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Cilloniz C, Pericas JM, Curioso WH. Interventions to improve outcomes in community-acquired pneumonia. Expert Rev Anti Infect Ther 2023; 21:1071-1086. [PMID: 37691049 DOI: 10.1080/14787210.2023.2257392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/25/2023] [Accepted: 09/06/2023] [Indexed: 09/12/2023]
Abstract
INTRODUCTION Community-acquired pneumonia (CAP) is a common infection associated with high morbimortality and a highly deleterious impact on patients' quality of life and functionality. We comprehensively review the factors related to the host, the causative microorganism, the therapeutic approach and the organization of health systems (e.g. setting for care and systems for allocation) that might have an impact on CAP-associated outcomes. Our main aims are to discuss the most controversial points and to provide some recommendations that may guide further research and the management of patients with CAP, in order to improve their outcomes, beyond mortality. AREA COVERED In this review, we aim to provide a critical account of potential measures to improve outcomes of CAP and the supporting evidence from observational studies and clinical trials. EXPERT OPINION CAP is associated with high mortality and a highly deleterious impact on patients' quality of life. To improve CAP-associated outcomes, it is important to understand the factors related to the patient, etiology, therapeutics, and the organization of health systems.
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Affiliation(s)
- Catia Cilloniz
- IDIBAPS, Center for Biomedical Research in Respiratory Diseases Network (CIBERES), Barcelona, Spain
- Facultad de Ciencias de la Salud, Universidad Continental, Huancayo, Peru
| | - Juan Manuel Pericas
- Liver Unit, Internal Medicine Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute for Research (VHIR), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain
| | - Walter H Curioso
- Facultad de Ciencias de la Salud, Universidad Continental, Huancayo, Peru
- Health Services Administration, Continental University of Florida, Margate, FL, USA
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Oakes DB, Baker MJ, McLeod C, Nattabi B, Blyth CC. Patient-reported outcome measures for paediatric acute lower respiratory infection studies. Eur Respir Rev 2023; 32:32/167/220229. [PMID: 36889787 PMCID: PMC10032589 DOI: 10.1183/16000617.0229-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/17/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are recommended for capturing meaningful outcomes in clinical trials. The use of PROMs for children with acute lower respiratory infections (ALRIs) has not been systematically reported. We aimed to identify and characterise patient-reported outcomes and PROMs used in paediatric ALRI studies and summarise their measurement properties. METHODS Medline, Embase and Cochrane were searched (until April 2022). Studies that reported on patient-reported outcome (or measure) use or development and included subjects aged <18 years with ALRIs were included. Study, population and patient-reported outcome (or measure) characteristics were extracted. RESULTS Of 2793 articles identified, 18 met inclusion criteria, including 12 PROMs. Two disease-specific PROMs were used in settings in which they had been validated. The Canadian Acute Respiratory Illness and Flu Scale was the most frequently used disease-specific PROM (five studies). The EuroQol-Five Dimensions-Youth system was the most frequently used generic PROM (two studies). There was considerable heterogeneity in validation methods. The outcome measures identified in this review lack validation for young children and none involve sufficient content validity for use with First Nations children. CONCLUSIONS There is an urgent need for PROM development that considers the populations in which the burden of ALRI predominates.
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Affiliation(s)
- Daniel B Oakes
- School of Population and Global Health, The University of Western Australia, Crawley, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Australia
| | - Megan J Baker
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Australia
| | - Charlie McLeod
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Australia
| | - Barbara Nattabi
- School of Population and Global Health, The University of Western Australia, Crawley, Australia
| | - Christopher C Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Nedlands, Australia
- School of Medicine, University of Western Australia, Perth, Australia
- Department of Microbiology, PathWest Laboratory Medicine, Perth, Australia
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Ohno K, Tomori K, Sawada T, Seike Y, Yaguchi A, Kobayashi R. Measurement Properties of the Canadian Occupational Performance Measure: A Systematic Review. Am J Occup Ther 2021; 75:23077. [PMID: 34817593 DOI: 10.5014/ajot.2021.041699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE The Canadian Occupational Performance Measure (COPM) is widely used in clinical practice and research. However, the measurement properties of the COPM were not reviewed using rigorous systematic methodology. OBJECTIVE To evaluate the measurement properties of the COPM. DATA SOURCES MEDLINE, Web of Science, Scopus, OTseeker, and Cochrane Library. Study Selection and Data Collection: We used the updated COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist to evaluate the measurement properties of the COPM reported in relevant studies. FINDINGS Our search identified 35 articles that reported measurement properties for the COPM with samples that differed in age, country, diagnosis, and disease stage. For content validity, the evidence was inconsistent and of low quality; no studies assessed structural validity. For reliability, the internal consistency was indeterminate and of low quality. One study reported indeterminate and very low quality evidence for cross-cultural validity. According to the evidence reported in these studies, the COPM has inconsistent and moderate reliability, construct validity, and responsiveness and insufficient and high-quality evidence for criterion validity. CONCLUSIONS AND RELEVANCE Our review of the evidence using the COSMIN Risk of Bias checklist indicates that the Canadian Occupational Performance Measure lacks high-quality validation. What This Article Adds: High-quality validation of the Canadian Occupational Performance Measure is lacking. Further examination of its measurement properties using updated relevant guidelines is required.
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Affiliation(s)
- Kanta Ohno
- Kanta Ohno, MS, Major of Occupational Therapy, is Assistant Professor and Occupational Therapist, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan, and PhD Student, Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan;
| | - Kounosuke Tomori
- Kounosuke Tomori, PhD, Major of Occupational Therapy, is Associate Professor and Occupational Therapist, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - Tatsunori Sawada
- Tatsunori Sawada, PhD, Major of Occupational Therapy, is Professor and Occupational Therapist, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - Yousuke Seike
- Yousuke Seike, PhD, Major of Occupational Therapy, is Assistant Professor and Occupational Therapist, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - Ayana Yaguchi
- Ayana Yaguchi, BS, is Occupational Therapist, Department of Occupational Therapy, Gyoda General Hospital, Gunma, Japan
| | - Ryuji Kobayashi
- Ryuji Kobayashi, PhD, is Professor and Occupational Therapist, Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
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Abstract
Pneumonia is a common acute respiratory infection that affects the alveoli and distal airways; it is a major health problem and associated with high morbidity and short-term and long-term mortality in all age groups worldwide. Pneumonia is broadly divided into community-acquired pneumonia or hospital-acquired pneumonia. A large variety of microorganisms can cause pneumonia, including bacteria, respiratory viruses and fungi, and there are great geographical variations in their prevalence. Pneumonia occurs more commonly in susceptible individuals, including children of <5 years of age and older adults with prior chronic conditions. Development of the disease largely depends on the host immune response, with pathogen characteristics having a less prominent role. Individuals with pneumonia often present with respiratory and systemic symptoms, and diagnosis is based on both clinical presentation and radiological findings. It is crucial to identify the causative pathogens, as delayed and inadequate antimicrobial therapy can lead to poor outcomes. New antibiotic and non-antibiotic therapies, in addition to rapid and accurate diagnostic tests that can detect pathogens and antibiotic resistance will improve the management of pneumonia.
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Hadning I, Andayani TM, Endarti D, Triasih R. Health-Related Quality of Life Among Children With Pneumonia in Indonesia Using the EuroQoL Descriptive System Value Set for Indonesia. Value Health Reg Issues 2021; 24:12-16. [PMID: 33465710 DOI: 10.1016/j.vhri.2020.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 03/20/2020] [Accepted: 05/11/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE In Indonesia, no study has been published to evaluate the utility scores among children with pneumonia. This study aims to quantify the health-related quality of life (HRQOL) of children with pneumonia in Indonesia using the EuroQoL Descriptive System (EQ-5D-5L) value set for Indonesia. METHODS A hospital-based cross-sectional survey was conducted between September 2017 and March 2018. Children aged <14 years old who were hospitalized for pneumonia in 11 hospitals in Yogyakarta were recruited for this study. The EQ-5D-5L and visual analogue scale (EQ-VAS) were applied to the parents (proxy-assessment). RESULTS A total of 384 patients were hospitalized with pneumonia. Among those patients, 338 (88.02%) were without congenital diseases; and 46 (11.98%) were with congenital diseases. The mean of utility scores in all patients was 0.67 ± 0.28, while the mean of visual analog scale (VAS) score was 67.66 ± 21.98. The mean of utility scores and VAS scores decreased among those with congenital diseases, which is 0.51 ± 0.51 and 65.41 ± 19.42, respectively. However, the utility score and VAS scores among patients without congenital diseases were higher than the category of all patients. Showing the number of,0.69 ± 0.23 and 68.0 ± 22.3, respectively. CONCLUSIONS This study confirmed that children with pneumonia had a negative impact on HRQOL. The HRQOL could be used for future economic evaluation studies.
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Affiliation(s)
- Ingenida Hadning
- Doctoral Study Program of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia; School of Pharmacy, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia.
| | - Tri Murti Andayani
- Department of Pharmacology and Clinical Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Dwi Endarti
- Department of Pharmaceutics, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Rina Triasih
- Department of Paediatrics, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Lodise TP, Colman S, Alexander E, Stein DS, Fitts D, Goldberg L, Schranz J. Health-Related Quality of Life as Measured by the 12-Item Short-Form Survey Among Adults With Community-Acquired Bacterial Pneumonia who Received Either Lefamulin or Moxifloxacin in 2 Phase III Randomized, Double-Blind, Double-Dummy Clinical Trials. Open Forum Infect Dis 2020; 7:ofaa209. [PMID: 32617376 PMCID: PMC7314585 DOI: 10.1093/ofid/ofaa209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 05/29/2020] [Indexed: 01/27/2023] Open
Abstract
Background Interest in patient-reported outcomes (PROs) as part of benefit–risk assessment for new drug approvals is increasing. Lefamulin is the first intravenous (IV) and oral pleuromutilin antibiotic for treatment of adults with community-acquired bacterial pneumonia (CABP). Assessment of health-related quality of life (HRQoL) was prospectively incorporated in its CABP trials (Lefamulin Evaluation Against Pneumonia [LEAP] 1 and 2) via the 12-Item Short-Form Survey (SF-12), a widely used PRO that measures general health status in 8 domains. Methods HRQoL was evaluated by SF-12 at baseline and test of cure (TOC; 5–10 days after the last study drug dose) in patients who received lefamulin or moxifloxacin in LEAP 1 (IV/oral treatment) and LEAP 2 (oral-only treatment). SF-12 outcomes included the 8 domains, physical component and mental component summary scores, and the Short-Form Six-Dimension health utility score. Results Analysis included 1215 patients (lefamulin: n = 607; moxifloxacin: n = 608). At baseline, all mean SF-12 scores in both treatment groups were well below the United States reference mean. Clinically meaningful and significant improvements from baseline to TOC were observed in all SF-12 scores. No significant differences in mean score improvements from baseline to TOC between treatment groups were observed. SF-12 score improvements at TOC across predefined subgroups were comparable between treatment groups. Conclusions Results indicate that adults with CABP experienced comparable HRQoL improvements with lefamulin relative to moxifloxacin, and treatment with either agent resulted in returns to population norm HRQoL levels. These data suggest that lefamulin is a potential alternative to moxifloxacin for treatment of adults with CABP.
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Affiliation(s)
- Thomas P Lodise
- Albany College of Pharmacy and Health Sciences, Albany, New York, USA
| | - Sam Colman
- Covance Market Access Services Inc., Gaithersburg, Maryland, USA
| | | | - Daniel S Stein
- Nabriva Therapeutics US, Inc., King of Prussia, Pennsylvania, USA
| | - David Fitts
- Nabriva Therapeutics US, Inc., King of Prussia, Pennsylvania, USA
| | - Lisa Goldberg
- Nabriva Therapeutics US, Inc., King of Prussia, Pennsylvania, USA
| | - Jennifer Schranz
- Nabriva Therapeutics US, Inc., King of Prussia, Pennsylvania, USA
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