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Abbott J, Hurley MA, Chadwick H, Peckham D. Ways of coping and survival in Cystic Fibrosis: a 20-year longitudinal study. J Cyst Fibros 2023; 22:112-118. [PMID: 35461783 DOI: 10.1016/j.jcf.2022.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/14/2022] [Accepted: 04/11/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The relationship between ways of coping and health outcomes has been a focus of interest for decades. There is increasing recognition that positive psychological functioning can influence health outcomes beneficially. This work investigated the role of coping in predicting survival in CF. METHODS A longitudinal observational cohort study with a 20-year follow-up period was undertaken. At entry to the study, demographic and clinical variables were recorded, and ways of coping were assessed using the Cystic Fibrosis Coping Scale which measures four distinct ways of coping: optimism, hopefulness, distraction and avoidance. Survival outcome was measured as time in days from the date of recruitment to exit from the study, where exit was either death, loss to follow-up or the end of the follow-up period. RESULTS Survival time was modelled using Cox's proportional hazards model. At baseline, 116 people with CF were recruited. By the census date, 54 people had died (14 men had died during 248,565 person-days of observation and 40 women had died during 358,372 person-days of observation). Optimism was the only way of coping that showed any beneficial effect on survival (RR=0.984, p=0.040) after adjustments for age, gender, ppFEV1 and the three other coping variables measured at baseline. CONCLUSION This work suggests that optimistic coping serves as a prognostic measure of survival in CF beyond key clinical and demographic variables. Ways of coping are modifiable, providing a target for clinical intervention; to improve quality of life and clinical outcomes and potentially increase longevity.
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Affiliation(s)
- Janice Abbott
- School of Psychology, University of Central Lancashire, Preston, PR1 2HE, UK.
| | - Margaret A Hurley
- Faculty of Health, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Helen Chadwick
- Adult Cystic Fibrosis Unit, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, United Kingdom; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, LS2 9JT, UK
| | - Daniel Peckham
- Adult Cystic Fibrosis Unit, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, United Kingdom; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, LS2 9JT, UK
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Moore T, Nees D, Hightower B, Brock L, Kee M, Wise A, Heigle B, Ottwell R, Hartwell M, Vassar M. Underreporting of patient-reported outcomes in cystic fibrosis randomized controlled trials using CONSORT-PRO and RoB 2.0. Respir Med Res 2022; 83:100962. [PMID: 36563550 DOI: 10.1016/j.resmer.2022.100962] [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: 03/23/2022] [Revised: 07/23/2022] [Accepted: 10/03/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Patient-reported outcomes (PROs) are increasingly used in randomized controlled trials (RCTs) to foster patient-centered healthcare. The aim of this investigation was to assess the completeness of reporting of PROs in RCTs pertaining to cystic fibrosis (CF). METHODS We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials for RCTs concerning CF that included PROs as a primary or secondary outcome. The RCTs were assessed by 2 independent investigators using an adaptation of the Consolidated Standards of Reporting Trials for Patient-Reported Outcomes (CONSORT-PRO) and the Cochrane Risk of Bias (RoB) 2.0 assessment. We calculated the mean completion percentage of adherence to the CONSORT-PRO adaptation and used bivariate regression models to evaluate for associations with particular trial characteristics. RESULTS Our systematic search returned 2302 potential studies. Fifty-nine eligible RCTs were included after full-text screening. The RCT mean completeness of reporting was 38.38% (SD = 12.74). We found the following associations between trial characteristics and completeness of PRO reporting: (1) significantly higher reporting completeness for RCTs published in journals requiring adherence to the CONSORT guideline (p-value = 0.049), (2) improved reporting completeness in studies with 'some concerns' of RoB versus 'high' RoB (p-value = 0.042), and (3) significantly better reporting completeness when the PRO is the primary outcome of a RCT (p-value = 0.006). CONCLUSION Inadequate PRO reporting exists within RCTs focused on CF. Given that CF has substantial effects on quality of life, PROs are imperative to understand patients' experiences. We believe greater adherence to CONSORT-PRO will promote the standardization of PRO reporting and will facilitate comprehension of PROs by stakeholders, patients, and clinicians.
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Affiliation(s)
- Ty Moore
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States.
| | - Danya Nees
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States
| | - Brooke Hightower
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States
| | - Lydia Brock
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States
| | - Micah Kee
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States
| | - Audrey Wise
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States
| | - Benjamin Heigle
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States
| | - Ryan Ottwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States; Department of Internal Medicine, University of Oklahoma, School of Community Medicine, Tulsa, OK, United States
| | - Micah Hartwell
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, 1111 W 17th St., Tulsa, OK 74107, United States; Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, United States
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Lee DJ, Sykes J, Griffin K, Noel CW, Hyung B, Chokar K, Yao CM, Tullis E, Lee JM. The negative impact of chronic rhinosinusitis on the health-related quality of life among adult patients with cystic fibrosis. J Cyst Fibros 2022; 21:800-806. [PMID: 35660273 DOI: 10.1016/j.jcf.2022.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/06/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND With improved survival in cystic fibrosis (CF) patients, it is crucial to evaluate the impact of chronic co-morbidities such as chronic rhinosinusitis (CRS). The objectives were 1) To determine the prevalence of CRS with a large series of CF patients 2) To evaluate the impact of CRS on the Health-Related Quality of Life (HRQoL) of CF patients and 3) To compare CRS-specific, CF-specific and general HRQoL instruments. METHODS Consecutive CF patients from the Toronto Adult Cystic Fibrosis Centre were recruited between March 2018 and January 2020. Participants completed the 22-Item Nasal Outcome Test (SNOT-22), Cystic Fibrosis Questionnaire-Revised for adolescents and adults over 14 years of age (CFQ-R), Cystic Fibrosis Quality of Life Evaluative Self-administered Test (CF-QUEST) and the 36-Item Short Form Survey (SF-36). HRQoL scores were correlated using Spearman's correlation coefficients. RESULTS Out of 195 patients eligible for analysis, the prevalence of CRS with positive endoscopic findings was 42.6% (95% confidence interval: 35.5-49.8%). CRS patients reported significantly lower HRQoL with higher SNOT-22 scores and lower scores in the respiratory domain of CFQ-R and physical health domains of CF-QUEST and SF-36. The physical (ρ= -0.63) and mental (ρ= -0.66) domains of SF-36 and CF-QUEST (ρ= -0.76) had a strong correlation with SNOT-22. Higher scores of SNOT-22 nasal subdomains correlated with lower scores of SF-36, CFQ-R and CF-QUEST. CONCLUSION CRS is a prevalent co-morbidity of CF patients, which significantly reduces HRQoL. SNOT-22, CFQ-R, CF-QUEST and SF-36 were strongly correlated. Severity of sinonasal symptoms have a strong correlation with HRQoL in CF patients.
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Affiliation(s)
- Daniel J Lee
- Department of Otolaryngology-Head and Neck Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jenna Sykes
- Adult Cystic Fibrosis Centre, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Katherine Griffin
- Adult Cystic Fibrosis Centre, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Christopher W Noel
- Department of Otolaryngology-Head and Neck Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Brian Hyung
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kamalprit Chokar
- Adult Cystic Fibrosis Centre, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Christopher Mkl Yao
- Department of Otolaryngology-Head and Neck Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth Tullis
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - John M Lee
- Department of Otolaryngology-Head and Neck Surgery, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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Efficacy and safety of elexacaftor plus tezacaftor plus ivacaftor versus tezacaftor plus ivacaftor in people with cystic fibrosis homozygous for F508del-CFTR: a 24-week, multicentre, randomised, double-blind, active-controlled, phase 3b trial. THE LANCET RESPIRATORY MEDICINE 2022; 10:267-277. [DOI: 10.1016/s2213-2600(21)00454-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 12/20/2022]
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Viñado C, Girón RM, Ibáñez E, García-Ortega A, Pérez I, Polanco D, Pemán J, Solé A. Filamentous fungi in the airway of patients with cystic fibrosis: Just spectators? Rev Iberoam Micol 2021; 38:168-174. [PMID: 34535388 DOI: 10.1016/j.riam.2021.03.005] [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: 11/12/2020] [Revised: 01/17/2021] [Accepted: 03/24/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND There are important advances in the management of bacterial infection in patients with cystic fibrosis (CF), but there are many gaps in the field of fungal infections. AIMS The aim of this study was to analyse whether chronic respiratory filamentous fungal colonization had clinical impact and whether antifungal treatment can change the disease. METHODS The prospective, bicentric and descriptive study was carried out within a 3-year follow-up period, with four-month periodicity medical controls. Adult patients from two CF units of tertiary hospitals were included. Clinical, microbiological, analytical and spirometric variables were collected. Quality of life was evaluated in a subgroup, using the Spanish version of the Revised Cystic Fibrosis Quality of Life Questionnaire (CFQ-R). To statistically analyze the evolution of forced expiratory along time (volume of air blown out in 1 second -FEV1-) and the forced vital capacity (FVC), mixed linear models were carried out. RESULTS From the ninety-eight patients under study, 40 suffered chronic filamentous fungal colonization. The presence of filamentous fungi in airway was associated to an annual fall of FEV1 and FVC of 0.029 and 0.017 litres, respectively (p<0.001). In addition, worse quality of life based on CFQ-R, significant when concerning physical condition and emotional state, was also linked with the fungal colonization. Protocolized antifungal therapy, nebulized or oral, improved FEV1 in 0.023 and 0.024 litres per year, respectively (p<0.001). CONCLUSIONS Chronic filamentous fungal colonization in patients with CF is associated with a significant annual decline of lung function that persists over time. Chronic antifungal therapy slows down this progression, mainly in the patient with more advanced disease.
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Affiliation(s)
- Clara Viñado
- Servicio de Neumología del Hospital de Barbastro, Spain.
| | - Rosa María Girón
- Unidad de Fibrosis Quística del Hospital Universitario de la Princesa de Madrid, Spain
| | - Elisa Ibáñez
- Servicio de Microbiología del Hospital Universitario y Politécnico La Fe de Valencia, Spain
| | - Alberto García-Ortega
- Unidad de Fibrosis Quística y Trasplante Pulmonar del Hospital Universitario y Politécnico La Fe de Valencia, Spain
| | - Inés Pérez
- Unidad de Fibrosis Quística y Trasplante Pulmonar del Hospital Universitario y Politécnico La Fe de Valencia, Spain
| | - Dinora Polanco
- Servicio de Neumología del Hospital Universitario Arnau de Vilanova de Lleida, Spain
| | - Javier Pemán
- Servicio de Microbiología del Hospital Universitario y Politécnico La Fe de Valencia, Spain
| | - Amparo Solé
- Unidad de Fibrosis Quística y Trasplante Pulmonar del Hospital Universitario y Politécnico La Fe de Valencia, Spain
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Abstract
BACKGROUND To determine patient-reported outcome measures (PROMs) which may be suitable for incorporation into the Australian Cystic Fibrosis Data Registry (ACFDR) by identifying PROMs administered in adult and paediatric cystic fibrosis (CF) populations in the last decade. METHODS We searched MEDLINE, EMBASE, Scopus, CINAHL, PsycINFO and Cochrane Library databases for studies published between January 2009 and February 2019 describing the use of PROMs to measure health-related quality of life (HRQoL) in adult and paediatric patients with CF. Validation studies, observational studies and qualitative studies were included. The search was conducted on 13 February 2019. The COnsensus-based Standards for the selection of health Measurement INstruments Risk of Bias Checklist was used to assess the methodological quality of included studies. RESULTS Twenty-seven different PROMs were identified. The most commonly used PROMs were designed specifically for CF. Equal numbers of studies were conducted on adult (32%, n=31), paediatric (35%, n=34) and both (27%, n=26) populations. No PROMs were used within a clinical registry setting previously. The two most widely used PROMs, the Cystic Fibrosis Questionnaire-Revised (CFQ-R) and the Cystic Fibrosis Quality of Life Questionnaire (CFQoL), demonstrated good psychometric properties and acceptability in English-speaking populations. DISCUSSION We found that although PROMs are widely used in CF, there is a lack of reporting on the efficacy of methods and timepoints of administration. We identified the CFQ-R and CFQoL as the most suitable for incorporation in the ACFDR as they captured significant effects of CF on HRQoL and were reliable and valid in CF populations. These PROMs will be used in a further qualitative study assessing patients' with CF and clinicians' perspectives toward the acceptability and feasibility of incorporating a PROM in the ACFDR. PROSPERO REGISTRATION NUMBER CRD42019126931.
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Affiliation(s)
- Irushi Ratnayake
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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Burgess BE, Gresham BL, Mrug S, Bray LA, Leon KJ, Troxler RB. Religious coping and psychosocial adjustment in patients with cystic fibrosis. J Health Psychol 2020; 26:2886-2895. [PMID: 32594758 DOI: 10.1177/1359105320935979] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The role of religious coping (RC) in psychosocial outcomes and health-related quality of life (HRQoL) in adults with cystic fibrosis has not been addressed. Multivariate regressions evaluated the effects of baseline RC on depressive and anxiety symptoms and HRQoL at 3-month follow-up in 123 adult cystic fibrosis patients. Higher positive RC attenuated the effects of perceived stress on greater depressive and anxiety symptoms. Negative RC predicted less vitality and social HRQoL, as well as more digestion symptoms. Positive RC may buffer the impact of stress on patients' psychological distress, whereas negative RC may contribute to lower health-related quality of life.
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Zupanič MV, Škerjanc A. Cystic fibrosis and career counselling. Cent Eur J Public Health 2020; 27:279-284. [PMID: 31951686 DOI: 10.21101/cejph.a5634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 07/22/2019] [Accepted: 07/22/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Cystic fibrosis is a genetic disorder that affects mostly lungs but also other organs. Modern treatment has transformed once fatal disease of childhood into the chronic disease of adulthood. Hence more patients enter the job market. Very few adolescents with cystic fibrosis receive some formal career guidance. There is still no professional career guidance for them in Slovenia. METHODS Literature on workability of patients with cystic fibrosis was reviewed. Following the articles and Slovenian and foreign manuals the guidelines on career counselling of young patients with cystic fibrosis is proposed, as well as the suggestions for professional qualification of these patients. RESULTS The results of the studies present that workability of patients with cystic fibrosis is associated to forced expiratory volume in 1 second (FEV1) (p < 0.05), the achieved educational level more than 3 years of faculty study (p < 0.001-p < 0.013), self-assessment of quality of life (p = 0.005), age (p = 0.01), and the number of admissions to the hospital (p = 0.001). CONCLUSIONS The interactions among work, quality of life and survival require that healthcare workers strive to help their patients with cystic fibrosis to succeed in their professional lives. The young patients should achieve the highest level of education possible and follow their wishes in line with the realistic possibilities.
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Affiliation(s)
- Marija Vita Zupanič
- University Medical Centre Maribor, Department of Ophthalmology, Maribor, Slovenia
| | - Alenka Škerjanc
- University Medical Centre Ljubljana, Clinical Institute for Occupational, Traffic and Sports Medicine, Ljubljana, Slovenia
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Gur M, Masarweh K, Toukan Y, Nir V, Bar-Yoseph R, Hanna M, Manor E, Hakim F, Bentur L. Six-minute walk, lung clearance index, and QOL in bronchiolitis obliterans and cystic fibrosis. Pediatr Pulmonol 2019; 54:451-456. [PMID: 30575341 DOI: 10.1002/ppul.24223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/18/2018] [Accepted: 11/21/2018] [Indexed: 11/07/2022]
Abstract
INTRODUCTION The 6-min walk test (6MWT) predicts outcome in pulmonary hypertension. Recently, its use was reported in both cystic fibrosis (CF) and bronchiolitis obliterans (BO). While the 6MWT is a simple, non-invasive and inexpensive tool, lung clearance index (LCI) measurement requires expensive equipment and expertise. We aimed to evaluate 6MWT in BO and CF, and to compare to MBW (multiple breath washout), pulmonary function tests and quality of life (QOL). METHODS A prospective single center study assessing 6MWT, MBW, spirometry, whole-body plethysmography and QOL (SF-36 questionnaire) in BO and CF patients and correlations between them. RESULTS Thirty-three BO patients and 37 CF patients. LCI was significantly higher in BO (12.4 ± 4.2 vs 10.5 ± 3.4, P = 0.044) while FEF 25-75% was significantly lower in BO (43.9 ± 24.4 vs 60.8 ± 30.8, P = 0.014). 6MWD was 474.8 ± 76.3 in BO and 506.6 ± 70 in CF (P > 0.05). There was no correlation between 6MWD and LCI in these small study groups There were few correlation between spirometry prameters and 6MWD. In CF, SF-36 scores correlated with pulmonary functions. CONCLUSIONS The 6MWT is an easy-to-perform test that may be helpful in chronic lung diseases in regions with limited resources. However,with the current limited data, 6MWT cannot replace LCI or spirometry as a marker of disease progression. Is is suggested that, together with QOL, the 6MWT may provide a global estimation of the physiological and general well-being of these patients. Further larger multi-center studies are warranted to evaluate the correlations of 6MWT with pulmonary physiology parameters in various chronic diseases.
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Affiliation(s)
- Michal Gur
- Pediatric Pulmonary Institute and CF Center, Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Kamal Masarweh
- Pediatric Pulmonary Institute and CF Center, Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Yazeed Toukan
- Pediatric Pulmonary Institute and CF Center, Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Vered Nir
- Pediatric Pulmonary Institute and CF Center, Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Ronen Bar-Yoseph
- Pediatric Pulmonary Institute and CF Center, Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Moneera Hanna
- Pediatric Pulmonary Institute and CF Center, Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Eynav Manor
- Pediatric Pulmonary Institute and CF Center, Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Fahed Hakim
- Pediatric Pulmonary Institute and CF Center, Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Lea Bentur
- Pediatric Pulmonary Institute and CF Center, Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Li SS, Tumin D, Krone KA, Boyer D, Kirkby SE, Mansour HM, Hayes D. Risks associated with lung transplantation in cystic fibrosis patients. Expert Rev Respir Med 2018; 12:893-904. [PMID: 30198350 DOI: 10.1080/17476348.2018.1522254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Survival after lung transplantation lags behind outcomes of other solid organ transplants, and complications from lung transplant are the second most common cause of death in cystic fibrosis. Evolving surgical techniques, therapeutics, and perioperative management have improved short-term survival after lung transplantation, yet have not translated into significant improvement in long-term mortality. Areas covered: We review risk factors for poor long-term outcomes among patients with cystic fibrosis undergoing lung transplantation to highlight areas for improvement. This includes reasons for organ dysfunction, complications of immunosuppression, further exacerbation of extrapulmonary complications of cystic fibrosis, and quality of life. A literature search was performed using PubMed-indexed journals. Expert commentary: There are multiple medical and socioeconomic barriers that threaten long-term survival following lung transplant for patients with cystic fibrosis. An understanding of the causes of each could elucidate treatment options. There is a lack of prospective, multicenter, randomized control trials due to cost, complexity, and feasibility. Ongoing prospective studies should be reserved for the most promising interventions identified in retrospective studies in order to improve long-term outcomes.
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Affiliation(s)
- Susan S Li
- a Department of Pediatrics, Nationwide Children's Hospital , The Ohio State University College of Medicine , Columbus , OH , USA
| | - Dmitry Tumin
- a Department of Pediatrics, Nationwide Children's Hospital , The Ohio State University College of Medicine , Columbus , OH , USA
| | - Katie A Krone
- b Division of Respiratory Diseases, Boston Children's Hospital , Harvard Medical School , Boston , MA, OH , USA
| | - Debra Boyer
- b Division of Respiratory Diseases, Boston Children's Hospital , Harvard Medical School , Boston , MA, OH , USA
| | - Stephen E Kirkby
- a Department of Pediatrics, Nationwide Children's Hospital , The Ohio State University College of Medicine , Columbus , OH , USA
| | - Heidi M Mansour
- c Department of Pharmacology and Toxicology , The University of Arizona Colleges of Pharmacy and Medicine , Tucson , AZ , USA
| | - Don Hayes
- a Department of Pediatrics, Nationwide Children's Hospital , The Ohio State University College of Medicine , Columbus , OH , USA
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Solé A, Olveira C, Pérez I, Hervás D, Valentine V, Baca Yepez AN, Olveira G, Quittner AL. Development and electronic validation of the revised Cystic Fibrosis Questionnaire (CFQ-R Teen/Adult). J Cyst Fibros 2018; 17:672-679. [DOI: 10.1016/j.jcf.2017.10.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/28/2017] [Accepted: 10/28/2017] [Indexed: 10/18/2022]
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Abbott J. Patient-reported outcomes: Time for a new approach? J Cyst Fibros 2018; 17:560-561. [PMID: 30089531 DOI: 10.1016/j.jcf.2018.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 07/17/2018] [Accepted: 07/17/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Janice Abbott
- University of Central Lancashire, Preston PR1 2HE, UK.
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13
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Caregiver burden of parents of young children with cystic fibrosis. J Cyst Fibros 2017; 17:125-131. [PMID: 29150357 DOI: 10.1016/j.jcf.2017.08.016] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 08/20/2017] [Accepted: 08/31/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND There is a paucity of research examining the impact of informal caregiving on parents of young children with cystic fibrosis (CF). The aim of this study was to examine caregiver burden and identify risk factors associated with high caregiver burden in mothers and fathers of young children with CF. METHODS This was a cross-sectional study of parents of young children with CF. A total of 213 families were invited to complete the CarerQoL questionnaire, a validated tool composed of two parts: (i) the CarerQol-7D which describes the care situation in terms of the negative and positive effects of caregiving and (ii) the visual analogue scale (VAS) which measures happiness on a scale from 0 to 10 (0=completely unhappy and 10=completely happy). The utility score (US) is a weighted average of the subjective burden derived from the CarerQol-7D (0-100); higher US indicates reduced burden. Differences in mother-father dyad median utility scores were examined using Wilcoxon signed rank test. Generalised linear mixed models were used to identify factors associated with high caregiver burden. RESULTS At least one parent from 195 families completed the questionnaire (130 mother-father dyads, 189 mothers and 137 fathers). Fathers had a significantly higher median utility score than mothers [(89.2 (IQR 79.6-96.5) vs. 84.7 (74.5-88.0) p<0.001]. Factors found to be significantly associated with higher caregiver burden were increasing child age (OR 1.02; CI: 1.00-1.04), having a child ever positive for Pseudomonas aeruginosa (Pa) (OR 2.48; CI: 1.30-4.73) and being a mother (OR 1.65; CI: 1.02-2.65). CONCLUSIONS This study contributes new findings to the sparse literature on caregiver burden of parents of young children with CF. Increasing child age and infection with Pa, associated with higher morbidity, were linked to greater parental burden.
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Broekema K, Weber KM. Disclosures of Cystic Fibrosis-Related Information to Romantic Partners. QUALITATIVE HEALTH RESEARCH 2017; 27:1575-1585. [PMID: 28728531 DOI: 10.1177/1049732317697675] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this article, we offer insights into how individuals with cystic fibrosis (CF) share information about their disease with a romantic partner. Using communication privacy management as a sensitizing theoretical construct, four themes emerged following 13 qualitative interviews with persons with CF. Themes about sharing CF-related information with a romantic partner include weighing the risks and benefits of sharing information, the role of health-related triggered rules, the motivations for disclosures, and the reactions from outsiders. Implications of the research suggest a need for more nuanced understandings of how privacy rules are communicated in relationships, how the mismanagement of co-owned information influences future disclosures, how the public-private nature of rare genetic illnesses is managed, and how people with genetic illnesses make disclosure decisions.
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Affiliation(s)
- Katie Broekema
- 1 Central Michigan University, Mount Pleasant, Michigan, USA
| | - Kirsten M Weber
- 1 Central Michigan University, Mount Pleasant, Michigan, USA
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Ashbrook JE, Shacklady C, Johnson S, Yeowell G, Goodwin PC. Is there an association between back pain and stress incontinence in adults with cystic fibrosis? A retrospective cross-sectional study. J Cyst Fibros 2017; 17:78-82. [PMID: 28476560 DOI: 10.1016/j.jcf.2017.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 02/26/2017] [Accepted: 04/01/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Back pain and stress urinary incontinence (SUI) are common in adults with cystic fibrosis (CF). This study aimed to establish whether there is an association between back pain, lung function and stress urinary incontinence and its relative risk. METHOD This was a cross-sectional, retrospective analysis of the Manchester Musculoskeletal Screening Tool (MMST) data. It includes pain, (Short Form McGill Pain Questionnaire (SF-MPQ and VAS)) and International Consultation on Incontinence Short Form (ICIQ-UI-SF) measures. Associations were tested using Spearman's rank correlation coefficient. Relative risk of developing symptoms was calculated the sig level was p=0.05. RESULTS ICIQ-UI-SF was associated with back pain (SF-MPQ) (Rho=0.32, p<0.001) and pain (VAS) (Rho=0.23, p<0.01). RR of developing SUI with back pain was 2; RR of developing back pain with SUI was 1.3. CONCLUSIONS An association is indicated between back pain (SF-MPQ and VAS), and SUI in adults with CF. This information is important when developing management strategies in the CF population.
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Affiliation(s)
- Jane E Ashbrook
- Manchester Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Southmoor Rd, Manchester M23 9LT, United Kingdom
| | - Carol Shacklady
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester M15 6GX, United Kingdom
| | - Sue Johnson
- Manchester Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Southmoor Rd, Manchester M23 9LT, United Kingdom
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester M15 6GX, United Kingdom
| | - Peter Charles Goodwin
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester M15 6GX, United Kingdom.
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Patient-reported symptoms and functioning as indicators of mortality in advanced cystic fibrosis: A new tool for referral and selection for lung transplantation. J Heart Lung Transplant 2016; 35:789-94. [DOI: 10.1016/j.healun.2016.01.1233] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 01/02/2016] [Accepted: 01/26/2016] [Indexed: 11/24/2022] Open
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Del Corral T, Percegona J, López N, Valiente A, Garriga M, Seborga M, Vilaró J. Validity of a Spanish Version of the Leicester Cough Questionnaire in Children With Cystic Fibrosis. Arch Bronconeumol 2015; 52:63-9. [PMID: 26163742 DOI: 10.1016/j.arbres.2015.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 01/05/2015] [Accepted: 01/28/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cystic fibrosis (CF) patients present chronic cough as one of the main symptoms, which has an important effect on quality of life and social relations. Our goal was to validate the Spanish version of the Leicester Cough Questionnaire (LCQ) in a group of children and teenagers with CF. METHODS After adapting to Spanish by standardized translation and retro-translation methodology, a sample of 58 stable CF patients from 7 to 18 years were recruited from three CF specialized centers in Spain. The questionnaire was administered twice; the second administration (LCQ2) was performed between 2-4 weeks later than the first one (LCQ1), in order to analyse the reliability and validity of the Spanish version. To correlate results with health related quality of life (HRQoL) we used the Cystic Fibrosis Questionnaire-Revised (CFQ-R). RESULTS Population was composed by 62% male, age 11.7 ± 3.1 years and body mass index (BMI) 19 ± 3 kg/m(2). Total scores from LCQ were: LCQ1 19 (17.75-21) vs LCQ2 19 (16-21) (P=.199). Cronbach's Alpha coefficient was 0.83 for the LCQtotal and for each specific domain was: 0.82 LCQphysical; 0.74 LCQpsychological and 0.62 LCQsocial. Intraclass correlation coefficient was: 0.69 LCQphysical; 0.59 LCQpsychological; 0.45 LCQsocial and 0.71 LCQtotal (good reliability). Relations with CFQ-R showed moderated and significant results: for the LCQtotal: respiratory symptom domain r = 0,51 (P<.001) and physical capacity domain r = 0,62 (P<.05). CONCLUSION The Spanish version of the Leicester Cough Questionnaire is reliable and valid for children and adolescents with CF and it has good relations with health related quality of life in this population.
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Affiliation(s)
- Tamara Del Corral
- Asociación Madrileña de Fibrosis Quística, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España
| | - Janaína Percegona
- Máster en Medicina Respiratoria, Universitat de Barcelona y Universitat Pompeu Fabra, Barcelona, España
| | - Núria López
- Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | - Andrea Valiente
- Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Sabadell, Barcelona, España
| | | | - Melisa Seborga
- Asociación Madrileña de Fibrosis Quística, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España
| | - Jordi Vilaró
- FCS Blanquerna, Grup de Recerca en Salut, Activitat Física i Esport (SAFE), Universitat Ramon Llull, Barcelona, España.
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Abbott J, Morton AM, Hurley MA, Conway SP. Longitudinal impact of demographic and clinical variables on health-related quality of life in cystic fibrosis. BMJ Open 2015; 5:e007418. [PMID: 25991453 PMCID: PMC4442198 DOI: 10.1136/bmjopen-2014-007418] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The insights that people with cystic fibrosis have concerning their health are important given that aspects of health-related quality of life (HRQoL) are independent predictors of survival and a decrease in lung function is associated with a decrease in HRQoL over time. Cross-sectional data suggest that key variables, other than lung function, are also associated with HRQoL--although study results are equivocal. This work evaluates the relationship between these key demographic and clinical variables and HRQoL longitudinally. DESIGN Longitudinal observational study. Observations were obtained at seven time points: approximately every 2 years over a 12-year period. SETTING Large adult cystic fibrosis centre in the UK. PARTICIPANTS 234 participants aged 14-48 years at recruitment. OUTCOME MEASURE Nine domains of HRQoL (Cystic Fibrosis Quality of Life Questionnaire) in relation to demographic (age, gender) and clinical measures (forced expiratory volume in 1 s, (FEV1)% predicted, body mass index (BMI), cystic fibrosis-related diabetes, Burkholderia cepacia complex, totally implantable vascular access device, nutritional and transplant status). RESULTS A total of 770 patient assessments were obtained for 234 patients. The results of random coefficients modelling indicated that demographic and clinical variables were identified as being significant for HRQoL over time. In addition to lung function, transplant status, age, having a totally implantable vascular access device, cystic fibrosis-related diabetes, BMI and B. cepacia complex impacted on many HRQoL domains longitudinally. Gender was important for the domain of body image. CONCLUSIONS Demographic and changes in clinical variables were independently associated with a change in HRQoL over time. Compared with these longitudinal data, cross-sectional data are inadequate when evaluating the relationships between HRQoL domains and key demographic and clinical variables, as they fail to recognise the full impact of the CF disease trajectory and its treatments on quality of life.
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Affiliation(s)
- Janice Abbott
- School of Psychology, University of Central Lancashire, Preston, UK
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Norrish C, Norrish M, Fass U, Al-Salmani M, Lingam GS, Clark F, Kallesh H. The Cystic Fibrosis Symptom Progression Survey (CF-SPS) in Arabic: A Tool for Monitoring Patient's Symptoms. Oman Med J 2015; 30:17-25. [PMID: 25829996 DOI: 10.5001/omj.2015.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 01/20/2015] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE Our study aimed to develop a survey that could be used by nurses during regular cystic fibrosis (CF) clinic visits, providing clinicians with a standardized means of longitudinally assessing and monitoring symptom progression in their patients. In addition, the use of this survey would provide an opportunity for patient engagement and relationship building, thereby enhancing patient education and improving adherence to treatment. This is the first such survey designed specifically for use in Arab populations. . METHODS The Cystic Fibrosis Symptom Progression Survey (CF-SPS) was developed using previously published patient reported outcomes relating to pulmonary exacerbations in CF. It contains 10 items that provide a patient-focused account of symptoms. The survey was translated into Arabic and was completed by 12 patients on 139 occasions over 22 months. The psychometric properties of the survey were evaluated, as was the relationship between the survey findings and other known clinical measures of health status in CF. . RESULTS The CF-SPS performs well as a psychometrically valid clinical tool, with good internal consistency as determined by Cronbach's alpha analysis. Our results suggest that the CF-SPS is able to identify significant declines in health status in line with routine clinical patient assessment (chest sounds, body mass index and admissions). As such it is a useful tool that can support clinical decision making in the care of Arabic speaking CF patients. . CONCLUSION We recommend the CF-SPSa (Arabic version) as a valid tool for the longitudinal monitoring of symptom progression in CF in Arabic speaking populations.
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Affiliation(s)
| | | | - Uwe Fass
- Oman Medical College, Sohar, Oman
| | | | | | - Fiona Clark
- Sohar Regional Teaching Hospital, Sohar, Oman
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Michel-Cherqui M, Ley L, Szekely B, Dreyfus JF, Fischler M. Prevalence and characteristics of pain in patients awaiting lung transplantation. J Pain Symptom Manage 2015; 49:548-54. [PMID: 25150816 DOI: 10.1016/j.jpainsymman.2014.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 07/08/2014] [Accepted: 07/10/2014] [Indexed: 10/24/2022]
Abstract
CONTEXT Pain in patients awaiting lung transplantation is not well known. OBJECTIVES This study prospectively investigated prevalence and characteristics of pain in these patients. METHODS Assessment, undertaken at the time of registration, comprised an interview, a physical examination by a pain-qualified anesthesiologist, and a questionnaire completed by the patient and investigator. This questionnaire included evaluation of pain (intensity, location, sensory and affective qualifications, and treatment), detection of neuropathic pain, and assessment of anxiety and depression. A patient was considered "with pain" when at least one of the following criteria was met: 1) positive answer to the question "Do you suffer regularly from pain?" and 2) score greater than 3 on at least one of three numeric pain scales (current, maximal, and average during the last eight days) ranging from 0 (no pain) to 10 (most severe pain imaginable). RESULTS One hundred forty-three patients were enrolled. Prevalence of pain was 59%. Three independent variables were correlated to the magnitude of the average pain score for the preceding eight days: female gender (P = 0.003), cystic fibrosis (P = 0.02), and depression score (P = 0.02). Among the pain patients, 39% took analgesic drugs daily and 36% regularly but less than daily; 2% used opioids. Nineteen percent used nonpharmacological strategies (e.g., hypnosis, relaxation). CONCLUSION This study highlights the prevalence of pain in this population and specific problems associated with pain such as anxiety and depression. Appropriate assessment and treatment of pain should be considered a component of pretransplantation management.
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Affiliation(s)
- Mireille Michel-Cherqui
- Department of Anesthesiology, Hôpital Foch, Suresnes, France; Pain Management Unit, Hôpital Foch, Suresnes, France; University Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | - Léa Ley
- Department of Anesthesiology, Hôpital Foch, Suresnes, France; University Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | - Barbara Szekely
- Department of Anesthesiology, Hôpital Foch, Suresnes, France; Pain Management Unit, Hôpital Foch, Suresnes, France; University Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | | | - Marc Fischler
- Department of Anesthesiology, Hôpital Foch, Suresnes, France; University Versailles Saint-Quentin-en-Yvelines, Versailles, France.
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A Systematic Review of Factors Associated with Health-Related Quality of Life in Adolescents and Adults with Cystic Fibrosis. Ann Am Thorac Soc 2015; 12:420-8. [DOI: 10.1513/annalsats.201408-393oc] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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22
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Dębska G, Mazurek H. Factors related to changes in the quality of life among Polish adolescents and adults with cystic fibrosis over a 1-year period. Patient Prefer Adherence 2015; 9:1763-70. [PMID: 26719679 PMCID: PMC4689266 DOI: 10.2147/ppa.s88385] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The aim of this study was to determine the effects of clinical factors, physical activity, and sociodemographic variables on 1-year changes in health-related quality of life (HRQoL) in Polish adolescents and adults with cystic fibrosis (CF). METHOD The study included 67 subjects with CF (mean age 21.1±5.1 years; range 14-37 years; 34 males and 33 females). The Cystic Fibrosis Quality of Life Questionnaire was used at baseline and after 1 year. Lung function data, body weight, and body height were extracted from medical records. Clinical assessment was performed with the Shwachman-Kulczycki scale. RESULTS The highest scores in both HRQoL examinations came from the domains of physical and social functioning, and the lowest from future concerns, body image, and career concerns. No significant changes of Cystic Fibrosis Quality of Life Questionnaire scores were documented over a period of 1 year. Patients with better baseline spirometry results more frequently reported an improvement in the treatment issues (subjects with FEV1 >50% of predicted, P=0.020) and in the career concerns (patients with FVC >50% of predicted, P=0.039). The improvement in the career concerns also depended upon daily physical activity (P=0.024), which was shown to modulate future concerns (P=0.032), along with place of residence and living conditions (P=0.003). Moreover, the time elapsed from the last pulmonary exacerbation was related to the change in social functioning (P=0.026). CONCLUSION When planning treatment, attention should be paid to interventions which may improve HRQoL. Systematic chronic therapy improves lung function, related to treatment issues and career concerns. Maintaining good physical condition and activity may positively influence future and career concerns. Special attention must be devoted to patients living in rural areas and enduring difficult living conditions, as they are especially vulnerable to deterioration in future concerns.
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Affiliation(s)
- Grażyna Dębska
- Faculty of Health and Medical Studies, Andrzej Frycz Modrzewski Krakow University, Krakow
- Correspondence: Grażyna Dębska, Faculty of Health and Medical Studies, Andrzej Frycz Modrzewski Krakow University, Herlinga-Grudzińskiego 1, 30-705 Krakow, Poland, Tel +48 12 252 4520, Fax +48 12 252 4523, Email
| | - Henryk Mazurek
- Department of Pneumonology and Cystic Fibrosis, National Tuberculosis and Lung Diseases Research Institute, Rabka, Poland
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Fidika A, Herle M, Goldbeck L. Symptoms of depression impact the course of lung function in adolescents and adults with cystic fibrosis. BMC Pulm Med 2014; 14:205. [PMID: 25515072 PMCID: PMC4277836 DOI: 10.1186/1471-2466-14-205] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 12/11/2014] [Indexed: 01/04/2023] Open
Abstract
Background Epidemiological studies report high rates of depression among patients with cystic fibrosis (CF). Assuming a causal relationship between depression and the progression of CF, our hypothesis is that elevated symptoms of depression would be a predictor of worse lung function after two years. Methods In the context of the TIDES study, 473 German patients with CF (age 12–53 years, FEV1% predicted M = 66.2, range 13–137) completed the Hospital Anxiety and Depression Scale (HADS). Lung function (FEV1% predicted) was assessed at baseline and followed up two years later. Repeated measures analysis was performed involving the level of FEV1% and the level of depressive symptoms at baseline as independent factors and FEV1% at the 2-year follow-up as the dependent variable. Results Interaction between lung function and depression at baseline significantly affected the change in lung function at the 2-years observation interval. The largest decline in FEV1% occurred in depressed patients with good lung function at baseline. In contrast, patients without any clinically relevant depressive symptoms and with poor lung function at baseline showed a slight increase two years later. Conclusion The findings emphasise the need to screen patients with CF for symptoms of depression and to treat co-morbid depression.
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Affiliation(s)
- Astrid Fidika
- Department of Child and Adolescent Psychiatry/ Psychotherapy, University Ulm Medical Centre, Steinhoevelstr, 1, 89075 Ulm, Germany.
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Hubert D, Soubeiran L, Gourmelon F, Grenet D, Serreau R, Perrodeau E, Zegarra-Parodi R, Boutron I. Impact of osteopathic treatment on pain in adult patients with cystic fibrosis--a pilot randomized controlled study. PLoS One 2014; 9:e102465. [PMID: 25029347 PMCID: PMC4100932 DOI: 10.1371/journal.pone.0102465] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 06/16/2014] [Indexed: 12/04/2022] Open
Abstract
Background Pain is a common complication in patients with cystic fibrosis (CF) and is associated with shorter survival. We evaluated the impact of osteopathic manipulative treatment (OMT) on pain in adults with CF. Methods A pilot multicenter randomized controlled trial was conducted with three parallel arms: OMT (group A, 16 patients), sham OMT (sham treatment, group B, 8 patients) and no treatment (group C, 8 patients). Medical investigators and patients were double-blind to treatment for groups A and B, who received OMT or sham OMT monthly for 6 months. Pain was rated as a composite of its intensity and duration over the previous month. The evolution of chest/back pain after 6 months was compared between group A and groups B+C combined (control group). The evolution of cervical pain, headache and quality of life (QOL) were similarly evaluated. Results There was no statistically significant difference between the treatment and control groups in the decrease of chest/back pain (difference = −2.20 IC95% [−4.81; 0.42], p = 0.098); also, group A did not differ from group B. However, chest/back pain decreased more in groups A (p = 0.002) and B (p = 0.006) than in group C. Cervical pain, headache and QOL scores did not differ between the treatment and control groups. Conclusion This pilot study demonstrated the feasibility of evaluating the efficacy of OMT to treat the pain of patients with CF. The lack of difference between the group treated with OMT and the control group may be due to the small number of patients included in this trial, which also precludes any definitive conclusion about the greater decrease of pain in patients receiving OMT or sham OMT than in those with no intervention. Trial Registration ClinicalTrials.gov NCT01293019
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Affiliation(s)
- Dominique Hubert
- Adult CF Center and Pulmonology Department, Hôpital Cochin APHP, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- * E-mail:
| | - Lucile Soubeiran
- Clinical Research Department, Hôpital Cochin APHP, Paris, France
| | | | - Dominique Grenet
- Adult CF Center and Pulmonology Department, Hôpital Foch, Suresnes, France
| | - Raphaël Serreau
- Clinical Research Department, Hôpital Cochin APHP, Paris, France
| | - Elodie Perrodeau
- Clinical Epidemiology Center, Hôpital Hôtel Dieu APHP, Paris, France
| | - Rafael Zegarra-Parodi
- A.T. Still Research Institute, A.T. Still University, Kirksville, Missouri, United States of America
| | - Isabelle Boutron
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
- Clinical Epidemiology Center, Hôpital Hôtel Dieu APHP, Paris, France
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Hebestreit H, Schmid K, Kieser S, Junge S, Ballmann M, Roth K, Hebestreit A, Schenk T, Schindler C, Posselt HG, Kriemler S. Quality of life is associated with physical activity and fitness in cystic fibrosis. BMC Pulm Med 2014; 14:26. [PMID: 24571729 PMCID: PMC3942299 DOI: 10.1186/1471-2466-14-26] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 02/19/2014] [Indexed: 12/04/2022] Open
Abstract
Background Health-related and disease-specific quality of life (HRQoL) has been increasingly valued as relevant clinical parameter in cystic fibrosis (CF) clinical care and clinical trials. HRQoL measures should assess – among other domains – daily functioning from a patient’s perspective. However, validation studies for the most frequently used HRQoL questionnaire in CF, the Cystic Fibrosis Questionnaire (CFQ), have not included measures of physical activity or fitness. The objective of this study was, therefore, to determine the cross-sectional and longitudinal relationships between HRQoL, physical activity and fitness in patients with CF. Methods Baseline (n = 76) and 6-month follow-up data (n = 70) from patients with CF (age ≥12 years, FEV1 ≥35%) were analysed. Patients participated in two multi-centre exercise intervention studies with identical assessment methodology. Outcome variables included HRQoL (German revised multi-dimensional disease-specific CFQ (CFQ-R)), body composition, pulmonary function, physical activity, short-term muscle power, and aerobic fitness by peak oxygen uptake and aerobic power. Results Peak oxygen uptake was positively related to 7 of 13 HRQoL scales cross-sectionally (r = 0.30-0.46). Muscle power (r = 0.25-0.32) and peak aerobic power (r = 0.24-0.35) were positively related to 4 scales each, and reported physical activity to 1 scale (r = 0.29). Changes in HRQoL-scores were directly and significantly related to changes in reported activity (r = 0.35-0.39), peak aerobic power (r = 0.31-0.34), and peak oxygen uptake (r = 0.26-0.37) in 3 scales each. Established associates of HRQoL such as FEV1 or body mass index correlated positively with fewer scales (all 0.24 < r < 0.55). Conclusions HRQoL was associated with physical fitness, especially aerobic fitness, and to a lesser extent with reported physical activity. These findings underline the importance of physical fitness for HRQoL in CF and provide an additional rationale for exercise testing in this population. Trial registration ClinicalTrials.gov, NCT00231686
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Affiliation(s)
- Helge Hebestreit
- Pediatric Department, University of Würzburg, Würzburg, Germany.
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Dill EJ, Dawson R, Sellers DE, Robinson WM, Sawicki GS. Longitudinal trends in health-related quality of life in adults with cystic fibrosis. Chest 2014; 144:981-989. [PMID: 23670667 DOI: 10.1378/chest.12-1404] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Health-related quality-of-life (HRQOL) measures have been used as patient-reported outcomes in clinical trials in cystic fibrosis (CF), but there are limited data on HRQOL changes over time in adults with CF. METHODS The Project on Adult Care in Cystic Fibrosis, a prospective, longitudinal panel study of 333 adults with CF at 10 CF centers in the United States, administered a disease-specific HRQOL measure, the Cystic Fibrosis Questionnaire-Revised (CFQ-R), seven times over 21 months. The CFQ-R assesses both physical and psychosocial domains of health. Growth curve regression models were developed for each CFQ-R domain, adjusting for demographic and clinical characteristics. RESULTS Between 205 and 303 adults completed surveys (response rate, 70%-93%). Mean age at baseline was 33 years (range, 19-64 years); mean FEV1 % predicted was 59.8% (SD, 22%). Over the 21 months of follow-up, lung function, frequency of pulmonary exacerbations, and nutritional indices were associated with physical CFQ-R domain scores. There were no significant population trends over time in the physical domain scores; however, there were population time trends in three psychosocial domains: treatment burden (+8.9 points/y), emotional functioning (+3.2 points/y), and social functioning (-2.4 points/y). Individual variation in both physical and psychosocial subscales was seen over 21 months. CONCLUSIONS In a longitudinal multicenter population of adults with CF, clinical variables such as FEV1, exacerbation frequency, and weight were correlated with related CFQ-R subscales. For the population as a whole, the physical domains of CFQ-R, such as respiratory symptoms, were stable. In contrast, population changes in several psychosocial domains of CFQ-R suggest that differentiating between the physical and the psychosocial trajectories in health among adults with CF is critical in evaluating patient-reported outcomes.
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Affiliation(s)
- Edward J Dill
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Ree Dawson
- Frontier Science and Technology Research Foundation, Boston, MA
| | - Deborah E Sellers
- Center for Applied Ethics, Education Development Center, Inc, Newton, MA
| | - Walter M Robinson
- Center for Applied Ethics, Education Development Center, Inc, Newton, MA
| | - Gregory S Sawicki
- Division of Respiratory Diseases, Children's Hospital, Boston, Harvard Medical School, Boston, MA.
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Havermans T, Colpaert K, De Boeck K, Dupont L, Abbott J. Pain in CF: Review of the literature. J Cyst Fibros 2013; 12:423-30. [DOI: 10.1016/j.jcf.2013.04.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 03/15/2013] [Accepted: 04/01/2013] [Indexed: 11/17/2022]
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28
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Möller A, Sartipy U. Quality of life six months after lung cancer surgery is associated with long-term survival. Acta Oncol 2012; 51:1029-35. [PMID: 22663251 DOI: 10.3109/0284186x.2012.689112] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this study was to analyze the association between quality of life six months following lung cancer surgery and survival. METHODS In a prospective population-based cohort study, quality of life was estimated by the Medical Outcomes Study 36-Item Short Form (SF-36) questionnaire before and six months after surgery for lung cancer. Cox regression models adjusting for potential confounding factors were used to analyze the association between SF-36 scores six months after surgery and survival. We also estimated the risk of death in patients scoring below the normal population mean at six months after surgery. RESULTS We included 249 patients, and 79 patients were excluded because of histopathology other than primary lung cancer. After six months, 11 patients had died, and 18 patients did not respond to the second SF-36 questionnaire, leaving a study population of 141 patients with SF-36 data from both baseline and follow-up. During a median follow-up of 4.0 years, 35 deaths occurred. The SF-36 physical and mental component summary scores assessed at six months after lung cancer surgery were significantly associated with survival. Mental component summary scores below the mean of the age- and gender-matched normal population were associated with a three-fold increase in the risk of death. CONCLUSIONS Quality of life scores six months after surgery contained prognostic information regarding long-term survival that was independent of baseline scores. If these findings can be validated, cross-sectional post-treatment measurements of quality of life can prove valuable, especially when baseline information is unavailable.
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Growing up with cystic fibrosis: achievement, life satisfaction, and mental health. Qual Life Res 2012; 21:1829-35. [DOI: 10.1007/s11136-011-0096-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2011] [Indexed: 10/14/2022]
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Yohannes AM, Dodd M, Morris J, Webb K. Reliability and validity of a single item measure of quality of life scale for adult patients with cystic fibrosis. Health Qual Life Outcomes 2011; 9:105. [PMID: 22117573 PMCID: PMC3235057 DOI: 10.1186/1477-7525-9-105] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 11/25/2011] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND It is important to monitor health related quality of life in order to determine the efficacy of interventions and physical functioning of patients with cystic fibrosis in their daily activities. There is no a single-item global quality of life scale for routine clinical practice for adult patients with cystic fibrosis. We assessed the reliability and validity of a single-item global quality of life scale and compared with the Cystic Fibrosis Quality of Life Questionnaire (CF-QOL) for adult patients with cystic fibrosis. METHOD 121 (men = 66, women = 55) adult cystic fibrosis patients self-completed the CF-QOL, the Hospital Anxiety Depression Scale, and the single item global quality of life scale at the out patient clinic. 33 (17 women) completed the repeat questionnaires at home within two weeks. Socio-demographic characteristic and lung function data were extracted from the recent medical notes. RESULTS Mean (SD) age was 29.6 (8.9) years and mean (SD) forced expiratory volume in 1 second was 2.20 (0.94) litres. The test-retest reproducibility using the intra-class correlation coefficient (ICC) for the CF-QOL was 0.83, 95% confidence interval 0.68 to 0.91. The single item global quality of life ICC score was 0.78, 95% confidence interval 0.59 to 0.88. Concurrent validity of the single-item global quality of life was examined in relation to all items of the CF-QOL, frequent episodes of readmission, anxiety and depression (all, p < 0.01) were moderately correlated. CONCLUSION The study provides preliminary evidence that the single-item quality of life scale is acceptable, valid and repeatable for adult patients with cystic fibrosis. It is a promising tool that can be easily incorporated into a routine clinical practice to assess patients' quality of life.
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Affiliation(s)
- Abebaw M Yohannes
- Department of Health Professions, Research Institute for Health and Social Change, Manchester Metropolitan University, Elizabeth Gaskell Campus, Hathersage Road, M13 0JA, UK
| | - Mary Dodd
- Department of Adult Cystic Fibrosis Unit, University of South Manchester, Wythenshawe Hospital, Manchester, Southmoor Road, M23 9LT, UK
| | - Julie Morris
- Department of Medical Statistics, 1st Floor, Education & Research Centre, University Hospital of South Manchester, Wythenshawe Hospital, Southmoor Road, Manchester, M23 9LT, UK
| | - Kevin Webb
- Department of Adult Cystic Fibrosis Unit, University of South Manchester, Wythenshawe Hospital, Manchester, Southmoor Road, M23 9LT, UK
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Laborde-Castérot H, Donnay C, Chapron J, Burgel PR, Kanaan R, Honoré I, Dusser D, Choudat D, Hubert D. Employment and work disability in adults with cystic fibrosis. J Cyst Fibros 2011; 11:137-43. [PMID: 22104952 DOI: 10.1016/j.jcf.2011.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 10/11/2011] [Accepted: 10/25/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND As a result of prolonged survival, more patients with cystic fibrosis (CF) participate in the labour force. The aim of this study was to evaluate their education, occupation levels and risk factors for work disability. METHOD 207 patients answered a self-administered questionnaire about their educational level and work status. Independently, medical records were reviewed for illness severity indicators. RESULTS 39 patients (19%) were students, 117 (57%) were in the labour force, 13 (6%) were seeking employment and 38 (18%) were inactive. CF patients had a higher educational level and were more likely to hold skilled jobs and to work part time than the general population. FEV1 and educational level were the strongest predictive factors of disability. CONCLUSION Many CF patients have access to professional life. Their higher educational levels improve the chances of attaining employment, which highlights the need for career counselling. Working part time helps to maintain employment despite declining health.
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Affiliation(s)
- Hervé Laborde-Castérot
- Service de Pathologie Professionnelle, Université Paris Descartes, Sorbonne Paris Cité and Hôpital Cochin, AP-HP, Paris, France
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Abdulrahman BA, Khweek AA, Akhter A, Caution K, Kotrange S, Abdelaziz DHA, Newland C, Rosales-Reyes R, Kopp B, McCoy K, Montione R, Schlesinger LS, Gavrilin MA, Wewers MD, Valvano MA, Amer AO. Autophagy stimulation by rapamycin suppresses lung inflammation and infection by Burkholderia cenocepacia in a model of cystic fibrosis. Autophagy 2011; 7:1359-70. [PMID: 21997369 DOI: 10.4161/auto.7.11.17660] [Citation(s) in RCA: 150] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Cystic fibrosis (CF) is the most common inherited lethal disease of Caucasians which results in multi organ dysfunction. However, 85% of the deaths are due to pulmonary infections. Infection by Burkholderia cenocepacia (B. cepacia) is a particularly lethal threat to CF patients because it causes severe and persistent lung inflammation and is resistant to nearly all available antibiotics. In CFTR ΔF508 mouse macrophages, B. cepacia persists in vacuoles that do not fuse with the lysosomes and mediates increased production of IL-1β. It is believed that intracellular bacterial survival contributes to the persistence of the bacterium. Here we show for the first time that in wild-type macrophages but not in ΔF508 macrophages, many B. cepacia reside in autophagosomes that fuse with lysosomes at later stages of infection. Accordingly, association and intracellular survival of B. cepacia are higher in CFTR-ΔF508 (ΔF508) macrophages than in WT macrophages. An autophagosome is a compartment that engulfs non-functional organelles and parts of the cytoplasm then delivers them to the lysosome for degradation to produce nutrients during periods of starvation or stress. Furthermore, we show that B. cepacia downregulates autophagy genes in WT and ΔF508 macrophages. However, autophagy dysfunction is more pronounced in ΔF508 macrophages since they already have compromised autophagy activity. We demonstrate that the autophagy-stimulating agent, rapamycin markedly decreases B. cepacia infection in vitro by enhancing the clearance of B. cepacia via induced autophagy. In vivo, Rapamycin decreases bacterial burden in the lungs of CF mice and drastically reduces signs of lung inflammation. Together, our studies reveal that if efficiently activated, autophagy can control B. cepacia infection and ameliorate the associated inflammation. Therefore, autophagy is a novel target for new drug development for CF patients to control B. cepacia infection and accompanying inflammation.
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Affiliation(s)
- Basant A Abdulrahman
- Center for Microbial Interface Biology, Department of Microbial Infection, Ohio State University, Columbus, OH, USA
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Zhang L, Wang J, Zhou R, Jia J. Discovery of quantitative trait loci for crossability from a synthetic wheat genotype. J Genet Genomics 2011; 38:373-8. [PMID: 21867963 DOI: 10.1016/j.jgg.2011.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Revised: 06/30/2011] [Accepted: 07/05/2011] [Indexed: 11/19/2022]
Abstract
Crossability between wheat and rye is an important trait for wheat improvement. No quantitative trait loci (QTLs) were detected from wheat ancestors previously. The objectives of this study were to dissect the QTLs for crossability using 111 introgression lines (ILs) derived from synthetic hexaploid wheat. A total of 1275 SSR markers were screened for polymorphism between the two parents, and 552 markers of them displayed polymorphism, of which 64 were selected for genotyping the 111 BC(5)F(6) ILs. Field trials were performed in a Latinized α-lattice design in Luoyang and Jiaozuo of Henan Province of China in 2007-2008 and 2008-2009 cropping seasons. One-way ANOVA and interval mapping (IM) analysis were used to detect QTL for crossability between wheat and rye. A total of 13 putative QTLs were detected. Five of them, QCa.caas.1A, QCa.caas.2D, QCa.caas.4B, QCa.caas.5B and QCa.caas.6A, were detected in both trials and three of them, QCa.caas.2D, QCa.caas.4B and QCa.caas.6A, were novel. The positive effect allele of the four QTLs came from the donor parent Am3 except QCa.caas.6A that came from the recurrent parent Laizhou953. ILs with both higher positive effect alleles and favorable agronomic traits developed in present study are elite germplasm for wide crossing in wheat. Results from the current study suggest that wheat ancestors can be rich in new sources of crossability genes.
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Affiliation(s)
- Li Zhang
- China Agricultural University, Beijing
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Hayes M, Yaster M, Haythornthwaite JA, Riekert KA, Nelson McMillan K, White E, Mogayzel PJ, Lechtzin N. Pain is a common problem affecting clinical outcomes in adults with cystic fibrosis. Chest 2011; 140:1598-1603. [PMID: 21659431 DOI: 10.1378/chest.11-0132] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND As the cystic fibrosis (CF) population has aged, many chronic health problems have emerged, including diabetes mellitus and osteoporosis. Previous studies have suggested that pain is common in patients with CF; however, little is known about the factors associated with it or its impact on clinical outcomes. We hypothesized that pain is common, is associated with psychologic distress, and adversely affects clinical outcomes. METHODS From February 1, 2008, to April 3, 2008, adults with CF from Johns Hopkins Hospital were surveyed about their pain. Outcomes were assessed for 12 months following survey completion. Bivariate analyses were performed using Wilcoxon log rank, Kruskal-Wallis tests, and Spearman correlations. Logistic regression models and Cox proportional hazard models were used to analyze clinical outcomes. RESULTS Eighty-three patients (61%) completed the survey. Eighty-two percent of patients reported pain within the past month, the most common sites being the head, sinuses, back, and chest. Pain frequently interfered with general activities (41.9%), mood (56.8%), and work (47.3%). Symptoms of depression and anxiety, as well as lower quality-of-life (QOL) scores, were associated with the presence of pain (P < .05 for each). The risk of pulmonary exacerbations was increased in patients with higher levels of pain, even after adjusting for FEV(1) and age (OR = 1.65; P = .038; 95% CI, 1.03-2.64). Additionally, the risk of death was higher in patients with higher average pain scores (HR = 2.28; P = .008; 95% CI = 1.2-4.2). CONCLUSIONS Pain is common in adults with CF, interferes with activities, and is associated with lower QOL and an increased risk of both exacerbations and death.
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Affiliation(s)
- Margaret Hayes
- Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Myron Yaster
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jennifer A Haythornthwaite
- Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kristin A Riekert
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kristen Nelson McMillan
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Elizabeth White
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Peter J Mogayzel
- Department of Pediatrics, Division of Pulmonary Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Noah Lechtzin
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
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Cavrini G, Broccoli S, Puccini A, Zoli M. EQ-5D as a predictor of mortality and hospitalization in elderly people. Qual Life Res 2011; 21:269-80. [DOI: 10.1007/s11136-011-9937-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2011] [Indexed: 11/28/2022]
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Sawicki GS, Rasouliyan L, McMullen AH, Wagener JS, McColley SA, Pasta DJ, Quittner AL. Longitudinal assessment of health-related quality of life in an observational cohort of patients with cystic fibrosis. Pediatr Pulmonol 2011; 46:36-44. [PMID: 20848580 DOI: 10.1002/ppul.21325] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 04/30/2010] [Accepted: 05/25/2010] [Indexed: 11/08/2022]
Abstract
BACKGROUND Patient-reported outcomes (PROs) are increasingly used to evaluate the efficacy of new treatments and the progression of chronic diseases. The Cystic Fibrosis Questionnaire-Revised (CFQ-R) is a disease-specific, PRO measure of health-related quality of life (HRQOL). We evaluated associations between changes in health status over time and HRQOL in a national CF database. METHODS Using the Epidemiologic Study of Cystic Fibrosis (ESCF) data, we identified participants who had completed age-appropriate CFQ-R assessments on two occasions separated by 9-15 months. Next, we developed multivariate regression models to test whether associations existed between (1) changes in respiratory signs/symptoms and changes in the respiratory health domains of the CFQ-R, (2) changes in nutritional health status and changes in the nutritional health domains of the CFQ-R, and (3) changes in treatment complexity and changes in the Treatment Burden scale of the CFQ-R. RESULTS We analyzed 1,947 pairs of assessments: 337 child (mean age 8.9, range 6-13 years), 581 parent (mean age of child 8.8, range 6-13 years), 398 adolescent (mean age 15.3, range 14-17 years), and 631 adult (mean age 26.9, range 18-73 years). On average, we found little change in both health status indicators and CFQ-R domain scores over 1 year. Significant associations over time, however, were found between increases in respiratory symptoms and worse CFQ-R Respiratory Symptom scores, declining weight and worsening scores on CFQ-R nutritional health domains, and increases in treatment complexity and worsening CFQ-R Treatment Burden scores for parent respondents. CONCLUSION Health status and HRQOL changes were small over a 1-year period in this CF population. However, changes in respiratory symptoms and weight were associated with significant changes on relevant CFQ-R scores, indicating that this PRO is sensitive to changes in health status over time.
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Affiliation(s)
- Gregory S Sawicki
- Division of Respiratory Diseases, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
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Selvadurai H. Detecting acute pulmonary exacerbations in cystic fibrosis--evolving concepts. THE CLINICAL RESPIRATORY JOURNAL 2010; 4:65-66. [PMID: 20565478 DOI: 10.1111/j.1752-699x.2010.00189.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Adler FR, Aurora P, Barker DH, Barr ML, Blackwell LS, Bosma OH, Brown S, Cox DR, Jensen JL, Kurland G, Nossent GD, Quittner AL, Robinson WM, Romero SL, Spencer H, Sweet SC, van der Bij W, Vermeulen J, Verschuuren EAM, Vrijlandt EJLE, Walsh W, Woo MS, Liou TG. Lung transplantation for cystic fibrosis. PROCEEDINGS OF THE AMERICAN THORACIC SOCIETY 2009; 6:619-33. [PMID: 20008865 PMCID: PMC2797068 DOI: 10.1513/pats.2009008-088tl] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2009] [Accepted: 09/24/2009] [Indexed: 12/22/2022]
Abstract
Lung transplantation is a complex, high-risk, potentially life-saving therapy for the end-stage lung disease of cystic fibrosis (CF). The decision to pursue transplantation involves comparing the likelihood of survival with and without transplantation as well as assessing the effect of wait-listing and transplantation on the patient's quality of life. Although recent population-based analyses of the US lung allocation system for the CF population have raised controversies about the survival benefits of transplantation, studies from the United Kingdom and Canada have suggested a definite survival advantage for those receiving transplants. In response to these and other controversies, leaders in transplantation and CF met together in Lansdowne, Virginia, to consider the state of the art in lung transplantation for CF in an international context, focusing on advances in surgical technique, measurement of outcomes, use of prognostic criteria, variations in local control over listing, and prioritization among the United States, Canada, the United Kingdom, and The Netherlands, patient adherence before and after transplantation and other issues in the broader context of lung transplantation. Finally, the conference members carefully considered how efforts to improve outcomes for lung transplantation for CF lung disease might best be studied. This Roundtable seeks to communicate the substance of our discussions.
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Affiliation(s)
- Frederick R. Adler
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Paul Aurora
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - David H. Barker
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Mark L. Barr
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Laura S. Blackwell
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Otto H. Bosma
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Samuel Brown
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - D. R. Cox
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Judy L. Jensen
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Geoffrey Kurland
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - George D. Nossent
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Alexandra L. Quittner
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Walter M. Robinson
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Sandy L. Romero
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Helen Spencer
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Stuart C. Sweet
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Wim van der Bij
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - J. Vermeulen
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Erik A. M. Verschuuren
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Elianne J. L. E. Vrijlandt
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - William Walsh
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Marlyn S. Woo
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
| | - Theodore G. Liou
- Departments of Mathematics and Biology, and Division of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; Cardiothoracic Transplant Unit, Great Ormond Street Hospital for Children NHS Trust, London; Portex Unit: Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, United Kingdom; Department of Psychology, University of Miami, Coral Gables, Florida; Division of Cardiothoracic Surgery, University of Southern California, Los Angeles, California; Department of Pulmonary Diseases, Paediatrics and Epidemiology, the Lung Transplant Team, University Medical Center Groningen (UMCG), Groningen, The Netherlands; Nuffield College, Oxford, United Kingdom; Division of Pediatric Pulmonology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Center for Applied Ethics, Newton, Massachusetts; Department of Pediatrics, Washington University, St. Louis, Missouri; Cardiothoracic Transplant Team, Division of Pediatric Pulmonology, Children's Hospital of Los Angeles, Los Angeles, California
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Abbott J, Holt A, Hart A, Morton AM, MacDougall L, Pogson M, Milne G, Rodgers HC, Conway SP. What defines a pulmonary exacerbation? The perceptions of adults with cystic fibrosis. J Cyst Fibros 2009; 8:356-9. [PMID: 19665437 DOI: 10.1016/j.jcf.2009.07.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 07/02/2009] [Accepted: 07/09/2009] [Indexed: 11/18/2022]
Abstract
BACKGROUND There is no standardised definition of a pulmonary exacerbation in cystic fibrosis (CF). In attempting to achieve standardised criteria it is important to identify patient-reported indicators. METHODS Interviews were undertaken with 47 adults with CF. Participants were asked to report symptoms experienced during a pulmonary exacerbation in two ways: the first symptoms they become aware of, and how they subsequently recognised when they were improving. RESULTS A range of systemic and respiratory symptoms were reported. Their relative importance varied by severity of disease. The severity and subsequent improvement of an exacerbation was often described as limitations on their activities. CONCLUSION These preliminary data suggest that patient-reported indicators of a pulmonary exacerbation may not be the same for all adults with CF. Whether different indicators are associated with specific demographic or clinical variables remains to be evaluated.
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Affiliation(s)
- J Abbott
- University of Central Lancashire, Preston, UK.
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41
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Health related quality of life in cystic fibrosis: To work or not to work? J Cyst Fibros 2009; 8:218-23. [DOI: 10.1016/j.jcf.2009.03.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Revised: 12/09/2008] [Accepted: 03/11/2009] [Indexed: 11/24/2022]
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