1
|
McDool E, Powell P, Carlton J. Measuring health related quality of life (HRQoL) in Lysosomal Storage Disorders (LSDs): a rapid scoping review of available tools and domains. Orphanet J Rare Dis 2024; 19:252. [PMID: 38965628 PMCID: PMC11225496 DOI: 10.1186/s13023-024-03256-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 06/16/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Lysosomal storage diseases (LSDs) are a group of rare inherited metabolic disorders, consisting of over 70 diseases that are characterised by lysosomal dysfunction. Due to their varied and progressive symptoms, LSDs have a continual impact on patients' health-related quality of life (HRQoL). Several recently published studies have provided insight into the HRQoL of individuals with LSDs. However, it is challenging to meaningfully synthesise this evidence, since studies often focus upon a particular type of LSD and / or utilise different self-report questionnaires or patient-reported outcome measures (PROMs) to assess HRQoL. AIMS The aim of this study was to review the published literature in LSDs, to identify the PROMs which have been used to assess HRQoL and generate a conceptual map of HRQoL domains measured in individuals diagnosed with LSDs. METHODS Three electronic databases were searched in March 2022. Primary studies of any design which utilised multi-item PROMs to assess at least one aspect of HRQoL in individuals with LSDs since 2017 were identified. Data were extracted to assess both the characteristics of each study and of the PROMs utilised within each study. The extraction of HRQoL domains and synthesis were informed by an a priori framework, inductively modified to reflect data emerging from the identified literature. Selection and extraction was undertaken independently by two reviewers; discrepancies were ratified by a third reviewer. RESULTS Sixty nine studies were identified which were published 2017-2022, with a combined total of 52 PROMs (71 variants) used to assess HRQoL in individuals with LSDs. The final extracted HRQoL framework included 7 domains (Activities; Physical sensations; Autonomy; Cognition; Feelings and emotions; Self-identity; Relationships), characterised by 37 sub-domains. CONCLUSIONS This review highlights the breadth and variety of HRQoL domains assessed in individuals with LSDs, across three broad domains of physical, psychological and social functioning. The resultant framework and mapped PROMs will aid researchers and clinicians in the selection of PROMs to assess aspects of HRQoL in people living with LSDs, based on their conceptual coverage.
Collapse
Affiliation(s)
- Emily McDool
- Sheffield Centre for Health and Related Research (SCHARR), University of Sheffield, Sheffield, England
| | - Philip Powell
- Sheffield Centre for Health and Related Research (SCHARR), University of Sheffield, Sheffield, England
| | - Jill Carlton
- Sheffield Centre for Health and Related Research (SCHARR), University of Sheffield, Sheffield, England.
| |
Collapse
|
2
|
Becker-Cohen M, Revel-Vilk S, Frydman D, Dinur T, Tiomkin M, Istaiti M, Arbel N, Bauer P, Cozma C, Rolfs A, Szer J, Zimran A. Rapid home therapy infusion of velaglucerase alfa in naïve patients with Gaucher disease. Intern Med J 2024; 54:398-403. [PMID: 37493453 DOI: 10.1111/imj.16179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/18/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Enzyme replacement therapy (ERT) has revolutionised the management of patients with Gaucher disease (GD). In 2018, we published the safety and efficacy of rapid 10-min infusion of velaglucerase alfa in previously treated patients, mostly on low-dose therapy. AIM To improve quality of life (QoL) for patients needing lifelong bi-weekly infusions by introducing a 10-min infusion instead of 1 h per label in patients naive to ERT and on high-dose therapy. METHODS Fifteen naive patients were enrolled; all received bi-weekly infusions of 60 units/kgBW velaglucerase alfa; the infusion rate was gradually reduced in the hospital, followed by home infusions. Each infusion was followed for safety. Efficacy parameters were assessed every 3 months. Patient-reported outcome questionnaires were collected at baseline and follow-up. RESULTS Ten-minute rapid infusions were well tolerated without related severe adverse events (SAEs). Two patients experienced a non-related SAE and another a possibly related AE. In three patients, the infusion rate was increased to 30 or 60 min (two because of suboptimal response and one because of AE). Two patients dropped out because of an unwillingness to attend follow-up visits during the COVID-19 pandemic. All 13 remaining patients reached the 24-month end-point. The platelet counts increased by a median (range) of 68.38% (12.5-300%) and the lyso-Gb1 levels decreased by 62.6% (32.9-89.9%). CONCLUSION Home therapy with rapid infusion of high-dose velaglucerase alfa was a safe, effective and preferable alternative for patients with GD naïve to treatment. We believe that shortening the infusion time improves the QoL of patients with GD who have a lifelong commitment to intravenous therapy.
Collapse
Affiliation(s)
| | - Shoshana Revel-Vilk
- Gaucher Unit, Shaare Zedek Medical Centre, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dafna Frydman
- Gaucher Unit, Shaare Zedek Medical Centre, Jerusalem, Israel
| | - Tama Dinur
- Gaucher Unit, Shaare Zedek Medical Centre, Jerusalem, Israel
| | - Maayan Tiomkin
- Gaucher Unit, Shaare Zedek Medical Centre, Jerusalem, Israel
| | | | | | | | | | - Arndt Rolfs
- Department of Neurology and Psychiatry, Medical Faculty, University of Rostock, Rostock, Germany
- Arcensus GmbH, Rostock, Germany
| | - Jeff Szer
- Peter MacCallum Cancer Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Ari Zimran
- Gaucher Unit, Shaare Zedek Medical Centre, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
3
|
Rossi C, Ferrante R, Valentinuzzi S, Zucchelli M, Buccolini C, Di Rado S, Trotta D, Stuppia L, Federici L, Aricò M. Noninvasive DBS-Based Approaches to Assist Clinical Diagnosis and Treatment Monitoring of Gaucher Disease. Biomedicines 2023; 11:2672. [PMID: 37893047 PMCID: PMC10604114 DOI: 10.3390/biomedicines11102672] [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: 08/30/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
Gaucher disease (GD) is an autosomal recessive inborn error of metabolism, belonging to the group of lysosomal storage diseases (LSDs). GD is caused by a defect in lysosomal glucocerebrosidase, responsible for glucosylceramide breakdown into glucose and ceramide. Because of this dysfunction, glucosylceramide progressively accumulates in the liver, spleen, bone marrow, bones, and in other tissues and organs, also causing anemia, hepatosplenomegaly, thrombocytopenia, and bone symptoms. Depending on neurological symptoms, GD is classified into three main types. Treatment options for LSDs, including enzyme replacement therapy, hematopoietic stem cell transplantation, small molecular weight pharmacologic chaperones, and, for some LSDs, gene therapy, are increasingly available. For this reason, many efforts are aimed at implementing newborn screening for LSDs since early detection accompanied by a prompt intervention has been demonstrated to be essential for reducing morbidity and mortality and for improved clinical outcomes. Herein, we report two siblings of preschool age, presenting with hepatosplenomegaly and thrombocytopenia. The initial suspicion of GD based on the clinical picture was further supported by biochemical confirmation, through newborn screening workflow, including first- and second-level testing on the same dried blood spot samples, and finally by molecular testing.
Collapse
Affiliation(s)
- Claudia Rossi
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (R.F.); (S.V.); (M.Z.); (C.B.); (S.D.R.); (L.S.); (L.F.)
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Rossella Ferrante
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (R.F.); (S.V.); (M.Z.); (C.B.); (S.D.R.); (L.S.); (L.F.)
| | - Silvia Valentinuzzi
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (R.F.); (S.V.); (M.Z.); (C.B.); (S.D.R.); (L.S.); (L.F.)
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Mirco Zucchelli
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (R.F.); (S.V.); (M.Z.); (C.B.); (S.D.R.); (L.S.); (L.F.)
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Carlotta Buccolini
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (R.F.); (S.V.); (M.Z.); (C.B.); (S.D.R.); (L.S.); (L.F.)
| | - Sara Di Rado
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (R.F.); (S.V.); (M.Z.); (C.B.); (S.D.R.); (L.S.); (L.F.)
| | - Daniela Trotta
- Department of Pediatrics, S. Spirito Hospital, Azienda Sanitaria Pescara, 65121 Pescara, Italy;
| | - Liborio Stuppia
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (R.F.); (S.V.); (M.Z.); (C.B.); (S.D.R.); (L.S.); (L.F.)
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Luca Federici
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy; (C.R.); (R.F.); (S.V.); (M.Z.); (C.B.); (S.D.R.); (L.S.); (L.F.)
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Maurizio Aricò
- Department of Pediatrics, S. Spirito Hospital, Azienda Sanitaria Pescara, 65121 Pescara, Italy;
| |
Collapse
|
4
|
Koto Y, Narita A, Noto S, Okada M, Ono M, Baba T, Sagara R, Sakai N. Burden of caregivers of patients with neuronopathic and non-neuronopathic Gaucher disease in Japan: A survey-based study. Mol Genet Metab Rep 2023; 36:100994. [PMID: 37576570 PMCID: PMC10412861 DOI: 10.1016/j.ymgmr.2023.100994] [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] [Received: 04/26/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/15/2023] Open
Abstract
Background Gaucher disease (GD), a rare lysosomal storage disorder, is associated with considerable patient and caregiver burden. We examined the applicability of existing caregiver questionnaires and assessed the level of burden in caregivers of patients with GD. Methods This cross-sectional, non-interventional study was conducted in Japan. Caregivers of patients with confirmed GD (any type) were recruited (patient association group and referral) for pre-testing (May 2021) or the main survey (October-December 2021). Caregivers completed the Caregiver Impact Questionnaire (CIQ; 30 items) and Zarit Caregiver Burden Interview (ZBI; 22 items) on paper. Total CIQ and ZBI scores and subscores were determined overall and by GD type. Inter-item correlations and test-retest reliability (2 rounds, 2 weeks apart) were calculated. The relationship between caregiving duration and caregiver burden was also analyzed. Results Nine caregivers (type 2 [GD2]: n = 6; type 3 [GD3]: n = 3) and 25 caregivers (type 1 [GD1]: n = 2; GD2: n = 17; GD3: n = 6) completed the pre-test and main survey, respectively. In the main survey, mean total CIQ score, all CIQ subscores (except emotional function), and total ZBI score were highest in caregivers of patients with GD2 compared with caregivers of patients with GD1/GD3. High test-retest reliability (Kappa >0.6) was observed for 15 CIQ items and 16 ZBI items. CIQ and ZBI scores appeared to be positively correlated with each other and negatively correlated with caregiving duration. Conclusions The CIQ and ZBI are applicable, reliable measures to assess burden in caregivers of patients with GD in Japan. Caregiver burden was highest in caregivers of patients with GD2 and decreased with caregiving duration.
Collapse
Affiliation(s)
- Yuta Koto
- Child Healthcare and Genetic Science Laboratory, Division of Health Sciences, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Aya Narita
- Division of Child Neurology, Institute of Neurological Science, Tottori University Faculty of Medicine, 86 Nishi-cho, Yonago-shi, Tottori 683-8503, Japan
| | - Shinichi Noto
- Department of Rehabilitation, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata 950-3198, Japan
| | - Masafumi Okada
- Real-World Evidence Solutions & HEOR, IQVIA Solutions Japan K.K., 4-10-18 Takanawa, Minato-ku, Tokyo 108-0074, Japan
| | - Midori Ono
- Japan Medical Office, Takeda Pharmaceutical Company Limited, 2-1-1 Nihonbashi-Honcho, Chuo-ku, Tokyo 103-8688, Japan
| | - Terumi Baba
- Japan Medical Office, Takeda Pharmaceutical Company Limited, 2-1-1 Nihonbashi-Honcho, Chuo-ku, Tokyo 103-8688, Japan
| | - Rieko Sagara
- Japan Medical Office, Takeda Pharmaceutical Company Limited, 2-1-1 Nihonbashi-Honcho, Chuo-ku, Tokyo 103-8688, Japan
| | - Norio Sakai
- Child Healthcare and Genetic Science Laboratory, Division of Health Sciences, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| |
Collapse
|
5
|
Sudul P, Piatkowska-Jakubas B, Pawlinski L, Galazka K, Sacha T, Kiec-Wilk B. The Complexities of Diagnosis with Co-Existing Gaucher Disease and Hemato-Oncology-A Case Report and Review of the Literature. J Clin Med 2023; 12:5518. [PMID: 37685585 PMCID: PMC10488105 DOI: 10.3390/jcm12175518] [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: 07/07/2023] [Revised: 08/05/2023] [Accepted: 08/16/2023] [Indexed: 09/10/2023] Open
Abstract
Hematological abnormalities are the most common early symptoms of Gaucher disease (GD), with an increased risk of hematopoietic system malignancies reported in patients with GD. GD may be associated with monoclonal and polyclonal gammopathies; however, the mechanism of association of GD with multiple myeloma (MM) remains uncertain. Enzyme replacement therapy (ERT) has been shown to improve patients' cytopenia and it seems to facilitate anti-myeloma therapy in patients with co-occurring GD and MM. Although it is necessary to demonstrate the deficiency of enzymatic activity, as well as using genetic tests to finally diagnose GD, due to changes in the blood count image, bone marrow biopsy is still a frequent element of the GD diagnosis procedure. The diagnosis of GD is often delayed, mainly due to the heterogeneity of the histopathological picture of bone marrow biopsy or overlapping hematological abnormalities. Unrecognized and untreated GD worsens the response of a patient with an oncological disease to targeted treatment. We present a literature review, inspired by the case of a Caucasian patient initially diagnosed with MM and later confirmed with comorbid GD type 1 (GD1). We would like to point out the problem of underdiagnosis and delay in patients with GD.
Collapse
Affiliation(s)
- Paulina Sudul
- University Hospital, 30-688 Krakow, Poland
- Unit of Rare Metabolic Diseases, Department of Metabolic Diseases, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Beata Piatkowska-Jakubas
- University Hospital, 30-688 Krakow, Poland
- Department of Hematology, Jagiellonian University Medical College, 30-501 Krakow, Poland
| | - Lukasz Pawlinski
- University Hospital, 30-688 Krakow, Poland
- European Reference Network for Rare Metabolic Disease MetabERN, 30-688 Krakow, Poland
| | - Krystyna Galazka
- Department of Pathomorphology, Jagiellonian University Medical College, 31-531 Krakow, Poland
| | - Tomasz Sacha
- University Hospital, 30-688 Krakow, Poland
- Department of Hematology, Jagiellonian University Medical College, 30-501 Krakow, Poland
| | - Beata Kiec-Wilk
- University Hospital, 30-688 Krakow, Poland
- Unit of Rare Metabolic Diseases, Department of Metabolic Diseases, Jagiellonian University Medical College, 30-688 Krakow, Poland
- European Reference Network for Rare Metabolic Disease MetabERN, 30-688 Krakow, Poland
| |
Collapse
|
6
|
Feng J, Gao Z, Shi Z, Wang Y, Li S. Patient-reported outcomes in Gaucher's disease: a systematic review. Orphanet J Rare Dis 2023; 18:244. [PMID: 37626429 PMCID: PMC10463869 DOI: 10.1186/s13023-023-02844-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/23/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Gaucher's disease (GD), a rare condition, represents the most common lysosomal storage disorder. The cardinal manifestations of GD are fatigue, hepatosplenomegaly, anemia, thrombocytopenia, bone pain, and bone infarction, thereby culminating in a marked deterioration of patients' quality of life (QoL). Patient-reported outcomes (PROs) offer valuable insights into the impact of GD on patients' QoL and symptoms. This systematic review aimed to identify and analyze PROs and outcome measures in GD patients. METHODS We systematically searched PubMed, Web of Science Core Collections, EMBASE, SCOPUS, Cochrane Library, PsycINFO, Wan Fang Data, China National Knowledge Infrastructure (CNKI), and the Chinese Biomedical Literature Database (CBM). The methodological quality of the included studies was assessed using a mixed methods assessment tool. RESULTS A total of 33 studies were identified, encompassing 24 distinct patient-reported outcome instruments, with the most frequently employed instrument being the SF-36. The study designs included eighteen cross-sectional studies, seven pre- and post-intervention investigations, three randomized controlled trials, two cohort studies, two qualitative inquiries, and one validation study. These studies explored diverse domains such as the QoL and cardinal symptoms (e.g., fatigue, pain, bleeding, cognition, social relationships, and psychological functioning) in patients with GD. Furthermore, significant attention was directed towards the appraisal of the therapeutic benefits of various interventions in patients with GD. A novel GD-specific instrument has also been developed, which has two applied versions: a 24-item variant for routine clinical monitoring and a 17-item form for use in clinical trials. CONCLUSION PROs have garnered increased attention and concern in the realm of GD. Despite this progress, it is noteworthy that the instruments used to measure PROs in GD are still predominantly generic instruments. While researchers have endeavored to develop and validate a disease-specific instrument, currently the use of this instrument is limited. Owing to several challenges, including the small number of patients, heterogeneity of the disease, and cross-regional discrepancies in study findings, GD poses substantial difficulties in the measurement of QoL and development of instruments. Consequently, patients with GD require more dependable measurement instruments that accurately reflect their QoL, efficacy of treatment, and facilitate healthcare decision-making.
Collapse
Affiliation(s)
- Junchao Feng
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Center for Health Preference Research, Shandong University, Jinan, 250012, China
| | - Zhongchun Gao
- Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, 266011, China
| | - Zhao Shi
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Center for Health Preference Research, Shandong University, Jinan, 250012, China
| | - Yue Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Center for Health Preference Research, Shandong University, Jinan, 250012, China
| | - Shunping Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
- Center for Health Preference Research, Shandong University, Jinan, 250012, China.
| |
Collapse
|
7
|
Velvin G, Dammann B, Haagensen T, Johansen H, Strømme H, Geirdal AØ, Bathen T. Work participation in adults with rare genetic diseases - a scoping review. BMC Public Health 2023; 23:910. [PMID: 37208707 DOI: 10.1186/s12889-023-15654-3] [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: 11/09/2022] [Accepted: 04/11/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Work participation is a crucial aspect of health outcome and an important part of life for most people with rare genetic diseases. Despite that work participation is a social determinant of health and seems necessary for understanding health behaviours and quality of life, it is an under-researched and under-recognized aspect in many rare diseases. The objectives of this study was to map and describe existing research on work participation, identify research gaps, and point to research agendas in a selection of rare genetic diseases. METHODS A scoping review was performed by searching relevant literature in bibliographic databases and other sources. Studies addressing work participation in people with rare genetic diseases published in peer reviewed journals were assessed using EndNote and Rayyan. Data were mapped and extracted based on the research questions concerning the characteristics of the research. RESULTS Of 19,867 search results, 571 articles were read in full text, and 141 satisfied the eligibility criteria covering 33 different rare genetic diseases; 7 were reviews and 134 primary research articles. In 21% of the articles the primary aim was to investigate work participation. The extent of studies varied between the different diseases. Two diseases had more than 20 articles, but most had only one or two articles. Cross-sectional quantitative studies were predominant, with few utilizing prospective or qualitative design. Nearly all articles (96%) reported information about work participation rate, and 45% also included information about factors associated with work participation and work disability. Due to differences in methodologies, cultures and respondents, comparison between and within diseases are difficult. Nevertheless, studies indicated that many people with different rare genetic diseases experience challenges related to work, closely associated to the symptoms of the disease. CONCLUSION While studies indicate high prevalence of work disability in many patients with rare diseases, the research is scarce and fragmented. More research is warranted. Information about the unique challenges of living with different rare diseases is crucial for health and welfare systems to better facilitate work participation. In addition, the changing nature of work in the digital age, may also open up new possibilities for people with rare genetic diseases and should be explored.
Collapse
Affiliation(s)
- Gry Velvin
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Oslo, 1450, Norway.
| | - Brede Dammann
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Oslo, 1450, Norway
| | - Trond Haagensen
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Oslo, 1450, Norway
| | - Heidi Johansen
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Oslo, 1450, Norway
| | - Hilde Strømme
- Library of Medicine and Science, University of Oslo, Oslo, Norway
| | - Amy Østertun Geirdal
- Department of Social Work, Child Welfare and Social Policy, Faculty of Social Science, Oslo Metropolitan University, Oslo, Norway
| | - Trine Bathen
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Oslo, 1450, Norway
| |
Collapse
|
8
|
Owen Z, Saeb S, Short S, Ong N, Angi G, Ghoreyshi A, Sullivan SS. Lingering impacts on sleep following the Daylight Savings Time transition in the Project Baseline Health Study. SLEEP SCIENCE AND PRACTICE 2022. [DOI: 10.1186/s41606-022-00082-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Abstract
Background
The “spring forward” change to Daylight Savings Time (DST) has been epidemiologically linked with numerous health and safety risks in the days following the transition, but direct measures of sleep are infrequently collected in free-living individuals.
Methods
The Project Baseline Health Study (PBHS), a prospective, multicenter, longitudinal representative U.S. cohort study that began in 2017 launched a Sleep Mission in March 2021 to characterize sleep using patient-reported and wearable device measures, in free-living circumstances during the DST switch. Estimated sleep period duration, subjective restedness, and sleep quality were compared before and after the DST transition during specified timeframes.
Results
Of the total PBHS population of 2502 participants, 912 participants received an invitation and 607 responded by March 6th. Among those, 420 participants opted into the Sleep Mission (69.2%). The transition to DST resulted in both acute and lingering impacts on sleep. Acute effects included a 29.6 min reduction in sleep period (p = 0.03), increases in the proportion of patients who reported ‘sleeping poorly’ (from 1.7 to 13.6% [p < 0.01]), and with scores falling into the ‘unrested’ category (from 1.7 to 8.5% [p = 0.046]). There was also a downward trend in the proportion of participants reporting being rested in the morning following the DST transition (from 62.7% on March 7 to 49.2% on March 14 [p = 0.10]). Lingering effects included a 18.7% relative decrease in the daily likelihood of participants reporting restedness (from 49.2% in the week prior to the DST transition to 40.0% in the week after [p < 0.01]).
Conclusion
The DST transition is associated with an acute reduction in sleep period, as well as an increased proportion of individuals reporting poor sleep and unrestedness. The DST transition also resulted in lingering impacts on self-reported restedness, lasting into the week following the transition. This work adds to a growing understanding of the persistence of impacts on sleep health metrics due to the DST transition.
Collapse
|
9
|
Koto Y, Narita A, Noto S, Ono M, Hamada AL, Sakai N. Qualitative analysis of patient interviews on the burden of neuronopathic Gaucher disease in Japan. Orphanet J Rare Dis 2022; 17:280. [PMID: 35854314 PMCID: PMC9295096 DOI: 10.1186/s13023-022-02429-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gaucher disease (GD) is a rare, autosomal recessive lysosomal storage disorder that adversely affects life expectancy and health-related quality of life (HRQOL). Although HRQOL questionnaires are available for type 1 GD, they are not suitable for patients with the neuronopathic types 2 and 3 GD who have neurological symptoms that develop during early childhood or adolescence. Here we report the development of a language-validated HRQOL questionnaire specifically for patients with neuronopathic types 2 and 3 GD in Japan, which is the first step toward HRQOL questionnaire provision for all types of GD in the future. METHODS In February and March 2021, semi-structured interviews were conducted by the authors (supported by qualified interviewers) with patients and/or their caregivers (for patients < 16 years old) who were recruited from a Japanese patient association, the Association of Gaucher Disease Patients in Japan. Qualitative analysis of interview transcripts was used to identify major themes and key topics within those themes. Hierarchical cluster analysis and co-occurrence network analysis were performed to map relationships between commonly occurring words. The study is registered at the UMIN Clinical Trials Registry ( https://www.umin.ac.jp/ctr/index.htm [UMIN000042872]). RESULTS Three main themes emerged from qualitative analysis: treatment status, patient burden, and social support systems. Key topics within each theme included hearing impairment, visual impairment, difficulty swallowing, difficulty speaking, involuntary movement of extremities, epileptic seizures, and body aches (treatment status); anxiety about symptoms, difficulty with exercise and work, anxiety about continuing treatment, anxiety about going out, and tiredness from hospital visit or treatment (patient burden); and dissatisfaction about government service, lack of social support, and information exchange in the patient association (social support systems). Commonly used words and the relationships between words identified through the hierarchical cluster and co-occurrence network analyses supported these themes and topics. CONCLUSIONS The themes and topics identified in this analysis were specific to patients with types 2 and 3 GD and will be used to inform the development of a HRQOL questionnaire specifically for patients with all GD types.
Collapse
Affiliation(s)
- Yuta Koto
- Child Healthcare and Genetic Science Laboratory, Division of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Aya Narita
- Division of Child Neurology, Institute of Neurological Science, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan
| | - Shinichi Noto
- Department of Rehabilitation, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, Niigata, 950-3198, Japan
| | - Midori Ono
- Japan Medical Office, Takeda Pharmaceutical Company Limited, 1-1 Nihonbashi-Honcho 2-chome Chuo-ku, Tokyo, 103-8668, Japan
| | - Anna Lissa Hamada
- Japan Medical Office, Takeda Pharmaceutical Company Limited, 1-1 Nihonbashi-Honcho 2-chome Chuo-ku, Tokyo, 103-8668, Japan
| | - Norio Sakai
- Child Healthcare and Genetic Science Laboratory, Division of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| |
Collapse
|
10
|
Qi X, Xu J, Shan L, Li Y, Cui Y, Liu H, Wang K, Gao L, Kang Z, Wu Q. Economic burden and health related quality of life of ultra-rare Gaucher disease in China. Orphanet J Rare Dis 2021; 16:358. [PMID: 34380529 PMCID: PMC8356434 DOI: 10.1186/s13023-021-01963-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 07/18/2021] [Indexed: 11/25/2022] Open
Abstract
Background The diagnosis and health care of patients with rare diseases present a tremendous challenge worldwide. This study described the health care service utilization through participants’ perspective and estimated the cost of illness (COI), and patients with Gaucher disease (GD)’s/caregivers’ health-related quality of life in China. Method An online retrospective survey of patients with GD and their caregivers was conducted during May–June 2018. Socio-demographic, health service utilization, disease-related expenses, social support, sleep quality (Pittsburgh Sleep Quality Index [PSQI]), and the Short Form Health Survey (SF-36) were investigated. Using self-reported information, we estimated the annual COI, including direct healthcare, direct non-healthcare, and indirect costs. Results Forty patients and their 49 caregivers were surveyed. The patients’ onset age of GD was 9.3 ± 10.9; their disease course was 3.5 ± 3.1 years. 21 (42.9%) patients had ≥ 2 caregivers, but 35 (71.4%) caregivers reported have no experience as a caregiver. 79.6% caregivers have stopped working, and 87.8% changed weekly working schedule. Before final diagnosis, patients visited 3.9 ± 3.1 (max = 20) hospitals and took 1.2 ± 1.7 (max = 6.6) years for confirmed diagnosis. On average, 5.0 ± 9.6 misdiagnoses occurred, and the per-patient diagnoses cost was USD ($) 7576. After GD confirmation, 8 (16.3%) patients received no treatment, 40 (81.6%) received pharmacotherapy, 10 (20.4%) received surgery, 38 (77.6%) received outpatient service (8.8 ± 9.1 times/annually), and 37 (77.5%) received inpatient service (4.0 ± 3.5 times/annually). Annual per-patient COI was USD ($) 49,925 (95% confidence interval: 29,178, 70,672). Average direct healthcare cost was $41,816, including pharmaceutical ($29,908), inpatient ($7,451), and outpatient ($1,838). Productivity loss per-caregiver was $1,980, and their Zarit Burden Inventory score was moderate-severe (48.6 ± 19.6). Both patients/caregivers reported lower social support (32.4 ± 7.4, 34.9 ± 7.6), two times higher PSQI (7.9 ± 2.9, 8.7 ± 3.6), and half lower SF-36 (41.3 ± 18.6, 46.5 ± 19.3) than those reported for healthy Chinese individuals. Conclusions The high misdiagnosis rate, together with delayed diagnosis, substantial costs, and deteriorated health-related quality of life of GD patients as well as their heavy care burden, calls for extreme attention from policymakers in China. Further efforts of government and society are urgently demanded, including pharmaceutical reimbursement, screening newborns, developing precise diagnostic tools, and training doctors. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-01963-6.
Collapse
Affiliation(s)
- Xinye Qi
- Department of Health Policy, Health Management College, Harbin Medical University, No. 157, Baojian 21 Road, Nangang District, Harbin, 150081, Heilongjiang Province, China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jiao Xu
- Department of Health Policy, Health Management College, Harbin Medical University, No. 157, Baojian 21 Road, Nangang District, Harbin, 150081, Heilongjiang Province, China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Linghan Shan
- Department of Health Policy, Health Management College, Harbin Medical University, No. 157, Baojian 21 Road, Nangang District, Harbin, 150081, Heilongjiang Province, China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ye Li
- Department of Health Policy, Health Management College, Harbin Medical University, No. 157, Baojian 21 Road, Nangang District, Harbin, 150081, Heilongjiang Province, China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yu Cui
- Department of Health Policy, Health Management College, Harbin Medical University, No. 157, Baojian 21 Road, Nangang District, Harbin, 150081, Heilongjiang Province, China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Huan Liu
- Department of Health Policy, Health Management College, Harbin Medical University, No. 157, Baojian 21 Road, Nangang District, Harbin, 150081, Heilongjiang Province, China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Kexin Wang
- Department of Health Policy, Health Management College, Harbin Medical University, No. 157, Baojian 21 Road, Nangang District, Harbin, 150081, Heilongjiang Province, China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lijun Gao
- Department of Health Policy, Health Management College, Harbin Medical University, No. 157, Baojian 21 Road, Nangang District, Harbin, 150081, Heilongjiang Province, China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Zheng Kang
- Department of Health Policy, Health Management College, Harbin Medical University, No. 157, Baojian 21 Road, Nangang District, Harbin, 150081, Heilongjiang Province, China.,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qunhong Wu
- Department of Health Policy, Health Management College, Harbin Medical University, No. 157, Baojian 21 Road, Nangang District, Harbin, 150081, Heilongjiang Province, China. .,Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China.
| |
Collapse
|
11
|
Revel-Vilk S, Szer J, Zimran A. Hematological manifestations and complications of Gaucher disease. Expert Rev Hematol 2021; 14:347-354. [PMID: 33759681 DOI: 10.1080/17474086.2021.1908120] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction: Gaucher disease (GD), although pan-ethnic and rare (common in Ashkenazi Jews), is of great importance to hematologists both for diagnosis and management. The need for increased awareness of GD is that delayed diagnosis may lead to preventable irreversible complications (mainly skeletal) or unnecessary invasive procedures (e.g. bone marrow biopsy), and the birth of another affected sibling due to lack of genetic consulting.Areas covered: The review outlines the common hematological manifestations of GD, including splenomegaly, thrombocytopenia, and anemia. Other hematological manifestations such as coagulation abnormalities, platelet dysfunction, gammopathy, and other hematological malignancies associated with GD are also discussed. Current and future treatment modalities are delineated, including enzyme replacement and substrate reduction therapy, pharmacological chaperon, and gene therapy. A literature search was conducted to identify original research articles relevant to hematology manifestations and GD published before November 2020.Expert opinion: Patients with GD should be ideally followed and treated in a center of excellence where the GD expert benefits from experienced consultants in relevant disciplines. Due to the availability of several very expensive treatment options, it is important to have an unbiased expert who can select the most suitable management for the individual patients (including withholding prescription in asymptomatic patients).
Collapse
Affiliation(s)
- Shoshana Revel-Vilk
- Gaucher Unit, Shaare Zedek Medical Centre, Jerusalem, Israel.,Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jeff Szer
- Clinical Haematology at Peter MacCallum Cancer Centre and The Royal Melbourne Hospital, Melbourne, Australia.,Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - Ari Zimran
- Gaucher Unit, Shaare Zedek Medical Centre, Jerusalem, Israel.,Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
12
|
Zimran A, Ruchlemer R, Revel-Vilk S. A patient with Gaucher disease and plasma cell dyscrasia: bidirectional impact. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2020; 2020:389-394. [PMID: 33275748 PMCID: PMC7727517 DOI: 10.1182/hematology.2020000123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Patients with Gaucher disease (GD), a rare autosomal recessive glycosphingolipid storage disease, commonly present to hematologists with unexplained splenomegaly, thrombocytopenia, anemia, and bone symptoms. Patients with GD may develop other manifestations, such as autoimmune thrombocytopenia, monoclonal gammopathy, multiple myeloma, or, even more rarely, other hematological malignancies; sometimes they are first diagnosed during an assessment of those disorders. Although the diagnosis and management of patients with GD have significantly evolved over the last 30 years, some patients remain poor responders to GD-specific therapy, needing novel and investigational therapies. Ideally, patients with GD, like patients with other rare diseases, should be managed by a multidisciplinary team expert with the diverse clinical manifestations and potential GD-related or -unrelated comorbidities. The hematology community should be knowledgeable regarding the presentation and the variety of hematologic complications and comorbidities associated with Gaucher disease.
Collapse
Affiliation(s)
- Ari Zimran
- Gaucher Unit
- School of Medicine, Hebrew University, Jerusalem, Israel
| | - Rosa Ruchlemer
- Department of Hematology, Shaare Zedek Medical Center, and
- School of Medicine, Hebrew University, Jerusalem, Israel
| | | |
Collapse
|