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Holik H, Lucijanić M, Krečak I. The impact of statin use on disease-related symptoms in patients with chronic myeloproliferative neoplasms. Ann Hematol 2024; 103:1783-1785. [PMID: 38472363 DOI: 10.1007/s00277-024-05693-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/02/2024] [Indexed: 03/14/2024]
Affiliation(s)
- Hrvoje Holik
- Department of Internal Medicine, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia
- Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Marko Lucijanić
- Division of Hematology, University Hospital Dubrava, Zagreb, Croatia
- Faculty of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivan Krečak
- Department of Internal Medicine, General Hospital of Šibenik-Knin County, Šibenik, 22000, Croatia.
- University of Applied Sciences, Šibenik, Croatia.
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
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Sohn M, Lim S. The Role of Cilostazol, a Phosphodiesterase-3 Inhibitor, in the Development of Atherosclerosis and Vascular Biology: A Review with Meta-Analysis. Int J Mol Sci 2024; 25:2593. [PMID: 38473840 DOI: 10.3390/ijms25052593] [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: 01/11/2024] [Revised: 02/07/2024] [Accepted: 02/14/2024] [Indexed: 03/14/2024] Open
Abstract
Atherosclerotic cardiovascular disease (ASCVD) stands as the leading global cause of mortality. Addressing this vital and pervasive condition requires a multifaceted approach, in which antiplatelet intervention plays a pivotal role, together with antihypertensive, antidiabetic, and lipid-lowering therapies. Among the antiplatelet agents available currently, cilostazol, a phosphodiesterase-3 inhibitor, offers a spectrum of pharmacological effects. These encompass vasodilation, the impediment of platelet activation and aggregation, thrombosis inhibition, limb blood flow augmentation, lipid profile enhancement through triglyceride reduction and high-density lipoprotein cholesterol elevation, and the suppression of vascular smooth muscle cell proliferation. However, the role of cilostazol has not been clearly documented in many guidelines for ASCVD. We comprehensively reviewed the cardiovascular effects of cilostazol within randomized clinical trials that compared it to control or active agents and involved individuals with previous coronary artery disease or stroke, as well as those with no previous history of such conditions. Our approach demonstrated that the administration of cilostazol effectively reduced adverse cardiovascular events, although there was less evidence regarding its impact on myocardial infarction. Most studies have consistently reported its favorable effects in reducing intermittent claudication and enhancing ambulatory capacity in patients with peripheral arterial disease. Furthermore, cilostazol has shown promise in mitigating restenosis following coronary stent implantation in patients with acute coronary syndrome. While research from more diverse regions is still needed, our findings shed light on the broader implications of cilostazol in the context of atherosclerosis and vascular biology, particularly for individuals at high risk of ASCVD.
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Affiliation(s)
- Minji Sohn
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 13620, Republic of Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam 13620, Republic of Korea
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van den Houdt SCM, Mommersteeg PMC, Widdershoven J, Kupper N. Sex and Gender Differences in Psychosocial Risk Profiles Among Patients with Coronary Heart Disease - the THORESCI-Gender Study. Int J Behav Med 2024; 31:130-144. [PMID: 37170007 PMCID: PMC10803502 DOI: 10.1007/s12529-023-10170-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Psychosocial factors tend to cluster and exhibit differences associated with sex assigned at birth. Gender disparities, though, remain uncharted so far. The current study aimed to first explore the clustering of eight established psychosocial risk factors among patients with coronary heart disease (CHD), followed by examining how sex and gender differences characterize these psychosocial risk profiles, while adjusting for the effect of age. METHOD In total, 532 patients with CHD (Mage = 68.2 ± 8.9; 84% male) completed the comprehensive psychosocial screener and questionnaires to gauge gender identity, traits, and sociocultural norm scores. A three-step latent profile analysis (LPA) was performed to identify latent profiles and their correlates. RESULTS LPA revealed six psychosocial risk profiles: (1) somewhat distressed overall (32%); (2) low distress (27%); (3) anger, hostility, and Type D (15%); (4) emotional distress and trauma (11%); (5) anxiety (9%); and (6) high overall distress (7%). Masculine traits and older age increased the odds to belong to the low distress profile (#2), while feminine traits and a feminine gender norm score increased the chance to belong to profiles with moderate to high distress. The effects of gender identity and feminine traits were sex dependent. CONCLUSION The current study's findings explain heterogeneity among patients with CHD by considering the joint occurrence of psychosocial risk factors, and the role of sex, age, and gender within those profiles. Being more sensitive to the roles that sex, gender, and an integrated set of risk factors play may ultimately improve treatment and adherence.
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Affiliation(s)
- Sophie C M van den Houdt
- Center of Research On Psychological Disorders and Somatic Diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Paula M C Mommersteeg
- Center of Research On Psychological Disorders and Somatic Diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Jos Widdershoven
- Center of Research On Psychological Disorders and Somatic Diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
- Department of Cardiology, Elisabeth-TweeSteden Hospital, Doctor Deelenlaan 5, 5042 AD, Tilburg, the Netherlands
| | - Nina Kupper
- Center of Research On Psychological Disorders and Somatic Diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands.
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Marznaki ZH, Khalilizad M, Moradi A, Mamun MA. Impact of spirituality on elderly people's quality of life and life satisfaction after acute myocardial infarction: Iranian hospital-based study. BJPsych Open 2023; 10:e4. [PMID: 38059462 PMCID: PMC10755561 DOI: 10.1192/bjo.2023.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/08/2023] [Accepted: 09/22/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND As people age, survival after a heart attack can affect their quality of life and lead to a decrease in life satisfaction. After a myocardial infarction, elderly patients may experience physical, psychological, emotional and social changes that affect their thoughts and behaviour in relation to spirituality. AIMS To investigate the relationship between spiritual well-being and other sociodemographic and medical history-related factors on quality of life and life satisfaction among elderly people after myocardial infarction. METHOD In a census-based cross-sectional study conducted at the Imam Reza Hospital in Amol, Iran, from May 2020 to May 2021, data on sociodemographics, medical history, subjective well-being, life satisfaction and quality of life were collected from 502 participants who were referred at the heart clinic. RESULTS The findings showed that spiritual well-being dimensions (religious well-being, [self-assessment of one's relationship with God], and existential well-being, [self-assessment of one's sense of purpose in life and life satisfaction]) were not significantly associated with life satisfaction, but a high perception of both dimensions of spiritual well-being were associated with higher self-reported quality of life. A history of past-year hospital admission and cardiopulmonary resuscitation were significant predictors of life satisfaction, and educational level was a predictor of quality of life. CONCLUSIONS The study found no significant association between spiritual well-being and life satisfaction among elderly people following myocardial infarction. This finding might have been influenced by the physical and emotional challenges experienced by the participants during the COVID-19 pandemic. Further studies are needed to confirm this relationship.
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Affiliation(s)
| | - Majid Khalilizad
- Department of Orthopedic and Trauma Surgery, Shahid Beheshti Hospital, Babol, Iran; and Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Azadeh Moradi
- Imam Reza Hospital at Amol City, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammed A. Mamun
- CHINTA Research Bangladesh, Dhaka, Bangladesh; Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh; and Department of Public Health, University of South Asia, Dhaka, Bangladesh
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van den Houdt SCM, Widdershoven J, Kupper N. Patient and healthcare professionals' perceived barriers and facilitators to the implementation of psychosocial screening in cardiac practice: A Delphi study. Gen Hosp Psychiatry 2023; 85:104-113. [PMID: 37862959 DOI: 10.1016/j.genhosppsych.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Psychosocial risk factors contribute to the incidence and progression of coronary heart disease (CHD). Psychosocial screening may identify individuals who are at risk and aid them with getting appropriate care. To successfully implement psychosocial screening in the cardiology practice, the current study aims to identify key barriers and facilitators to its implementation and evaluate their perceived importance among health care professionals (HCPs) and patients. METHODS We took a modified 3-round Delphi study approach to gain insight into key determinants that could either impede or ease implementation. Round 1 gathered data from HCPs (n = 9; cardiologists, medical psychologists, cardiac nurses) and CHD patients (n = 21), which we transcribed verbatim, coded, and processed into unique determinants. In rounds 2 and 3, participants were asked to select the most relevant determinants and rank them based on importance. Subsequently, determinants were classified by implementation level. RESULTS Patients were generally more positive towards screening. HCP barriers included time-constraints, disruption of primary activities, and limited knowledge on psychosocial risk and screening, while patient barriers were commonly related to accessibility and patient characteristics (e.g., health literacy, motivation). Facilitators of both groups mainly pertained to the use of the screener and follow-up care, such as increasing the accessibility and the benefits of the screener. CONCLUSION Barriers may be targeted by enhancing the effects of the facilitators. Increasing the accessibility to the screener and interventions, improving information provision, and appointing a contact person to oversee the screening process may ease the screening and care process for both patients and HCPs.
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Affiliation(s)
- Sophie C M van den Houdt
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands
| | - Jos Widdershoven
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands; Department of Cardiology, Elisabeth-TweeSteden hospital, the Netherlands
| | - Nina Kupper
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands.
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van der Sangen NMR, Azzahhafi J, Chan Pin Yin DRPP, Rayhi S, van Weede VM, Walhout RJ, Tjon Joe Gin M, Pisters R, Nicastia DM, Langerveld J, Vlachojannis GJ, van Bommel RJ, Appelman Y, Henriques JPS, Ten Berg J, Kikkert W. Impact of recurrent ischaemic and bleeding events on quality of life in patients with acute coronary syndrome: Insights from the FORCE-ACS registry. Open Heart 2023; 10:e002405. [PMID: 37527905 PMCID: PMC10394548 DOI: 10.1136/openhrt-2023-002405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/17/2023] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVE Patients with acute coronary syndrome (ACS) remain at high risk for recurrent ischaemic and bleeding events during follow-up. Our study aimed to quantify and compare the impact of these adverse events on quality of life (QoL). METHODS Data from patients with ACS prospectively enrolled in the FORCE-ACS registry between January 2015 and December 2019 were used for this study. The primary ischaemic and bleeding events of interest were hospital readmission for ACS and Bleeding Academic Research Consortium type 2 or 3 bleeding during 12 months follow-up. QoL was measured using the EQ-5D Visual Analogue Scale (VAS) score and the 12-item Short Form Survey version 2 derived Physical Component Summary (PCS) and Mental Health Component Summary (MCS) scores at 12 months follow-up. RESULTS In total, 3339 patients (mean age 66.8 years, 27.9% women) were included. During follow-up, ischaemic events occurred in 202 patients (6.0%) and bleeding events in 565 patients (16.9%). After adjustment for demographic and clinical characteristics, ischaemic events remained independently associated with lower QoL regardless of metric used. Bleeding was also independently associated with lower EQ-5D VAS and PCS scores, but not with a lower MCS score. The QoL decrement associated with ischaemic events was numerically larger than the decrement associated with bleeding. CONCLUSIONS Ischaemic and bleeding events remain prevalent and are independently associated with lower QoL at 12 months follow-up in patients previously admitted for ACS. The incidence and impact of these adverse events should be considered when balancing individual ischaemic and bleeding risks.
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Affiliation(s)
- Niels M R van der Sangen
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Jaouad Azzahhafi
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | | | - Senna Rayhi
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Victoria M van Weede
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Ronald J Walhout
- Department of Cardiology, Hospital Gelderse Vallei, Ede, The Netherlands
| | | | - Ron Pisters
- Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
| | | | - Jorina Langerveld
- Department of Cardiology, Rivierenland Hospital, Tiel, The Netherlands
| | | | | | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC, VU University, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - José P S Henriques
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Jurriën Ten Berg
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
- Department of Cardiology, Maastricht UMC+, Maastricht, The Netherlands
| | - Wouter Kikkert
- Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
- Department of Cardiology, Tergooi MC, Hilversum, The Netherlands
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Sulaiman AR, Oletu H, Chike A, Ani C, Twumasi F, Ikechukwu U, Okobi OE, Sani AM, Onyeaka FC, Dan-Eleberi AO, Iroro J. An Analysis of the Effect of Stroke on Health-Related Quality of Life of Older Adults With Coronary Heart Disease Who Take Aspirin. Cureus 2023; 15:e43611. [PMID: 37719612 PMCID: PMC10504463 DOI: 10.7759/cureus.43611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVE The aim of this study was to examine the impact of coronary heart disease (CHD) on health-related quality of life (HRQoL) among individuals taking aspirin, as well as to explore the potential association between stroke and CHD on HRQoL. METHOD A total of 17,106 respondents aged 50 years and above who reported using aspirin on "some days" or "daily" were included in the analysis. Among them, 4,036 individuals had a history of coronary heart disease. We utilized the Chi-square test to assess the proportion of individuals with CHD who reported poor self-rated health and experienced poor HRQoL in four domains: physical health, mental health, physical and mental health combined, and the number of days limited by poor health. Logistic regression was employed to investigate the interaction between stroke and CHD concerning the quality of life. RESULT Among adults aged 50 years and above using aspirin, those with CHD tended to be older (68.7 years ± 0.37 vs 66.6 ± 0.24), had a higher proportion of male respondents (60.0% vs 45.1%), and were mostly of white ethnicity (77.4% vs 76.2%). The group with CHD reported significantly poorer self-rated health compared to those without CHD (52.1% vs 25.6%, p<0.001), along with a higher prevalence of poor physical health (55.3% vs 42.7%, p<0.001) and poor mental health (50.2% vs 40.4%, p = 0.033) in comparison to aspirin users without CHD. However, there was no statistically significant association between stroke and CHD concerning the impact on all domains of quality of life (p>0.05). CONCLUSION Our findings indicate that individuals aged 50 years and above with CHD who are using aspirin experience a lower quality of life in both the physical and mental health domains when compared to their counterparts without CHD. Furthermore, there was no significant interaction between stroke and CHD in relation to the impact on HRQoL in this study.
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Affiliation(s)
- Adenike R Sulaiman
- Internal Medicine, Lagos State University College of Medicine, Lagos, NGA
| | - Helen Oletu
- Medicine and Surgery, University of Benin, Benin City, NGA
- Public Health, University of Wolverhampton, Wolverhampton, GBR
| | - Assumpta Chike
- Internal Medicine, University of Science, Arts and Technology, Olveston, MSR
| | - Chinenye Ani
- Internal Medicine, Savanna La Mar Public General Hospital, Savanna La Mar, JAM
| | | | | | - Okelue E Okobi
- Family Medicine, Larkin Community Hospital Palm Springs Campus, Miami, USA
- Family Medicine, Medficient Health Systems, Laurel, USA
- Family Medicine, Lakeside Medical Center, Belle Glade, USA
| | - Abubakar M Sani
- Internal Medicine, Kaduna State Ministry of Health, Kaduna, NGA
| | | | | | - Joy Iroro
- Internal Medicine, All Saints University School of Medicine, Roseau, DMA
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Hadi F, Molavynejad S, Elahi N, Haybar H, Maraghi E. King's Theory of Goal Attainment: Quality of Life for People With Myocardial Infarction. Nurs Sci Q 2023; 36:250-257. [PMID: 37309158 DOI: 10.1177/08943184231169771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The aim of this study was to evaluate the effects of a theory of goal attainment-based care plan on quality of life among patients with myocardial infarction. One hundred two patients were randomly assigned to two groups. The intervention group received a theory of goal attainment-based care plan during their hospital stay and a two-month follow-up assessment after hospital discharge. Quality of life was assessed using the Persian version of the MacNew Heart Disease Health-Related Quality of Life questionnaire. Despite no significant difference between the groups with respect to the pretest mean scores of quality of life and its dimensions (p > .05), the posttest mean scores of quality of life and its dimensions in the intervention group were significantly greater than those of the control group (p < .001). Moreover, while the mean scores of quality of life and its dimensions significantly increased in the intervention group (p < .001), they did not significantly change in the control group (p > .05), except for the mean score of physical functioning (p = .032).
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Affiliation(s)
- Fereshteh Hadi
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahram Molavynejad
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nasrin Elahi
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Habib Haybar
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Maraghi
- Department of Biostatistics and Epidemiology, Faculty of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Validity of a German Comprehensive Psychosocial Screening Instrument based on the ESC Cardiovascular Prevention Guidelines. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2023; 69:76-97. [PMID: 36927319 DOI: 10.13109/zptm.2023.69.1.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Background: Following guidelines for cardiovascular disease prevention of the European Society for Cardiology (ESC), the current study validated the German Comprehensive Psychosocial Screening Instrument in participants who underwent coronary angiography. Methods: 314 participants (Mage = 69.7 ± 12.0; 69 % male) completed the German Comprehensive Psychosocial Screening Instrument and validated comparison scales to measure depression (PHQ-9), anxiety (GAD-7), Type D personality (DS14), work stress (ERI), family stress (SMSS), trauma (PC-PTSD), and anger and hostility (Z-scale of MMPI-2). Results: Confirmatory factor analysis (CFA) confirmed that the psychosocial risk factors were separate entities rather than a signs or symptoms of a single broad indication of distress (CFI = .872, RMSEA = .056, SRMR = .058). Intraclass coefficients (ICC), kappa and diagnostic accuracy indicators (receiver operator characteristic [ROC] curves, sensitivity, specificity, and the positive and negative predictive values [PPV; NPV]) indicated that most screener scales were sufficient to good. We also compared patients with established coronary heart disease (CHD; n = 213) to those with no current CHD (n = 100) and found overall similar results. Discussion: The German version of the Comprehensive Psychosocial Screening Instrument has an acceptable performance. Aside from minor improvements, the screening instrument could be implemented in the cardiological practice to screen patients on multidimensional psychosocial risk.
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Wohlfahrt P, Jenča D, Stehlik J, Melenovský V, Mrázková J, Staněk V, Kettner J, Šramko M, Želízko M, Adámková V, Piťha J, Kautzner J. Heart failure-related quality-of-life impairment after myocardial infarction. Clin Res Cardiol 2023; 112:39-48. [PMID: 35304902 DOI: 10.1007/s00392-022-02008-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 03/07/2022] [Indexed: 01/21/2023]
Abstract
AIMS Recent advances in therapy led to a significant decrease in mortality and morbidity after myocardial infarction (MI). However, little is known about quality of life (QoL) after MI. We examined heart failure (HF)-related quality-of-life (QoL) impairment, its trajectories, and determinants after MI. METHODS Data from a single-center prospectively designed registry of consecutive patients hospitalized for MI at a large tertiary cardiology center were utilized. At 1 month and 1 year after hospital discharge, patients completed the Kansas City Cardiomyopathy Questionnaire (KCCQ). RESULTS In total, 850 patients (aged 65 ± 12 years, 27% female) hospitalized between June 2017 and October 2020 completed KCCQ at 1 month after discharge. Of these, 38.7% showed HF-related QoL impairment (KCCQ ≤ 75). In addition to characteristics of MI (MI size, diuretics need, heart rate), comorbidities as renal dysfunction and anemia were associated with QoL impairment. Of the 673 eligible, 500 patients (74.3%) completed KCCQ at 1 year after MI. On average, QoL improved by 5.9 ± 16.8 points during the first year after MI (p < 0.001); but, in 18% of patients QoL worsened. Diabetes control and hemoglobin level at the time of hospitalization were associated with QoL worsening. CONCLUSION Two out of 5 patients after MI present with HF-related QoL impairment. In addition to guideline-directed MI management, careful attention to key non-cardiac comorbidities as chronic kidney disease, anemia and diabetes may lead to further augmentation of the benefit of modern therapies in terms of QoL.
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Affiliation(s)
- Peter Wohlfahrt
- Department of Preventive Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. .,Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Videnska 800, 140 59, Prague, Czech Republic.
| | - Dominik Jenča
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Josef Stehlik
- University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Vojtěch Melenovský
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Jolana Mrázková
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Vladimír Staněk
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Jiří Kettner
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Marek Šramko
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Michael Želízko
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Věra Adámková
- Department of Preventive Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Jan Piťha
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Josef Kautzner
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
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Brajković A, Bićanić LA, Strgačić M, Orehovački H, Ramalho-de-Oliveira D, Mucalo I. The Impact of Pharmacist-Led Medication Management Services on the Quality of Life and Adverse Drug Reaction Occurrence. PHARMACY 2022; 10:pharmacy10050102. [PMID: 36136835 PMCID: PMC9498323 DOI: 10.3390/pharmacy10050102] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/24/2022] Open
Abstract
The aim of this research was to assess the impact of comprehensive medication management (CMM) services on patients’ health-related quality of life (HRQoL) and frequency of adverse drug reactions (ADRs) in older patients with cardiovascular diseases (CVDs). A prospective, pre- and post-intervention study with a one-year follow-up was conducted at the Health Care Centre Zagreb—Centre (HCZC). The Euro-Quality of Life Questionnaire 5 Dimensions 5 Levels (EQ-5D-5L) was used to measure the HRQoL at baseline (initial visit at the HCZC) and 12 months following CMM services. The ADRs collected at the initial assessment of the CMM services and throughout follow-up consultations were analyzed according to the occurrence mechanism, seriousness, expectedness and distribution of the Preferred Term according to the System Organ Class. Following the CMM intervention, 65 patients reported significant improvement in dimensions “self-care” (p = 0.011) and “usual activities” (p = 0.003), whereas no significant change was found in the “mobility” (p = 0.203), “pain/discomfort” (p = 0.173) and “anxiety/depression” (p = 0.083) dimensions and the self-rated VAS scale (p = 0.781). A total of 596 suspected ADR reports were found, the majority at patients’ initial assessment (67.3%), with a mean ± SD of 9.2 ± 16.9 per patient. The CMM services significantly reduced the rate of suspected ADRs, namely 2.7 ± 1.7 ADRs per patient at the initial assessment vs. 1.0 ± 1.5 ADRs per patient at the last consultation (p < 0.001). The obtained results indicate that CMM services may improve patients’ HRQoL. Additionally, as CMM services diminished the proportion of ADRs following 1-year patient follow-up, they may serve as a viable solution for safety management.
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Affiliation(s)
- Andrea Brajković
- Centre for Applied Pharmacy, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | - Lucija Ana Bićanić
- Centre for Applied Pharmacy, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | - Marija Strgačić
- Centre for Applied Pharmacy, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | | | - Djenane Ramalho-de-Oliveira
- Centre for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Iva Mucalo
- Centre for Applied Pharmacy, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
- Correspondence:
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Sadeghi-Bazargani H, Shahedifar N, Somi MH, Poustchi H, Bazargan-Hejazi S, Asghari Jafarabadi M, Sadeghi V, Golestani M, Pourasghar F, Mohebbi I, Ahmadi S, Shafiee-Kandjani AR, Ala A, Abdi S, Rezaei M, Farahbakhsh M. PERSIAN Traffic Safety and Health Cohort: a study protocol on postcrash mental and physical health consequences. Inj Prev 2022; 28:269-279. [PMID: 35292482 DOI: 10.1136/injuryprev-2021-044499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/10/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Cohort studies play essential roles in assessing causality, appropriate interventions. The study, Post-crash Prospective Epidemiological Research Studies in IrAN Traffic Safety and Health Cohort, aims to investigate the common health consequences of road traffic injuries (RTIs) postcrash through multiple follow-ups. METHODS This protocol study was designed to analyse human, vehicle and environmental factors as exposures relating to postcrash outcomes (injury, disability, death, property damage, quality of life, etc). Population sources include registered injured people and followed up healthy people in precrash cohort experienced RTIs. It includes four first-year follow-ups, 1 month (phone-based), 3 months (in-person, video/phone call), 6 and 12 months (phone-based) after crash. Then, 24-month and 36-month follow-ups will be conducted triennially. Various questionnaires such as Post-traumatic Stress Disorder Questionnaire, Patient Health Questionnaire, WHO Disability Assessment Schedules, Cost-related Information, etc are completed. Counselling with a psychiatrist and a medical visit by a practitioner are provided accompanied by extra tools (simulator-based driving assessment, and psychophysiological tests). Through preliminary recruitment plan, 5807, 2905, 2247 and 1051 subjects have been enrolled, respectively at the baseline, first, second and third follow-ups by now. At baseline, cars and motorcycles accounted for over 30% and 25% of RTIs. At first follow-up, 27% of participants were pedestrians engaged mostly in car crashes. Around a fourth of injuries were single injuries. Car occupants were injured in 40% of collisions. DISCUSSION The study provides an opportunity to investigate physical-psychosocial outcomes of RTIs, predictors and patterns at follow-up phases postinjury through longitudinal assessments, to provide advocates for evidence-based safety national policy-making.
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Affiliation(s)
- Homayoun Sadeghi-Bazargani
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Nasrin Shahedifar
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of) .,Injury Epidemiology and Prevention Research Group, Turku Brain Injury Center, Turku University Hospital and University of Turku, Turku, Finland
| | - Mohammad Hossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Shahrzad Bazargan-Hejazi
- College of Medicine, Charles Drew University of Medicine and Science, Los Angeles, California, USA
| | - Mohammad Asghari Jafarabadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of).,Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran (the Islamic Republic of)
| | - Vahideh Sadeghi
- Health Services Management Department, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Mina Golestani
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Faramarz Pourasghar
- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Iraj Mohebbi
- Department of Occupational Medicine, Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran (the Islamic Republic of)
| | - Sajjad Ahmadi
- Emergency Medicine Research Team, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Reza Shafiee-Kandjani
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Alireza Ala
- Emergency and Trauma Care Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Salman Abdi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Mahdi Rezaei
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
| | - Mostafa Farahbakhsh
- Research Center of Psychiatry and Behavioural Sciences, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
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Health-related quality of life increases after first-time acute myocardial infarction: A population-based study. Zdr Varst 2021; 61:24-31. [PMID: 35111263 PMCID: PMC8776287 DOI: 10.2478/sjph-2022-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 11/04/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction Acute myocardial infarction (AMI) affects patients’ health-related quality of life (HRQOL). AMI may decrease HRQOL, thus negatively affecting QOL. However, the improvements in interventional treatment and early rehabilitation after AMI may have a positive effect on HRQOL. Aim We evaluated HRQOL in patients after the first AMI treated in a reference cardiology centre in Poland and assessed which clinical variables affect HRQOL after AMI. Material and methods We prospectively evaluated HRQOL in 60 consecutive patients suffering after their first AMI during the index hospitalisation and again after 6 months, using: (i) MacNew, (ii) World Health Organization Quality of Life (WHOQOL) BREF, and (iii) Short Form (SF) 36. Results As measured by the MacNew questionnaire, global, social, and physical functioning did not change (p≥0.063), whereas emotional functioning improved 6 months after AMI, compared to index hospitalisation (p=0.002). As measured by WHOQOL BREF, physical health, psychological health, and environmental functioning did not change (p≥0.321), whereas social relationships improved 6 months after AMI (p=0.042). As assessed by SF-36, the global HRQOL improved after AMI (p=0.044). Patients with improved HRQOL in SF-36 often had a higher baseline body mass index (p=0.046), dyslipidaemia (p=0.046), and lower left ventricle ejection fraction (LVEF; p=0.013). LVEF<50% was the only variable associated with improved HRQOL in multivariate analysis (OR 4.463, 95% CI 1.045 - 19.059, p=0.043). Conclusions HRQOL increased 6 months after the first AMI, especially in terms of emotional functioning and social relationships. Patients with LVEF<50% were likely to have improved HRQOL.
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Abedi Gheslaghi L, Sharifi H, Noroozi M, Barouni M, Sadeghi-Bazargani H. Quality of Life after Motorcycle Traffic Injuries: A Cohort Study in Northwest of Iran. Bull Emerg Trauma 2021; 9:169-177. [PMID: 34692867 PMCID: PMC8525700 DOI: 10.30476/beat.2021.87236.1182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 03/07/2021] [Accepted: 06/25/2021] [Indexed: 11/24/2022] Open
Abstract
Objective: To investigate the quality of life (QOL) of injured motorcyclists and associated factors in a period of three months after the accident. Methods: In the present study, we were included 190 injured motorcyclists who admitted to two referral specialized hospitals (Emam Reza and Shohada) in Tabriz, between June 2018 and January 2019. All injured motorcyclists were contacted through the telephone one and 171 of them (90%) three months after their accident to complete an EQ-5D-3L questionnaire. The baseline measurements were gathered by using face to face interviews in the hospitals. The QOL score could vary between 1 and 3. The higher score showed a lower QOL. Results: The injured motorcyclist’s QOL score was relatively better in three months after the accident (mean±Standard Deviation (SD): 1.78±0.51) in comparison with their status a month after the accident (2.15±0.65) (p<0.001). The multivariable model showed that individuals with pelvis injuries (Coef: 0.29, (95% CI: 0.16, 0.42), p=0.001) and knee injuries (Coef: 0.26, (95% CI: 0.10, 0.42), p=0.001), experienced a higher QOL score. Also, those whose accident had happened in rainy weather experienced higher QOL score (Coef: 0.33, (95% CI: 0.12, 0.53), p=0.001). The patients who were in an accident with a vehicle were experienced a better QOL than others (Coef: -0.26, (95% CI: -0.43, -0.09), p=0.002). Conclusion: The assessment of three-months post-accident showed that the QOL score of the motorcyclists was reduced. It is recommended that the QOL of patients should be improved in hospital discharge victims.
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Affiliation(s)
- Leili Abedi Gheslaghi
- Student of Epidemiology, Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Noroozi
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohsen Barouni
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Zhang M, Chen P, Zhang Y, Su X, Chen J, Xu B, Tao J, Wang Z, Li H, Ma A. Predictors of Quality of Life in Patients With Myocardial Infarction Combined With Dyslipidemia. Front Public Health 2021; 9:713480. [PMID: 34692622 PMCID: PMC8528215 DOI: 10.3389/fpubh.2021.713480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 09/09/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Dyslipidemia is an important risk factor for myocardial infarction (MI). This study aimed to examine the health-related quality of life (HRQoL) and its predictors of patients with MI combined with dyslipidemia in China. Methods: Information on patients' sociological characteristics, lifestyle, clinical characteristics, and quality of life were collected by electronic medical records and questionnaires. Tobit regression model was used to investigate the predictors of quality of life. Results: There were 756 patients responded. The average EQ-5D score of all the patients was 0.95 (SD: 0.11). For all patients, factors such as age, high-fat and high-cholesterol diet, sports, family history of dyslipidemia, history of peripheral artery disease significantly affected HRQoL. Conclusions: Post-discharge care of the elderly group should be paid more attention to and suggestions on the healthy lifestyle (fat control) of the patients should be encouraged to improve the quality of life of these population.
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Affiliation(s)
- Mengran Zhang
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Pingyu Chen
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Xi Su
- Department of Cardiology, Wuhan Asia Heart Hospital, Wuhan, China
| | - Jiyan Chen
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Biao Xu
- Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing, China
| | - Jianhong Tao
- Department of Cardiology, Sichuan Provincial People's Hospital, Chengdu, China
| | - Zhen Wang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hongchao Li
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Aixia Ma
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
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Lamesgin Endalew H, Liyew B, Kassew T, Ewnetu Tarekegn G, Dejen Tilahun A, Sewunet Alamneh T. Health-Related Quality of Life Among Myocardial Infarction Survivors: Structural Equation Modeling Approach. J Multidiscip Healthc 2021; 14:1543-1552. [PMID: 34188481 PMCID: PMC8235930 DOI: 10.2147/jmdh.s296064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/09/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Myocardial infarction is the fifth leading causes of disability-adjusted life years in low-income countries including Ethiopia. The aim of this study was to construct a hypothetical model to determine the factors affecting the health-related quality of life of myocardial infarction survivors at the cardiac center Ethiopia. METHODS A cross-sectional study design was employed, and 421 myocardial infarction patients were enrolled through consecutive sampling technique from the outpatient clinic at the cardiac center of Ethiopia. The World Health Organization Quality of Life-BREF-26 tool was used to assess the problem. It consists of four domains such as physical, psychological, social relationships, and environmental health domains. The structural equation modeling (SEM) analysis was employed using STATA-14 software to examine the relationship between various exogenous and endogenous or mediating variables with overall quality of life. RESULTS Psychological, physical, environmental health domains and sex had significant association with health-related quality of life (β=0.708, p<0.001, β= 0.237, p=0.046, β=0.242, p=0.020, and β=0.189, p=0.017, respectively), whereas age had direct, negative association with health-related quality of life (β=-0.007, p=0.026). Residence and level of education were not directly associated with health-related quality of life. Residence indirectly, negatively influenced health-related quality of life (β= -0.379, p<0.001). On the other hand, level of education indirectly, positively affects health-related quality of life (β=i0.133, p<0.001). CONCLUSION Psychological health factors had the most substantial causal effect on health-related quality of life, which was larger than the causal effects of physical and environmental health-related factors. Developing and providing comprehensive interventions are necessary to assess and manage psychological, physical, and environmental health factors and to improve the quality of life in myocardial infarction patients.
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Affiliation(s)
- Helen Lamesgin Endalew
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bikis Liyew
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tilahun Kassew
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gebrekidan Ewnetu Tarekegn
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ambaye Dejen Tilahun
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Health-Related Quality of Life and Associated Factors among Myocardial Infarction Patients at Cardiac Center, Ethiopia. BIOMED RESEARCH INTERNATIONAL 2021. [DOI: 10.1155/2021/6675267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Introduction. Myocardial infarction is the most frequent manifestation of coronary heart disease and one of the leading causes of death worldwide. The sudden and often profound physiological and psychological effect of the acute onset of myocardial infarction hurts the health-related quality of life. Objective. To assess health-related quality of life and associated factors among myocardial infarction patients at Cardiac Center, Ethiopia, Addis Ababa, Ethiopia, 2020. Method. Institution-based cross-sectional study was conducted from April 10 to June 25, 2020, at the Cardiac Center-Ethiopia, Addis Ababa, Ethiopia. The sample consisted of 421 myocardial infarction patients. Data were collected through an interviewer-administered structured questionnaire by using the World Health Organization Quality of Life Questionnaire. Samples were selected using a consecutive sampling technique. The linear regression analysis model was fitted using SPSS 26 and STATA 14, and the unstandardized beta (𝛽) coefficient with a 95% confidence interval was used. A
value <0.05 was considered statistically significant for all analyses. Results. The mean score of the overall health-related quality of life was found to be
, and the mean score for the physical domain was
; for the psychological domain, it was
, and for environmental and social relationship domains, it was
and
, respectively. In the multiple regression analysis, increased age, living in a rural area, heart failure, and hypertension were inversely associated with overall health-related quality of life, while secondary and higher education were associated with better overall health-related quality of life. Conclusion. Patients with myocardial infarction at Cardiac Center, Ethiopia, had lower health-related quality of life. Hence, the finding of this study suggests the implementation of a cardiac rehabilitation program and comprehensive service given by healthcare providers.
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Cyr S, Guo DX, Marcil MJ, Dupont P, Jobidon L, Benrimoh D, Guertin MC, Brouillette J. Posttraumatic stress disorder prevalence in medical populations: A systematic review and meta-analysis. Gen Hosp Psychiatry 2021; 69:81-93. [PMID: 33582645 DOI: 10.1016/j.genhosppsych.2021.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE PTSD is increasingly recognized following medical traumas although is highly heterogeneous. It is difficult to judge which medical contexts have the most traumatic potential and where to concentrate further research and clinical attention for prevention, early detection and treatment. The objective of this study was to compare PTSD prevalence in different medical populations. METHODS A systematic review of the literature on PTSD following medical traumas was conducted as well as a meta-analysis with final pooled result and 95% confidence intervals presented. A meta-regression was used to investigate the impact of potential effect modifiers (PTSD severity, age, sex, timeline) on study effect size between prevalence studies. RESULTS From 3278 abstracts, the authors extracted 292 studies reporting prevalence. Using clinician-administered reports, the highest 24 month or longer PTSD prevalence was found for intraoperative awareness (18.5% [95% CI=5.1%-36.6%]) and the lowest was found for epilepsy (4.5% [95% CI=0.2%-12.6%]). In the overall effect of the meta-regression, only medical events or procedures emerged as significant (p = 0.006) CONCLUSION: This review provides clinicians with greater awareness of medical contexts most associated with PTSD, which may assist them in the decision to engage in more frequent, earlier screening and referral to mental health services.
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Affiliation(s)
- Samuel Cyr
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada; Faculty of Pharmacy, Université de Montréal, Montreal, Quebec, Canada
| | - De Xuan Guo
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Marie-Joëlle Marcil
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Patrice Dupont
- Health Sciences Library, Université de Montréal, Montreal, Quebec, Canada
| | - Laurence Jobidon
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - David Benrimoh
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Marie-Claude Guertin
- Montreal Health Innovations Coordinating Center, Montreal, Montreal, Quebec, Canada
| | - Judith Brouillette
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.
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How should we lengthen post-traumatic limb defects? a systematic review and comparison of motorized lengthening systems, combined internal and external fixation and external fixation alone. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2020. [PMID: 33222112 DOI: 10.1007/s00590-020-02831-y)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE Various external fixation systems for lower extremity long bone deformities have been used to various degrees of success, while newer mechanical lengthening nail (MLN) systems offer the potential for improved patient outcomes. Proponents of MLNs argue that they reduce the number of operations, infectious complications, and improve quality of life; however, the evidence to support these claims is scant. This systematic review aims to evaluate the optimal lengthening system for treating post-traumatic long bone deformity. METHODS The systematic review was conducted in accordance with PRISMA guidelines. PUBMED, EMBASE, CINAHL, and the Cochrane Library were searched for comparative studies of lengthening techniques among adult patients with axial deformities. Studies were screened and data extracted in duplicate. Treatment groups were pooled into external fixation (EF) alone, combined internal and external fixation (CIF), and mechanical lengthening nail (MLN). Outcomes were mean lengthening achieved, lengthening index, and reported complications. RESULTS Thirteen studies with 725 patients (mean age: 29.6 years, 74% male) were included. Nearly all of the studies were either prospective or retrospective cohort studies (n = 12), with one randomized controlled trial of moderate study quality. The mean limb lengthening achieved, lengthening index, and rate of reoperation were similar among the MLN, EF, and CIF groups. CONCLUSION The purported decreased the duration of lengthening and the risk of reoperation associated with MLNs was not demonstrated in this review. Patients with post-traumatic leg length deformities remain a challenging patient population to treat, with intervention being associated with high rates of infectious complications and need for revision operations.
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How should we lengthen post-traumatic limb defects? a systematic review and comparison of motorized lengthening systems, combined internal and external fixation and external fixation alone. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2020; 31:1015-1022. [PMID: 33222112 DOI: 10.1007/s00590-020-02831-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/10/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE Various external fixation systems for lower extremity long bone deformities have been used to various degrees of success, while newer mechanical lengthening nail (MLN) systems offer the potential for improved patient outcomes. Proponents of MLNs argue that they reduce the number of operations, infectious complications, and improve quality of life; however, the evidence to support these claims is scant. This systematic review aims to evaluate the optimal lengthening system for treating post-traumatic long bone deformity. METHODS The systematic review was conducted in accordance with PRISMA guidelines. PUBMED, EMBASE, CINAHL, and the Cochrane Library were searched for comparative studies of lengthening techniques among adult patients with axial deformities. Studies were screened and data extracted in duplicate. Treatment groups were pooled into external fixation (EF) alone, combined internal and external fixation (CIF), and mechanical lengthening nail (MLN). Outcomes were mean lengthening achieved, lengthening index, and reported complications. RESULTS Thirteen studies with 725 patients (mean age: 29.6 years, 74% male) were included. Nearly all of the studies were either prospective or retrospective cohort studies (n = 12), with one randomized controlled trial of moderate study quality. The mean limb lengthening achieved, lengthening index, and rate of reoperation were similar among the MLN, EF, and CIF groups. CONCLUSION The purported decreased the duration of lengthening and the risk of reoperation associated with MLNs was not demonstrated in this review. Patients with post-traumatic leg length deformities remain a challenging patient population to treat, with intervention being associated with high rates of infectious complications and need for revision operations.
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21
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Axelrod D, Rubinger L, Shah A, Guy P, Johal H. How should we lengthen post-traumatic limb defects? a systematic review and comparison of motorized lengthening systems, combined internal and external fixation and external fixation alone. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2020. [PMID: 33222112 DOI: 10.1007/s00590-020-02831-y).] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
PURPOSE Various external fixation systems for lower extremity long bone deformities have been used to various degrees of success, while newer mechanical lengthening nail (MLN) systems offer the potential for improved patient outcomes. Proponents of MLNs argue that they reduce the number of operations, infectious complications, and improve quality of life; however, the evidence to support these claims is scant. This systematic review aims to evaluate the optimal lengthening system for treating post-traumatic long bone deformity. METHODS The systematic review was conducted in accordance with PRISMA guidelines. PUBMED, EMBASE, CINAHL, and the Cochrane Library were searched for comparative studies of lengthening techniques among adult patients with axial deformities. Studies were screened and data extracted in duplicate. Treatment groups were pooled into external fixation (EF) alone, combined internal and external fixation (CIF), and mechanical lengthening nail (MLN). Outcomes were mean lengthening achieved, lengthening index, and reported complications. RESULTS Thirteen studies with 725 patients (mean age: 29.6 years, 74% male) were included. Nearly all of the studies were either prospective or retrospective cohort studies (n = 12), with one randomized controlled trial of moderate study quality. The mean limb lengthening achieved, lengthening index, and rate of reoperation were similar among the MLN, EF, and CIF groups. CONCLUSION The purported decreased the duration of lengthening and the risk of reoperation associated with MLNs was not demonstrated in this review. Patients with post-traumatic leg length deformities remain a challenging patient population to treat, with intervention being associated with high rates of infectious complications and need for revision operations.
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Affiliation(s)
- Daniel Axelrod
- Division of Orthopedic Surgery, McMaster University, 50 Charlton Avenue East, Hamilton, Ontario, L8N 4A6, Canada.
| | - Luc Rubinger
- Division of Orthopedic Surgery, McMaster University, 50 Charlton Avenue East, Hamilton, Ontario, L8N 4A6, Canada
| | - Ajay Shah
- McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S4L8, Canada
| | - Pierre Guy
- Division of Orthopedic Surgery, University of British Columbia, 2775 Laurel St Vancouver, British Columbia, Canada
| | - Herman Johal
- Division of Orthopedic Surgery, McMaster University, 50 Charlton Avenue East, Hamilton, Ontario, L8N 4A6, Canada.,McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S4L8, Canada
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Hurdus B, Munyombwe T, Dondo TB, Aktaa S, Oliver G, Hall M, Doherty P, Hall AS, Gale CP. Association of cardiac rehabilitation and health-related quality of life following acute myocardial infarction. Heart 2020; 106:1726-1731. [PMID: 32826289 PMCID: PMC7656151 DOI: 10.1136/heartjnl-2020-316920] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/30/2020] [Accepted: 07/14/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To study the association of cardiac rehabilitation and physical activity with temporal changes in health-related quality of life (HRQoL) following acute myocardial infarction (AMI). METHODS Evaluation of the Methods and Management of Acute Coronary Events-3 is a nationwide longitudinal prospective cohort study of 4570 patients admitted with an AMI between 1 November 2011 and 17 September 2013. HRQoL was estimated using EuroQol 5-Dimension-3 Level Questionnaire at hospitalisation, 30 days, and 6 and 12 months following hospital discharge. The association of cardiac rehabilitation and self-reported physical activity on temporal changes in HRQoL was quantified using inverse probability of treatment weighting propensity score and multilevel regression analyses. RESULTS Cardiac rehabilitation attendees had higher HRQoL scores than non-attendees at 30 days (mean EuroQol 5-Visual Analogue Scale (EQ-VAS) scores: 71.0 (SD 16.8) vs 68.6 (SD 19.8)), 6 months (76.0 (SD 16.4) vs 70.2 (SD 19.0)) and 12 months (76.9 (SD 16.8) vs 70.4 (SD 20.4)). Attendees who were physically active ≥150 min/week had higher HRQoL scores compared with those who only attended cardiac rehabilitation at 30 days (mean EQ-VAS scores: 79.3 (SD 14.6) vs 70.2 (SD 17.0)), 6 months (82.2 (SD 13.9) vs 74.9 (SD 16.7)) and 12 months (84.1 (SD 12.1) vs 75.6 (SD 17.0)). Cardiac rehabilitation and self-reported physical activity of ≥150 min/week were each positively associated with temporal improvements in HRQoL (coefficient: 2.12 (95% CI 0.68 to 3.55) and 4.75 (95% CI 3.16 to 6.34), respectively). CONCLUSIONS Cardiac rehabilitation was independently associated with temporal improvements in HRQoL at up to 12 months following hospitalisation, with such changes further improved in patients who were physically active.
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Affiliation(s)
- Ben Hurdus
- Leeds Institute for Data Analytics, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, UK
- Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Theresa Munyombwe
- Leeds Institute for Data Analytics, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, UK
| | | | - Suleman Aktaa
- Leeds Institute for Data Analytics, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, UK
- Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Marlous Hall
- Leeds Institute for Data Analytics, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, UK
| | - Patrick Doherty
- Health Sciences, University of York, York, North Yorkshire, UK
| | - Alistair S Hall
- Leeds Institute for Data Analytics, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, UK
- Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Chris P Gale
- Leeds Institute for Data Analytics, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, UK
- Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Du R, Wang P, Ma L, Larcher LM, Wang T, Chen C. Health-related quality of life and associated factors in patients with myocardial infarction after returning to work: a cross-sectional study. Health Qual Life Outcomes 2020; 18:190. [PMID: 32552846 PMCID: PMC7302164 DOI: 10.1186/s12955-020-01447-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/11/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Return to work following myocardial infarction (MI) represents an important indicator of recovery. However, MI can cause patients to feel pressure, loneliness and inferiority during work and even detachment from employment after returning to work, which may affect their quality of life. The aims of this study were to identify the influencing factors of Health-related quality of life (HRQoL) in patients with MI after returning to work and explore the correlations between these factors and HRQoL. METHOD This was a cross-sectional study. All participants were recruited from tertiary hospitals in China from October 2017 to March 2018. The general data questionnaire, Short-Form Health Survey-8 (SF-8), Health Promoting Lifestyle ProfileII (HPLPII), Medical Coping Modes Questionnaire (MCMQ) and Social Supporting Rating Scale (SSRS) were used to assess 326 patients with myocardial infarction returned to work after discharge. Multiple linear regression analysis was performed to explore factors related to HRQoL in patients with MI after returning to work. RESULTS The sample consisted of 326 patients. The mean total score of quality of life was 28.03 ± 2.554. According to the multiple linear regression analysis, next factors were associated with better HRQoL: younger age (B = - 0.354, P = 0.039), higher income (B = 0.513, P = 0.000), less co-morbidity (B = - 0.440, P = 0.000), the longer time taken to return to work (B = 0.235, P = 0.003), fewer stents installed (B = - 0.359, P = 0.003), participation in cardiac rehabilitation (CR) (B = - 1.777, P = 0.000), complete CR (B = - 1.409, P = 0.000), better health behaviors such as more health responsibility (B = 0.172, P = 0.000) and exercise (B = 0.165, P = 0.000), better nutrition (B = 0.178, P = 0.000) and self-realization (B = 0.165, P = 0.000), stress response (B = 0.172, P = 0.000), more social support such as more objective support (B = 0.175, P = 0.000), subjective support (B = 0.167, P = 0.000) and better utilization of social support (B = 0.189, P = 0.028), positive copping strategies such as more coping (B = 0.133, P = 0.000) and less yield (B = - 0.165, P = 0.000). CONCLUSIONS HRQoL of MI patients after returning to work is not satisfactory. Health behavior, coping strategies, social support are factors which can affect HRQoL. A comprehensive and targeted guide may be a way to improve HRQoL and to assist patients' successful return to society.
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Affiliation(s)
- Ruofei Du
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001 China
| | - Panpan Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001 China
| | - Lixia Ma
- School of Statistics, Henan University of Economics and Law, Zhengzhou, 450046 China
| | - Leon M. Larcher
- Centre for Comparative Genomics, Murdoch University, Perth, WA 6150 Australia
| | - Tao Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001 China
- Centre for Comparative Genomics, Murdoch University, Perth, WA 6150 Australia
| | - Changying Chen
- Department of Quality control, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 China
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24
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Health-Related Quality of Life in Antiphospholipid Syndrome: Current Knowledge and Future Perspectives. Curr Rheumatol Rep 2020; 22:20. [PMID: 32405870 DOI: 10.1007/s11926-020-00900-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE OF REVIEW Antiphospholipid syndrome (APS) is a chronic autoimmune disease that can be seen as a burden, with consequences on patients' daily life. Health has traditionally been measured using measures of morbidity or mortality. Health-related quality of life (HRQoL) is a concept that includes quality of life through physical, mental, and social domains. As in other autoimmune diseases, HRQoL has been investigated in patients with APS. Here, we provide a comprehensive review of the current knowledge of the assessment of HRQoL in APS. RECENT FINDINGS APS patients have an impaired HRQoL compared with the general population. The presence of systemic lupus erythematosus (SLE) in APS patients is associated with a worse HRQoL than in patients without SLE. Several determinants of HRQoL impairment in APS have been identified: age, gender, history of arterial thrombosis, organ damage, lack of social support and treatments. This review highlights the negative impact of thrombosis on APS patients' HRQoL that should not be neglected. Besides, there is a need for a better strategy of communication and information, in order to improve HRQoL in APS.
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25
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Munyombwe T, Hall M, Dondo TB, Alabas OA, Gerard O, West RM, Pujades-Rodriguez M, Hall A, Gale CP. Quality of life trajectories in survivors of acute myocardial infarction: a national longitudinal study. Heart 2020; 106:33-39. [PMID: 31699696 DOI: 10.1136/heartjnl-2019-315510] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/09/2019] [Accepted: 08/21/2019] [Indexed: 11/04/2022] Open
Abstract
AIM To define trajectories of perceived health-related quality of life (HRQoL) among survivors of acute myocardial infarction (AMI) and identify factors associated with trajectories. METHODS Data on HRQoL among 9566 survivors of AMI were collected from 77 National Health Service hospitals in England between 1 November 2011 and 24 June 2015. Longitudinal HRQoL was collected using the EuroQol five-dimension questionnaire measured at hospitalisation, 1, 6 and 12 months post-AMI. Trajectories of perceived HRQoL post-MI were determined using multilevel regression analysis and latent class growth analysis (LCGA). RESULTS One or more percieved health problems in mobility, self-care, usual activities, pain/discomfort and anxiety/depression was reported by 69.1% (6607/9566) at hospitalisation and 59.7% (3011/5047) at 12 months. Reduced HRQoL was associated with women (-4.07, 95% CI -4.88 to -3.25), diabetes (-2.87, 95% CI -3.87 to -1.88), previous AMI (-1.60, 95% CI -2.72 to -0.48), previous angina (-1.72, 95% CI -2.77 to -0.67), chronic renal failure (-2.96, 95% CI -5.08 to -0.84; -3.10, 95% CI -5.72 to -0.49), chronic obstructive pulmonary disease (-3.89, 95% CI -5.07 to -2.72) and cerebrovascular disease (-2.60, 95% CI -4.24 to -0.96). LCGA identified three subgroups of HRQoL which we labelled: improvers (68.1%), non-improvers (22.1%) and dis-improvers (9.8%). Non-improvers and dis-improvers were more likely to be women, non-ST-elevation myocardial infarction (NSTEMI) and have long-term health conditions, compared with improvers. CONCLUSIONS Quality of life improves for the majority of survivors of AMI but is significantly worse and more likely to decline for women, NSTEMI and those with long-term health conditions. Assessing HRQoL both in hospital and postdischarge may be important in determining which patients could benefit from tailored interventions. TRIAL REGISTRATION NCT01808027 and NCT01819103.
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Affiliation(s)
- Theresa Munyombwe
- Leeds Institute of Cardiovascular and Metabolic Medicine/Leeds Institute of Data Analytics, University of Leeds, Leeds, UK
| | - Marlous Hall
- Leeds Institute of Cardiovascular and Metabolic Medicine/Leeds Institute of Data Analytics, University of Leeds, Leeds, UK
| | - Tatendashe Bernadette Dondo
- Leeds Institute of Cardiovascular and Metabolic Medicine/Leeds Institute of Data Analytics, University of Leeds, Leeds, UK
| | - Oras A Alabas
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Oliver Gerard
- National Health Service cardiac service user, West Yorkshire, Lancashire, UK
| | - Robert M West
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | | | - Alistair Hall
- Leeds Institute of Cardiovascular and Metabolic Medicine/Leeds Institute of Data Analytics, University of Leeds, Leeds, UK
| | - Chris P Gale
- Leeds Institute of Cardiovascular and Metabolic Medicine/Leeds Institute of Data Analytics, University of Leeds, Leeds, UK
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26
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De Smedt D, Kotseva K, De Backer G, Wood D, Van Wilder L, De Bacquer D. EQ-5D in coronary patients: what are they suffering from? Results from the ESC EORP European Survey of Cardiovascular Disease Prevention and Diabetes (EUROASPIRE IV) Registry. Qual Life Res 2019; 29:1037-1046. [PMID: 31741215 DOI: 10.1007/s11136-019-02334-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Coronary patients often suffer from an impaired health, hence the aim of this study is to assess how coronary patients score on the different EQ-5D dimensions. METHODS Analyses are based on the EUROASPIRE IV survey, conducted across 24 European countries. 7567 patients with stable coronary heart disease (mean age = 64.1 (SD = 9.6); males = 75.8%) completed the EQ-5D-5L instrument, 6 months to 3 years after their index hospitalization. Descriptive statistics and multilevel logistic regression was used to assess the differences between patient groups in reported problems on the EQ-5D dimensions. Furthermore, age-standardized country-specific outcomes were reported. RESULTS About one out of four patients reported to have no problems on all five dimensions (57.9% reported no problems on mobility, 88.4% reported no problems on self-care, 67.1% reported no problems on usual activities, 41.1% reported no problems on pain/discomfort, and 56.2% reported no problems on anxiety/depression). Elderly patients and females reported more problems. Patients with behavioral risk factors and patients with comorbidities were more likely to have severe or extreme problems. Comparison across countries showed major differences in reported problems. CONCLUSIONS Whether or not coronary patients have problems on one or more EQ-5D dimension, as well as the severity of the problems reported is largely associated with the patient profile. The least problems are seen on the self-care dimension and most problems are reported on the pain/discomfort dimension.
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Affiliation(s)
- Delphine De Smedt
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Kornelia Kotseva
- National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland.,Imperial College Healthcare NHS Trust, London, UK
| | - Guy De Backer
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - David Wood
- National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland.,National Heart and Lung Institute, Imperial College London, London, UK
| | - Lisa Van Wilder
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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Health-related quality of life and exercise-based cardiac rehabilitation in contemporary acute coronary syndrome patients: a systematic review and meta-analysis. Qual Life Res 2019; 29:579-592. [PMID: 31691204 DOI: 10.1007/s11136-019-02338-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE To review the literature on health-related quality of life (HRQoL) outcomes for exercise-based cardiac rehabilitation (EBCR) in contemporary acute coronary syndrome (ACS) patients. METHODS Electronic databases (CENTRAL, MEDLINE, Embase, and CINAHL) were searched from January 2000 to March 2019 for randomised controlled trials (RCTs) comparing EBCR to a no-exercise control in ACS patients recruited after year 2000, follow-up of at least 6 months, and HRQoL as outcome. Potential papers were independently screened by two reviewers. Risks of bias were assessed using the Cochrane Tool. Data analyses were performed using RevMan v5.3, random effects model. RESULTS Fourteen RCTs (1739 participants) were included, with eight studies suitable for meta-analyses. EBCR resulted in statistically significant and clinically important improvements in physical performance (mean difference [MD] 7.09, 95% CI 0.08, 14.11) and general health (MD 5.08, 95% CI 1.03, 9.13) (SF-36) at 6 months, and in physical functioning (MD 9.82, 95% CI 1.46, 18.19) at 12 months. Statistically significant and sustained improvements were also found in social and physical functioning. Meta-analysis of two studies using the MacNew Heart Disease HRQoL instrument did not show any significant benefits. Of the six studies unsuitable for meta-analyses, five reported significant changes in overall HRQoL, general physical activity levels and functional capacity, or quality-adjusted life-years (QALYs). CONCLUSIONS In an era where adherence to clinical practice guidelines has improved survival, EBCR still achieves clinically meaningful improvements in physical performance, general health, and physical functioning in the short and long term in contemporary ACS patients.
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Gecaite J, Burkauskas J, Bunevicius A, Brozaitiene J, Kazukauskiene N, Mickuviene N. The association of cardiovascular reactivity during the Trier Social Stress Test with quality of life in coronary artery disease patients. J Psychosom Res 2019; 126:109824. [PMID: 31522009 DOI: 10.1016/j.jpsychores.2019.109824] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 09/05/2019] [Accepted: 09/05/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Knowledge of objective psychophysiological stress parameters and its relationship to health-related quality of life (HRQoL) is limited in patients with coronary artery disease (CAD). The aim was to investigate the association of cardiovascular reaction to psychosocial stress with HRQoL in patients with CAD. METHODS One-hundred and thirty-six patients (84.6% men, age 52 ± 8) within 2-3 weeks after acute coronary syndromes (ACS) during cardiac rehabilitation were recruited in this cross-sectional study. Patients were evaluated for HRQoL (SF-36 questionnaire), symptoms of anxiety and depression (Hospital Anxiety and Depression scale) and Type D personality (DS14 scale). Trier Social Stress Test (TSST) was employed to evaluate cardiovascular reactivity (systolic and diastolic blood pressure [BP], and heart rate [HR]) to psychosocial stress. Multiple linear regression analyses were performed to test for the associations between cardiovascular reactivity and HRQoL, while controlling for possible confounders. RESULTS After controlling for baseline levels of HR, gender, age, NYHA functional class, AH, Type D personality, symptoms of anxiety and depression, use of beta-blockers, and history of smoking, the SF-36 Social functioning scale (β = -0.182; p = .03) and SF-36 Vitality scale (β = -0.203; p = .03) was associated with prolonged HR recovery following stress evoking tasks. No associations were found between HRQoL and BP measures during the TSST. CONCLUSION In CAD patients who have experienced ACS, HRQoL was associated with prolonged HR recovery after mental stress, even after controlling for potential confounder. Future studies should investigate the possible role of mediating factors involved in the mechanisms relating cardiovascular stress response and HRQoL.
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Affiliation(s)
- Julija Gecaite
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, LT-00135 Palanga, Lithuania.
| | - Julius Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, LT-00135 Palanga, Lithuania.
| | - Adomas Bunevicius
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, LT-00135 Palanga, Lithuania.
| | - Julija Brozaitiene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, LT-00135 Palanga, Lithuania.
| | - Nijole Kazukauskiene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, LT-00135 Palanga, Lithuania.
| | - Narseta Mickuviene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Vyduno al. 4, LT-00135 Palanga, Lithuania.
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Wardoku R, Blair C, Demmer R, Prizment A. Association between physical inactivity and health-related quality of life in adults with coronary heart disease. Maturitas 2019; 128:36-42. [PMID: 31561820 PMCID: PMC7261413 DOI: 10.1016/j.maturitas.2019.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/24/2019] [Accepted: 07/07/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Health-related quality of life (HRQoL) provides an accurate measure of the health status of patients with coronary heart disease (CHD). However, few studies have examined the relationship between physical inactivity and HRQoL in CHD survivors. We evaluated this association in a cross-sectional study of 21,936 CHD participants in the 2015 Behavioral Risk Factor Surveillance System. METHODS CHD diagnosis, HRQoL and physical activity were self-reported. Physical activity (PA) was categorized (1) based on intensity, into no PA, light to moderate PA and vigorous PA; and (2) based on duration and frequency, into no PA, insufficiently active and active. HRQoL was assessed by the CDC HRQoL questionnaire. Participants with 14+ physical or mental unhealthy days in a 30-day window were grouped into poor physical or mental HRQoL. We estimated the odd ratios (AOR) and 95% confidence intervals (CI) of poor HRQoL associated with PA after adjusting for age, sex, education, income level, social support, smoking status, ethnicity/race, BMI, chronic conditions, and CHD groups. RESULTS Compared with vigorous PA, adults with no PA had higher odds (95% CI) of poor physical HRQoL [1.82 (1.58, 2.10)] and poor mental HRQoL [1.28 (1.05, 1.55)]. When compared with active adults, AOR (95% CI) for adults with no PA were 1.80 (1.55, 2.01) and 1.17 (0.97, 1.42) for poor physical and mental HRQoL, respectively. CONCLUSIONS We found an association between physical inactivity and poor physical and mental HRQoL among CHD survivors. There is a need for longitudinal studies to determine the temporality of this association.
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Affiliation(s)
- Reginald Wardoku
- Division of Epidemiology and Community Health, University of Minnesota, United States
| | - Cindy Blair
- Department of Internal Medicine, University of New Mexico, United States; University of New Mexico Comprehensive Cancer Center, United States
| | - Ryan Demmer
- Division of Epidemiology and Community Health, University of Minnesota, United States; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Anna Prizment
- Division of Epidemiology and Community Health, University of Minnesota, United States; Masonic Cancer Center, University of Minnesota, United States.
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Bhattacharjee S, Khobrani M, Alrabiah Z, Bilal J, Riaz IB. Healthcare expenditures among community-dwelling adults with thyroid cancer in the United States: A propensity score matched analysis. Heliyon 2019; 5:e01995. [PMID: 31297464 PMCID: PMC6597889 DOI: 10.1016/j.heliyon.2019.e01995] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 04/08/2019] [Accepted: 06/19/2019] [Indexed: 11/28/2022] Open
Abstract
Objective This study assessed the excess healthcare expenditures and factors associated with it among community-dwelling adults with thyroid cancer compared to non-cancer controls in the United States. Method A retrospective, cross-sectional, matched case-control study design was used by pooling multiple years of Medical Expenditure Panel Survey (MEPS) data (2002–2012). The eligible study sample comprised of adults (age ≥18 years), who were alive during the calendar year and reported positive healthcare expenditure. The case group consisted of adults with thyroid cancer only while the control group consisted of adults who did not have any form of cancer. Total and subtypes of mean annual healthcare expenditures comprised the main study outcome. We also calculated the total and subtypes of out-of-pocket (OOP) expenditures as well as OOP as a percentage of household income. Ordinary Least Square (OLS) regressions on log-transformed expenditures were conducted to elucidate the influence of different factors on healthcare expenditures among adults with thyroid cancer. Results The yearly average total healthcare expenditures among adults with thyroid cancer was significantly higher compared to propensity score matched controls ($9,585 vs. $5,830, p < 0.001). Similar observations were found in terms of inpatient, and outpatient expenditures. Functional status as well as comorbid conditions were significantly associated with excess expenditures. The yearly average total OOP expenditure for adults with thyroid cancer was significantly higher compared to matched controls ($1,425 vs. $974, p < 0.001), with major differences observed in inpatient OOP ($178 vs. $24, p = 0.003), outpatient OOP ($435vs. $256, p < 0.001), and prescription OOP ($554 vs. $423, p < 0.001) expenditures. There was a significant (p < 0.001) difference between the average OOP as a percentage of household income between adults with thyroid cancer (Mean: 7.54%, S.E: 1.52%) and matched controls (Mean: 5.80%, S.E: 0.47%). Conclusions Our findings suggest that holistic care approach could be helpful to significantly reduce the economic burden in this population. Viable strategies such as limits on OOP costs are required to minimize this high OOP burden among cancer survivors and their families.
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Affiliation(s)
- Sandipan Bhattacharjee
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ, USA
| | - Moteb Khobrani
- Health Outcomes & PharmacoEconomic Research (HOPE) Center, College of Pharmacy, The University of Arizona, Tucson, AZ, USA.,Clinical Pharmacy Department, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Ziyad Alrabiah
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ, USA.,College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Jawad Bilal
- Department of Internal Medicine, The University of Arizona, Tucson, AZ, USA
| | - Irbaz Bin Riaz
- Department of Internal Medicine, The University of Arizona, Tucson, AZ, USA
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