined by the Cronbach’s alpha and item-total correlation. Dimensionality was verified through confirmatory factor analysis (CFA). Convergent validity was also assessed. The generalized partial credit model was used for the IRT. The difficulty, discrimination, item fit, and differential item functioning (DIF) were calculated to assess the instrument’s psychometric properties.

Results

In all, 318 patients, aged between 26 and 82 years, completed the questionnaire. A good level of internal reliability was achieved (Cronbach’s alpha = 0.92). The item-total correlation coefficient ranged from 0.46 to 0.72. There was a mid-to-high correlation between CLL17 and domains of EQ-5D and QLQ-C30. The IRT model showed a satisfactory homogeneity, item fit and good discrimination of items, except for item 4, 6 and 16 (< 1.0). low information provided by item 16 and 17. SB and PC provided more information with theta > 0, whereas WF provided more information with theta < 0. Item 17 perform inconsistently for respondents from different age groups (DIF).

Conclusion

The EORTC-CLL17 Chinese version shows acceptable reliability and validity, making it a valuable instrument to evaluate the impact on the HRQoL of Chinese CLL patients.