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Zeijen VJ, Peeters LE, Asman A, Boersma E, Massey EK, van Dijk L, Daemen J, Versmissen J. Quality-of-life and beliefs about medication in relation to a therapy adherence intervention in resistant hypertension: the Resistant HYpertension: MEasure to ReaCh Targets trial. J Hypertens 2024; 42:1687-1694. [PMID: 38780122 PMCID: PMC11356742 DOI: 10.1097/hjh.0000000000003780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 04/30/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To assess the impact of personalized feedback on therapy adherence testing results on quality of life and beliefs about medication in patients with resistant hypertension, as well as to identify patient-oriented predictors of therapy adherence. METHODS This study was a prespecified post hoc analysis of the multicenter randomized controlled trial Resistant HYpertension: MEasure to ReaCh Targets (RHYME-RCT). Patients were randomized to a personalized feedback conversation on measured antihypertensive drug levels additional to standard-of-care, or standard-of-care only. The primary outcomes consisted of EuroQol EQ-5D-5L and Beliefs about Medicine Questionnaire (BMQ) scores at 12 months. RESULTS A total of 56 patients with median age 61.5 [25th-75th percentile: 55.8-69.3] years (21.4% women) were included. Mean blood pressure ±SD was 149.8/84.1 ± 14.9/13.8 mmHg while being on a median of 5.6 [4.8-7.3] defined daily dosages (DDD) of antihypertensive drugs. At 12 months, no differences were observed in EQ-5D-5L index (0.81 [0.69-0.89] vs. 0.89 [0.73-1.00]; P = 0.18) and visual analogue scale score on general patient-perceived health (70 [60-80] vs. 70 [60-82]; P = 0.53) between the intervention-arm and the standard-of-care only-arm. Likewise, individual EQ-5D-5L domain scores and BMQ scores did not differ between both arms. Irrespective of the intervention, independent positive predictors of the percentage adherence were patient age, EQ-5D-5L index score, BMQ-specific necessity score and concern score, whereas the total number of drugs prescribed was a negative predictor. CONCLUSION Within this prespecified subanalysis of the randomized RHYME-RCT trial, implementation of a personalized feedback conversation targeting therapy adherence did not improve health-related quality-of-life and beliefs about medication in patients with resistant hypertension.
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Affiliation(s)
| | - Laura E.J. Peeters
- Department of Internal Medicine
- Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam
| | - Azra Asman
- Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam
| | | | | | - Liset van Dijk
- Netherlands Institute for Health Services Research (NIVEL), Utrecht
- Department of PharmacoTherapy, Epidemiology and Economics (PTEE), Groningen Research Institute of Pharmacy, Faculty of Science and Engineering, University of Groningen, Groningen, the Netherlands
| | | | - Jorie Versmissen
- Department of Internal Medicine
- Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam
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Rupakheti B, KC B, Bista D, KC S, Pandey KR. Treatment Adherence and Health-Related Quality of Life Among Patients with Hypertension at Tertiary Healthcare Facility in Lalitpur, Nepal: A Cross-Sectional Study. Patient Prefer Adherence 2024; 18:2077-2090. [PMID: 39371197 PMCID: PMC11453163 DOI: 10.2147/ppa.s476104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Accepted: 09/24/2024] [Indexed: 10/08/2024] Open
Abstract
Background Measurement of medication adherence and health-related quality of life is extremely important when planning different health policies. Drug therapy and adherence to medication are critical to prevent complications of hypertension, especially in countries like Nepal, where hypertension is one of the most prevalent diseases. However, this has not been studied in Nepal. This study, hence, aimed to explore medication adherence, factors affecting medication adherence, health-related quality of life, and the correlation between medication adherence and health-related quality of life in hypertensive patients visiting tertiary care health facilities in Lalitpur district of Nepal. Methodology This quantitative cross-sectional study was conducted among 380 hypertensive patients at KIST Medical College and Teaching Hospital, Lalitpur, Nepal. The Nepali version of the European Quality of Life tool EQ-5D-5L and the Hill-Bone Compliance to High Blood Pressure Therapy Scale (HBCTS) were used. Intergroup differences in medication adherence, the EQ-5D index and EQ-VAS scores were assessed for statistical significance using either the Mann-Whitney or Kruskal-Wallis tests for numerical data. Spearman correlation coefficient was used to identify the relationship among medication adherence, EQ-5D-5L index values, and EQ-VAS scores. Results The mean treatment score was 22.43 ± 4.12. Age, sex, and occupation were significant factors that affected treatment adherence. The EQ-5D score was 0.72 with age, sex, income, and educational status as significant factors and marital status as an insignificant factor. A slightly negative correlation was found between the total treatment adherence score and the EQ-5D index. Conclusion The treatment adherence of patients to antihypertensive therapy was suboptimal, which could affect the outcome of therapy. Better treatment adherence was correlated with a better health-related quality of life. Hence, both health-care providers and patients should make efforts to increase treatment adherence to attain better HRQOL.
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Affiliation(s)
- Binita Rupakheti
- Department of Pharmacy, School of Science, Kathmandu University, Dhulikhel, Kavrepalanchowk, Nepal
| | - Badri KC
- Department of Pharmacy, School of Science, Kathmandu University, Dhulikhel, Kavrepalanchowk, Nepal
| | - Durga Bista
- Department of Pharmacy, School of Science, Kathmandu University, Dhulikhel, Kavrepalanchowk, Nepal
| | - Sunayana KC
- Department of Pharmacy, School of Science, Kathmandu University, Dhulikhel, Kavrepalanchowk, Nepal
| | - Kashi Raj Pandey
- Department of Languages and Mass Communication, School of Arts, Kathmandu University, Hattiban, Lalitpur, Nepal
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Commodore-Mensah Y, Delva S, Ogungbe O, Smulcer LA, Rives S, Dennison Himmelfarb CR, Kim MT, Bone L, Levine D, Hill MN. A Systematic Review of the Hill-Bone Compliance to Blood Pressure Therapy Scale. Patient Prefer Adherence 2023; 17:2401-2420. [PMID: 37790863 PMCID: PMC10544210 DOI: 10.2147/ppa.s412198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/05/2023] [Indexed: 10/05/2023] Open
Abstract
Background Poor medication adherence hampers hypertension control and increases the risk of adverse health outcomes. Medication adherence can be measured with direct and indirect methods. The Hill-Bone Compliance to High Blood Pressure Therapy (HBCHBPT) Scale, one of the most popular adherence measures, indirectly assesses adherence to hypertension therapy in three behavioral domains: appointment keeping, diet and medication adherence. Aim To synthesize evidence on the use of the HBCHBPT Scale, including psychometric properties, utility in diverse patient populations, and directions for future clinical use and research. Methods We searched electronic databases, specifically CINAHL, PubMed, PsychInfo, Embase, and Web of Science. We included original studies that used the HBCHBPT Scale or its subscales to measure a health outcome, or methodological studies involving translations and validations of the scale. We extracted and synthesized data following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Results Fifty studies were included in this review, 44 on hypertension, two on diabetes, and others on other chronic conditions. The scale was successfully translated into numerous languages and used in descriptive and intervention studies. The scale demonstrated sound psychometric properties (Cronbach's α coefficient 0.75) and sensitivity to capture intervention effects when used to evaluate the effectiveness of high blood pressure adherence interventions. The medication-taking subscale of HBCHBPT performs best and is widely used in diverse contexts to assess medication adherence for chronic conditions. Conclusion The HBCHBPT Scale has high versatility globally and has been used in various settings by various healthcare worker cadres and researchers. The scale has several strengths, including high adherence phenotyping capabilities, contributing to the paradigm shift toward personalized health care.
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Affiliation(s)
- Yvonne Commodore-Mensah
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sabianca Delva
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, USA
| | - Oluwabunmi Ogungbe
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Sally Rives
- Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Cheryl R Dennison Himmelfarb
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloombery School of Public Health, Baltimore, MD, USA
| | - Miyong T Kim
- School of Nursing, University of Texas at Austin, Austin, TX, USA
| | - Lee Bone
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - David Levine
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Martha N Hill
- Johns Hopkins School of Nursing, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Bernardes ML, Rosendo-Silva B, Rosendo I, Monteiro-Soares M. Web-based interventions to improve blood pressure control in patients with hypertension: a protocol for a systematic review. BMJ Open 2023; 13:e067610. [PMID: 37558452 PMCID: PMC10414092 DOI: 10.1136/bmjopen-2022-067610] [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: 08/18/2022] [Accepted: 06/22/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Hypertension is the major cause of cardiovascular disease and mortality in the world. Blood pressure control (BPC) is recognised as a key measure in the management of hypertension. Several studies have been conducted assessing the impact of specific web-based interventions in improving BPC. Our systematic review intends to identify all the available web-based interventions and determine if and which are more effective than usual care in improving BPC. METHODS AND ANALYSIS We will include randomised control trials completed until April 2023 including patients diagnosed with hypertension comparing the effect of receiving usual care versus web-based interventions in BPC. No language restriction will be applied. We will start with an extensive electronic database search, in the Cochrane Central Register of Controlled Trials, PubMed, Embase, Scopus, EU Clinical Trials Register, Pan-African Clinical Trials Registry and ClinicalTrials.gov. Eligibility criteria will be applied blindly and independently by two researchers to the title and abstract of the references, in the first stage, and to the full version of the ones selected. All divergences will be solved by a third researcher. We will conduct a narrative description and meta-analysis (if adequate) of the results of the included studies, structured according to the type of intervention, characteristics of the population and outcome measurement. We will extract features of the web-based interventions, selecting the ones with the best outcomes regarding BPC, to later propose an ideal web-based intervention to improve BPC in hypertensive patients and/or guide future research on this topic. The risk of bias will be assessed using Cochrane's RoB2 Tool. ETHICS AND DISSEMINATION Ethical approval is not required since this is a protocol for a systematic review. The findings of this study will be disseminated through peer-reviewed publications and national or international conference presentations. Updates of the review will be conducted, as necessary. PROSPERO REGISTRATION NUMBER PROSPERO CRD42020184166.
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Affiliation(s)
- Maria Leonor Bernardes
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Unidade de Saúde Familiar do Arco, Lisboa, Portugal
| | - Beatriz Rosendo-Silva
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- CINTESIS - Center for Health Technology and Services Research; Faculty of Medicine, University of Porto, Porto, Portugal
| | - Inês Rosendo
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- CINTESIS - Center for Health Technology and Services Research; Faculty of Medicine, University of Porto, Porto, Portugal
- Unidade de Saúde Familiar Coimbra Centro, Center Regional Health Administration, Coimbra, Portugal
| | - Matilde Monteiro-Soares
- CINTESIS - Center for Health Technology and Services Research; Faculty of Medicine, University of Porto, Porto, Portugal
- MEDCIDS - Departamento de Ciências da Informação e da Decisão em Saúde, Faculty of Medicine, University of Porto, Porto, Portugal
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Liskova S, Cacanyiova S, Cebova M, Berenyiova A, Kluknavsky M, Micurova A, Valachova K, Soltes L, Bernatova I. Taxifolin Reduces Blood Pressure via Improvement of Vascular Function and Mitigating the Vascular Inflammatory Response in Spontaneously Hypertensive Rats. Int J Mol Sci 2023; 24:12616. [PMID: 37628795 PMCID: PMC10454553 DOI: 10.3390/ijms241612616] [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: 06/29/2023] [Revised: 07/24/2023] [Accepted: 08/06/2023] [Indexed: 08/27/2023] Open
Abstract
The effect of a 10-day-long treatment with taxifolin (TAX, 20 mg/kg/day p.o.) was investigated on spontaneously hypertensive rats (SHRs) with a focus on the vascular functions of isolated femoral arteries and thoracic aortas. TAX reduced blood pressure in SHRs. In femoral arteries, TAX increased acetylcholine-induced relaxation, reduced the maximal NA-induced contraction, and reduced acetylcholine-induced endothelium-dependent contraction (EDC); however, TAX had no effect on the vascular reactivity of isolated thoracic aortas. In addition, TAX elevated the total nitric oxide synthase (NOS) activity and iNOS protein expression but reduced cyclooxygenase-2 (COX2) protein expression in the tissue of the abdominal aorta without changes in Nos2 and Ptgs2 gene expressions. TAX also increased the gene expression of the anti-inflammatory interleukin-10 (Il10). In addition, in vitro studies showed that TAX has both electron donor and H atom donor properties. However, TAX failed to reduce superoxide production in the tissue of the abdominal aorta after oral administration. In conclusion, our results show that a decrease in the blood pressure in TAX-treated SHRs might be attributed to improved endothelium-dependent relaxation and reduced endothelium-dependent contraction. In addition, the results suggest that the effect of TAX on blood pressure regulation also involves the attenuation of COX2-mediated pro-inflammation and elevation of anti-inflammatory pathways.
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Affiliation(s)
- Silvia Liskova
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute of Normal and Pathological Physiology, Sienkiewiczova 1, 813 71 Bratislava, Slovakia; (S.L.); (S.C.); (M.C.); (A.B.); (M.K.); (A.M.)
- Faculty of Medicine, Institute of Pharmacology and Clinical Pharmacology, Comenius University, Sasinkova 4, 811 08 Bratislava, Slovakia
| | - Sona Cacanyiova
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute of Normal and Pathological Physiology, Sienkiewiczova 1, 813 71 Bratislava, Slovakia; (S.L.); (S.C.); (M.C.); (A.B.); (M.K.); (A.M.)
| | - Martina Cebova
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute of Normal and Pathological Physiology, Sienkiewiczova 1, 813 71 Bratislava, Slovakia; (S.L.); (S.C.); (M.C.); (A.B.); (M.K.); (A.M.)
| | - Andrea Berenyiova
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute of Normal and Pathological Physiology, Sienkiewiczova 1, 813 71 Bratislava, Slovakia; (S.L.); (S.C.); (M.C.); (A.B.); (M.K.); (A.M.)
| | - Michal Kluknavsky
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute of Normal and Pathological Physiology, Sienkiewiczova 1, 813 71 Bratislava, Slovakia; (S.L.); (S.C.); (M.C.); (A.B.); (M.K.); (A.M.)
| | - Andrea Micurova
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute of Normal and Pathological Physiology, Sienkiewiczova 1, 813 71 Bratislava, Slovakia; (S.L.); (S.C.); (M.C.); (A.B.); (M.K.); (A.M.)
| | - Katarina Valachova
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute of Experimental Pharmacology and Toxicology, Dubravska cesta 9, 841 04 Bratislava, Slovakia; (K.V.); (L.S.)
| | - Ladislav Soltes
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute of Experimental Pharmacology and Toxicology, Dubravska cesta 9, 841 04 Bratislava, Slovakia; (K.V.); (L.S.)
| | - Iveta Bernatova
- Centre of Experimental Medicine, Slovak Academy of Sciences, Institute of Normal and Pathological Physiology, Sienkiewiczova 1, 813 71 Bratislava, Slovakia; (S.L.); (S.C.); (M.C.); (A.B.); (M.K.); (A.M.)
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Striberger R, Zarrouk M, Kumlien C, Axelsson M. Illness perception, health literacy, self-efficacy, adherence and quality of life in patients with intermittent claudication - a longitudinal cohort study. BMC Nurs 2023; 22:167. [PMID: 37198627 DOI: 10.1186/s12912-023-01329-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/05/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Patients with intermittent claudication need lifelong treatment with secondary prevention to prevent cardiovascular events and progression of atherosclerotic disease. Illness perception, health literacy, self-efficacy, adherence to medication treatment, and quality of life are factors influencing patients' self-management. Knowledge of these factors could be important when planning for secondary prevention in patients with intermittent claudication. AIM to compare illness perception, health literacy, self-efficacy, adherence to treatment, and quality of life in in patients with intermittent claudication. METHODS A longitudinal cohort study was conducted with 128 participants recruited from vascular units in southern Sweden. Data were collected through medical records and questionnaires regarding illness perception, health literacy, self-efficacy, adherence to treatment, and quality of life. RESULTS In the subscales in illness perception, patients with sufficient health literacy reported less consequences and lower emotional representations of the intermittent claudication. They also reported higher self-efficacy and higher quality of life than patients with insufficient health literacy. In comparison between men and women in illness perception, women reported higher illness coherence and emotional representations associated with intermittent claudication compared to men. A multiple regression showed that both consequences and adherence were negative predictors of quality of life. When examining changes over time, a significant increase in quality of life was seen between baseline and 12 months, but there were no significant differences in self-efficacy.. CONCLUSION Illness perception differs in relation to level of health literacy and between men and women. Further, the level of health literacy seems to be of importance for patients' self-efficacy and quality of life. This illuminates the need for new strategies for improving health literacy, illness perception, and self-efficacy over time. For example, more tailored information regarding secondary prevention could be provided to strengthen self-management to further improve quality of life in patients with intermittent claudication.
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Affiliation(s)
- Rebecka Striberger
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, SE-20506, Sweden.
- Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden.
| | - Moncef Zarrouk
- Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Christine Kumlien
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, SE-20506, Sweden
- Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden
| | - Malin Axelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, SE-20506, Sweden
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Adherence to Acromegaly Treatment and Analysis of the Related Factors-A Real-World Study in Bulgaria. Pharmaceutics 2023; 15:pharmaceutics15020438. [PMID: 36839760 PMCID: PMC9963513 DOI: 10.3390/pharmaceutics15020438] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/31/2023] Open
Abstract
The purpose was to assess the level of medication adherence (MA) and related factors among individuals with acromegaly. The secondary goal was to assess the quality of life of patients and whether and how it correlates with the level of adherence. A prospective one-year study was conducted among patients with acromegaly diagnosed, treated, and monitored in the reference center for rare endocrine diseases in Bulgaria in 2021. Clinical data, patients reported outcomes, and health economics data were collected to define the predictors of non-adherence to medicines. Medication adherence level was assessed through a free Morisky-Green 4-item questionnaire. A total of 179 patients with acromegaly were observed. Approximately 62% were female, 50% were between 41 and 60 years, and the mean age at diagnosis was 40.4 years. The response rate to the questionnaires was 53% (n = 95; mean age 53.5 years, 73% female and 26% male). Patients with high levels of MA reported higher median values for the 36-Item Short Form Health Survey (SF-36) in comparison with those with low levels: 65.5 vs. 48.5 (p = 0.017). Similar results for EQ-5D-3L (3-level EuroQol 5D version) values and the level of MA were found: 0.656 vs. 0.796 (p = 0.0123). A low level of adherence was revealed in 34.7% of the patients, with no difference among different age groups. A significant positive determinant for adherence was years lived with acromegaly (OR = 5.625, 95% CI 1.7401-18.1832, p = 0.0039), as shorter duration was related to higher odds for high level of adherence. The current study demonstrates the importance of MA assessment for patients with acromegaly in Bulgaria. The medication adherence to the prescribed therapy among the observed group of patients with acromegaly varied as the percentage of adherent patients was around 65%. Still, there are low-adherent patients, and the responsible factors should be further investigated.
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Kołtuniuk A, Pytel A, Krówczyńska D, Chojdak-Łukasiewicz J. The Quality of Life and Medication Adherence in Patients with Multiple Sclerosis-Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14549. [PMID: 36361427 PMCID: PMC9656792 DOI: 10.3390/ijerph192114549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Multiple sclerosis (MS) is a chronic, degenerative autoimmune inflammatory disease of the central nervous system. MS is characterized by a wide range of symptoms and unpredictable prognosis, which can severely affect patient quality of life (QOL). The treatment strategy includes acute relapse treatment, disease-modifying treatment (DMT), and symptomatic therapy. Adherence to long-term DMTs is essential in order to maximize the therapeutic effects for MS and is crucial to health-related quality of life (HRQOL). This study aimed to evaluate the relationship between QOL and adherence to DMTs in MS patients. A group of 344 patients (73% females) aged 39.1 years with relapsing-reemitting MS were included. The Multiple Sclerosis International Quality of Life (MusiQOL) and the Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ) were used. An injection of interferon (IFN)-β1b was used in 107 patients, IFN-β1a in 94 patients, and glatiramer acetate in 34 patients. The oral treatment includes teriflunomide in 14 patients, dimethyl fumarate in 86 patients, and fingolimod in nine patients. No statistically significant differences (p > 0.05) were observed in adherent (ADH) vs. non-adherent patients (non-ADH) in MusiQOL. The total adherence rate was 72% (MS-TAQ). An analysis of the univariate logistic regression model showed an effect of only the activities of daily living (ADL) and relationship with the healthcare system (RHCS) domains on the level of adherence to treatment recommendations. The other variables studied do not affect the level of adherence. Higher QOL levels in the ADL and RHCS domains affect medication adherence in MS patients. Our findings could help manage MS patients, promoting interventions on ADLs and good relationships with healthcare providers to improve their adherence to therapy and result in better QOL.
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Affiliation(s)
- Aleksandra Kołtuniuk
- Department of Nursing and Obstetrics, Faculty of Health Science, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | - Aleksandra Pytel
- Department of Nursing and Obstetrics, Faculty of Health Science, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | - Dorota Krówczyńska
- Cardinal Stefan Wyszynski Institute of Cardiology, 04-628 Warsaw, Poland
- Department of Nursing and Obstetrics, Collegium Mazovia, 08-110 Siedlce, Poland
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Ishinuki T, Ota S, Harada K, Kawamoto M, Meguro M, Kutomi G, Tatsumi H, Harada K, Miyanishi K, Kato T, Ohyanagi T, Hui TT, Mizuguchi T. Current standard values of health utility scores for evaluating cost-effectiveness in liver disease: A meta-analysis. World J Gastroenterol 2022; 28:4442-4455. [PMID: 36159009 PMCID: PMC9453766 DOI: 10.3748/wjg.v28.i31.4442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/26/2022] [Accepted: 07/25/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Health utility assessments have been developed for various conditions, including chronic liver disease. Health utility scores are required for socio-economic evaluations, which can aid the distribution of national budgets. However, the standard health utility assessment scores for specific health conditions are largely unknown.
AIM To summarize the health utility scores, including the EuroQOL 5-dimensions 5-levels (EQ-5D-5L), EuroQol-visual analogue scale, short from-36 (SF-36), RAND-36, and Health Utilities Index (HUI)-Mark2/Mark3 scores, for the normal population and chronic liver disease patients.
METHODS A systematic literature search of PubMed and MEDLINE, including the Cochrane Library, was performed. Meta-analysis was performed using the RevMan software. Multiple means and standard deviations were combined using the StatsToDo online web program.
RESULTS The EQ-5D-5L and SF-36 can be used for health utility evaluations during antiviral therapy for hepatitis C. HUI-Mark2/Mark3 indicated that the health utility scores of hepatitis B patients are roughly 30% better than those of hepatitis C patients.
CONCLUSION The EQ-5D-5L is the most popular questionnaire for health utility assessments. Health assessments that allow free registration would be useful for evaluating health utility in patients with liver disease.
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Affiliation(s)
- Tomohiro Ishinuki
- Department of Nursing, Surgical Sciences, Sapporo Medical University, Sapporo 0608556, Japan
| | - Shigenori Ota
- Departments of Surgery, Surgical Science and Oncology, Sapporo Medical University, Sapporo 0608543, Japan
| | - Kohei Harada
- Department of Radiology, Sapporo Medical University, Sapporo 0608543, Japan
| | - Masaki Kawamoto
- Departments of Surgery, Nemuro City Hospital, Nemuro 0870008, Japan
| | - Makoto Meguro
- Departments of Surgery, Sapporo Satozuka Hospital, Sapporo 0040811, Japan
| | - Goro Kutomi
- Departments of Surgery, Surgical Science and Oncology, Sapporo Medical University, Sapporo 0608543, Japan
| | - Hiroomi Tatsumi
- Department of Intensive Care Medicine, Sapporo Medical University, Sapporo 0608543, Japan
| | - Keisuke Harada
- Department of Emergency Medicine, Sapporo Medical University, Sapporo 0608543, Japan
| | - Koji Miyanishi
- Department of Medical Oncology, Sapporo Medical University, Sapporo 0608543, Japan
| | - Toru Kato
- Departments of Surgery, Surgical Science and Oncology, Sapporo Medical University, Sapporo 0608543, Japan
| | - Toshio Ohyanagi
- Department of Liberal Arts and Sciences, Center for Medical Education, Sapporo Medical University, Sapporo 0608556, Japan
| | - Thomas T Hui
- Departments of Surgery, Stanford University School of Medicine, Stanford, 94598, United States
| | - Toru Mizuguchi
- Department of Nursing, Surgical Sciences, Sapporo Medical University, Sapporo 0608556, Japan
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Relationship Between Cardiovascular Disease Risk Factors and Quality of Life in Patients with Metabolic-Associated Fatty Liver Disease. HEPATITIS MONTHLY 2022. [DOI: 10.5812/hepatmon-124229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Background: Metabolic-associated fatty liver disease (MAFLD) is a common cause of liver-related mortality and morbidity worldwide. However, there is a paucity of literature on the relationship between cardiovascular disease (CVD) risk factors and quality of life (QoL) in patients with MAFLD. Objectives: This study aimed to examine the association between QoL and CVD risk factors in an Iranian MAFLD population. Methods: This study was conducted on MAFLD patients, referred to the gastroenterology clinic of a general hospital from September 2017 until September 2018. The QoL and Framingham Risk Score (FRS) were determined using the WHOQOL-BREF questionnaire and an online web calculator, respectively. A hierarchical multiple linear regression model was developed to evaluate the association between QoL and FRS after adjusting for the sociodemographic characteristics. Results: This study was performed on 200 participants. All domains of QoL were associated with older age, hypertension, smoking, diabetes mellitus, higher systolic blood pressure, and lower high-density lipoprotein levels in the univariate regression analysis (P < 0.05 for all). Meanwhile, FRS was adversely correlated with the total QoL score (correlation coefficient: -0.49; 95% CI: -0.61, -0.35; P < 0.001). After adjusting for the sociodemographic variables, the results of the hierarchical multiple linear regression model showed that age, smoking, diabetes mellitus, hypertension, and FRS were correlated with the overall QoL score (P < 0.05 for all). Hypertension was the main predictor of the total QoL score (B = -5.51, 95% CI: -7.18, -3.68; P < 0.05). A higher FRS was inversely associated with the physical domain of QoL (B = -0.05, 95% CI: -0.09, -0.01; P < 0.05), the environment domain of QoL (B = -0.04, 95% CI: -0.09, -0.01; P < 0.05), and the total score of QoL (B = -0.04, 95% CI: -0.08, -0.02; P < 0.05). Conclusions: According to the results of this study, a higher risk of developing CVD may reduce QoL in patients with MAFLD. Hypertension, diabetes mellitus, and smoking were the key predictive determinants of QoL in this population. Further studies are suggested to determine if modification of the mentioned risk factors can improve QoL in MAFLD patients.
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Chantakeeree C, Sormunen M, Estola M, Jullamate P, Turunen H. Factors Affecting Quality of Life among Older Adults with Hypertension in Urban and Rural Areas in Thailand: A Cross-Sectional Study. Int J Aging Hum Dev 2021; 95:222-244. [PMID: 34931879 PMCID: PMC9316351 DOI: 10.1177/00914150211050880] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study explored factors affecting quality of life in older adults with
hypertension by comparing those living in urban and rural areas. A
cross-sectional study was conducted on 420 older adults living in urban and
rural areas in Thailand. Data were collected using the WHOQOL-OLD and
Health-Promoting Lifestyle Profile-II tools, which measured quality of life and
health-promoting behaviors among the participants. Older adults in urban areas
had higher quality of life scores than those in rural locations.
Health-promoting behaviors significantly predicted higher quality of life for
all residents. A high perceived health status predicted increase of quality of
life in urban residents, whereas the presence of comorbidity effects decreased
quality of life. A longer hypertension duration predicted higher quality of life
in rural residents. These findings suggest that healthy behaviors and
self-management interventions are critical to improve quality of life in older
Thai adults with hypertension.
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Affiliation(s)
- Chonticha Chantakeeree
- Department of Nursing Science, Faculty of Health Sciences, 101232University of Eastern Finland, Box 1627, 70211, Kuopio, Finland.,Gerontological Nursing Division, Faculty of Nursing, 37688Burapha University, 169 Long-Hard Bangsaen Road, Tambon Saensook, Amphur Muang, Chonburi, 20131, Thailand
| | - Marjorita Sormunen
- Institute of Public Health and Clinical Nutrition, Department of Medicine, Faculty of Health Sciences, 205537University of Eastern Finland, Box 1627, 70211, Kuopio, Finland
| | - Matti Estola
- Faculty of Social Sciences (Joensuu Campus), 122208University of Eastern Finland, Box 111, 80101, Joensuu, Finland
| | - Pornchai Jullamate
- Gerontological Nursing Division, Faculty of Nursing, 37688Burapha University, 169 Long-Hard Bangsaen Road, Tambon Saensook, Amphur Muang, Chonburi, 20131, Thailand
| | - Hannele Turunen
- Department of Nursing Science, Faculty of Health Sciences, 101232University of Eastern Finland, Box 1627, 70211, Kuopio, Finland.,60650Kuopio University Hospital, Box 100, 70029 KYS
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Elsa LP, Justo G, Blanca L. Patient's awareness on COPD is the strongest predictor of persistence and adherence in treatment-naïve patients in real life: a prospective cohort study. BMC Pulm Med 2021; 21:388. [PMID: 34837978 PMCID: PMC8627039 DOI: 10.1186/s12890-021-01754-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is little evidence about the factors that predict persistence/adherence in treatment-naïve patients with COPD in clinical practice. The aim of this study was to evaluate persistence and adherence levels among treatment-naïve patients diagnosed with COPD who had a prescribed inhaled medication, using data from real-world clinical practice. METHODS Multicentric study with a 6 month-followed-up period. Patients were considered persistent if they collected all their inhaler refills. In a random sample of patients, we evaluated adherence using the Test of Adherence to Inhalers (TAI). We assessed Health Related Quality of Life (HRQL) with St George's Respiratory Questionnaire (SGRQ). RESULTS Of the 114 patients included, 46 (40.4%) were defined as persistent. Patients who had awareness about COPD (adjusted RR 2.672, 95% CI 1.125-6.349) were more likely to be persistent; patients with multidose DPI were less likely to be persistent that those with single dose DPI (adjusted RR 0.341, 95% CI 0.133-0.877). Higher levels of SGRQ total were associated with a lower probability of persistence (adjusted RR 0.945, 95%CI 0.894-0.998). Patients who had had an appointment with their GP in the previous six months were more likely to be persistent (adjusted RR 3.107, 95% CI 1.022-9.466). Patients who had awareness about COPD and those with lower symptom SGQR score were more likely to be adherent (24/25, 96.0% vs 16/22, 72.7%, p = 0.025, and mean 29.1, sd 19.4 vs mean 41.4, sd 15.9, respectively, p = 0.026, respectively). CONCLUSIONS Less than 50% of patients were defined as persistent. Patients' awareness of their disease and levels of HRQL were associated with high rate of persistence and adherence. In addition, frequent visits to general practitioner, increases the rate of persistence to treatment.
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Affiliation(s)
- López-Pintor Elsa
- Department of Engineering, Area of Pharmacy and Pharmaceutical Technologies, Miguel Hernández University, Crtra Alicante-Valencia km 81, Sant Joan d'Alacant, 03550, Alicante, Spain.,CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Grau Justo
- Pneumology Department, General Hospital of Elche, Alicante, Spain
| | - Lumbreras Blanca
- CIBER en Epidemiología y Salud Pública, Madrid, Spain. .,Department of Public Health History of Science and Gynaecology, Miguel Hernández University, Crtra Alicante-Valencia km 81, Sant Joan d'Alacant, 03550, Alicante, Spain.
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13
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Suhail M, Saeed H, Saleem Z, Younas S, Hashmi FK, Rasool F, Islam M, Imran I. Association of health literacy and medication adherence with health-related quality of life (HRQoL) in patients with ischemic heart disease. Health Qual Life Outcomes 2021; 19:118. [PMID: 33849547 PMCID: PMC8045399 DOI: 10.1186/s12955-021-01761-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 04/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medication Adherence (MA) and Health Related Quality of Life (HRQoL) are two inter-connected concepts, co-influenced by Health Literacy (HL), with significant impact on patient management and care. Thus, we aimed to estimate the association of HL and MA with HRQoL in IHD patients. METHODS Cross-sectional study of 251 IHD patients recruited from Lahore over 6 months period. HL, MA and HRQoL was assessed using validated questionnaires; 16-items of HL, Morisky Green Levine Scale (MGLS) and SF-12, respectively. Chi-square for significance, logistic-regression for association and linear regression for predictions were used. RESULTS IHD patients; males (p = 0.0001), having secondary-higher education (p = 0.0001), middle/upper class (p = 0.0001) and employed (p = 0.005) had adequate HL, and were more likely to be adherent (OR; 4.3, p = 0.014). Both physical (PCS-12) and mental (MCS-12) component scores of HRQoL for age, gender, education, area of residence, employment and MA were significantly higher in patients with adequate HL. In multinomial regression, improved PCS-12 scores tend to be higher in subjects having secondary-higher education (OR; 3.5, p = 0.067), employed (OR; 6.1, p = 0.002) and adherent (OR; 2.95, p = 0.218), while MCS-12 scores tend to be higher in patients < 65 years (OR; 2.2, p = 0.032), employed (OR; 3, p = 0.002) and adherent (OR; 4, p = 0.004). In adjusted model, HL (β;0.383, p = 0.0001) and MA (β; - 0.133, p = 0.018) were significantly associated with PCS-12, and MCS-12 with MA (β; - 0.161, p = 0.009) only. CONCLUSION Data suggested that adequate HL was significantly associated with adherence and both physical and mental dimensions of HRQoL were higher in IHD patients with adequate HL. Besides, HL and MA are independent predictors of HRQoL in IHD patients.
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Affiliation(s)
- Muzna Suhail
- Department of Pharmaceutics, University College of Pharmacy, Universality of the Punjab, Allama Iqbal Campus, Lahore, 54000 Pakistan
| | - Hamid Saeed
- Department of Pharmaceutics, University College of Pharmacy, Universality of the Punjab, Allama Iqbal Campus, Lahore, 54000 Pakistan
| | - Zikria Saleem
- Department of Pharmacy, The University of Lahore, Lahore, Pakistan
| | - Saman Younas
- Department of Pharmaceutics, University College of Pharmacy, Universality of the Punjab, Allama Iqbal Campus, Lahore, 54000 Pakistan
| | - Furqan Khurshid Hashmi
- Department of Pharmaceutics, University College of Pharmacy, Universality of the Punjab, Allama Iqbal Campus, Lahore, 54000 Pakistan
| | - Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | - Muhammad Islam
- Department of Pharmaceutics, University College of Pharmacy, Universality of the Punjab, Allama Iqbal Campus, Lahore, 54000 Pakistan
| | - Imran Imran
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
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Peacock E, Joyce C, Craig LS, Lenane Z, Holt EW, Muntner P, Krousel-Wood M. Low medication adherence is associated with decline in health-related quality of life: results of a longitudinal analysis among older women and men with hypertension. J Hypertens 2021; 39:153-161. [PMID: 32675745 PMCID: PMC7752228 DOI: 10.1097/hjh.0000000000002590] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/16/2020] [Accepted: 06/21/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The aim of this study was to determine the association of low antihypertensive medication adherence with decline in health-related quality of life (HRQOL) over 1 year. METHODS We used data from older men and women with hypertension (n = 1525) enrolled in the Cohort Study of Medication Adherence among Older Adults. Adherence was measured using the validated self-report four-item Krousel-Wood Medication Adherence Scale (K-Wood-MAS-4) (low adherence = score ≥1) and prescription refill-based proportion of days covered (PDC) (low adherence = PDC < 0.80). We defined decline in HRQOL as a decrease in Mental Component Summary (MCS) or Physical Component Summary (PCS) score (from the RAND 36-Item Health Survey 1.0 administered at two time points - at the time of adherence assessment and 1 year later) equivalent to the minimal important difference (MID) for each respective summary score, calculated as the average of MID estimates derived from distribution and anchor-based approaches. RESULTS The prevalence of low adherence was 38.6% using the K-Wood-MAS-4 and 23.9% using PDC. On the basis of mean MID estimates of 4.40 for MCS and 5.16 for PCS, 21.8 and 25.2% of participants experienced a decline in MCS and PCS, respectively, over 1 year. Low adherence was associated with a decline in MCS for K-Wood-MAS-4 [prevalence ratio = 1.32, 95% confidence interval (95% CI) 1.08-1.62, P = 0.008], but not PDC (prevalence ratio = 1.17, 95% CI 0.94-1.47, P = 0.168). Low adherence was not associated with decline in PCS (K-Wood-MAS-4: prevalence ratio = 0.95, 95% CI 0.79-1.16; PDC: prevalence ratio = 1.10, 95% CI 0.90-1.35). CONCLUSION Low self-report medication adherence is associated with decline in mental HRQOL over 1 year in older adults with hypertension.
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Affiliation(s)
- Erin Peacock
- Tulane University School of Medicine, New Orleans, Louisiana
| | - Cara Joyce
- Loyola University Stritch School of Medicine, Chicago, Illinois
| | - Leslie S. Craig
- Tulane University School of Medicine, New Orleans, Louisiana
| | - Zachary Lenane
- San Mateo County Behavioral Health and Recovery Services, San Mateo, California
| | | | - Paul Muntner
- University of Alabama at Birmingham School of Public Health, Birmingham, Alabama
| | - Marie Krousel-Wood
- Tulane University School of Medicine, New Orleans, Louisiana
- Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
- Ochsner Health System, New Orleans, Louisiana, USA
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15
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Quality of Life of Patients with Arterial Hypertension. ACTA ACUST UNITED AC 2020; 56:medicina56090459. [PMID: 32916933 PMCID: PMC7559811 DOI: 10.3390/medicina56090459] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 12/19/2022]
Abstract
Symptoms of hypertension with accompanying complications result in a significant reduction in patients' quality of life. Effective conduct of prescribed pharmacotherapy supported by a healthy lifestyle allows to achieve satisfactory effects of treatment, which translates into an improvement in the quality of life of patients. The aim of the work was to determine the quality of life of patients with hypertension and the factors affecting it. The study included 100 people with hypertension, who are patients of the department of internal diseases of the hospital in Hajnówka during the period 1.6.2019-1.12.2019. The questionnaire survey, the standardized WHO Quality of Life (WHOQOL)-BREF scale and the Barthel scale were the research tools. The probability p < 0.05 was assumed as the level of statistical significance. The study group consisted of subjects between 30-89 years old. The majority were men and those living in the city. The average BMI (body mass index) of the subjects was 28.4 kg/m2. The duration of the disease among those surveyed was on average 7 ± 6.34 years. The highest-rated area of quality of life was the physical field and the lowest social sphere according to the WHOQOL-BREF questionnaire. Patients with hypertension have determined their quality of life at a good or medium level in the physical, psychological, social, and environmental sphere. There are many factors that improve quality of life in all areas. These include following the recommendations on modifiable risk factors.
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16
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Wong ELY, Xu RH, Cheung AWL. Health-related quality of life in elderly people with hypertension and the estimation of minimally important difference using EQ-5D-5L in Hong Kong SAR, China. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2020; 21:869-879. [PMID: 32242296 DOI: 10.1007/s10198-020-01178-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/10/2020] [Indexed: 05/15/2023]
Abstract
OBJECTIVE This study examined health-related quality of life (HRQoL) in elderly patients with hypertension in Hong Kong (HK) by using EQ-5D-5L and estimated the minimally important difference (MID) of the EQ-5D-5L index score for this population. METHOD We analysed secondary data from a population-based cross-sectional patient experience survey in HK. The EQ-5D-5L HK version was used to assess patients' HRQoL. The mean EQ-5D index scores for different subgroups were evaluated by ANOVA. Tobit regression models were used to investigate the relationship between hypertension and HRQoL. An instrument-defined approach was adopted to estimate the MID of the EQ-5D-5L index score. RESULT A total of 3,351 patients' records met the selection criteria and were used in this study for our analysis. The mean age was 72.74 years, and 54.97% of respondents were female. The mean EQ-5D index score was 0.83. Most of the respondents (83.36%) reported having no problem with self-care. The Tobit regression model indicated that an increasing number of chronic conditions co-morbidity with hypertension contribute to a decrease in the EQ-5D index score. The overall MID estimate of the EQ-5D index score was 0.0917 and the adjusted MID was 0.0715. The MID estimates varied among respondents of different sexes and ages. CONCLUSION The HRQoL and MID estimate of EQ-5D for elderly individuals with hypertension was reported, which provide valuable information for assisting health-care professionals in making clinical decisions in hypertensive care.
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Affiliation(s)
- Eliza Lai Yi Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Richard Huan Xu
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Annie Wai Ling Cheung
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Schulz M, Griese-Mammen N, Schumacher PM, Anker SD, Koehler F, Ruckes C, Rettig-Ewen V, Wachter R, Trenk D, Böhm M, Laufs U. The impact of pharmacist/physician care on quality of life in elderly heart failure patients: results of the PHARM-CHF randomized controlled trial. ESC Heart Fail 2020; 7:3310-3319. [PMID: 32700409 PMCID: PMC7754956 DOI: 10.1002/ehf2.12904] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/10/2020] [Accepted: 07/13/2020] [Indexed: 01/12/2023] Open
Abstract
Aims Patients with heart failure (HF) have impaired quality of life (QoL). The randomized controlled trial PHARM‐CHF investigated whether an interdisciplinary intervention consisting of regular contacts with the community pharmacy and weekly dosing aids improves medication adherence in patients with HF. It is unknown how an intervention involving frequent structured pharmacy visits affects QoL. Our aim was to explore adherence to the intervention and effects on QoL. Methods and results Among 237 patients, n = 110 were randomized to pharmacy care and n = 127 to usual care. The pharmacy care group received a medication review followed by (bi‐)weekly dose dispensing and counselling. The median follow‐up was 2.0 years [inter‐quartile range (IQR) 1.2–2.7]. Median interval between pharmacy visits was 8.4 days (IQR 8.0–10.3) and the visits lasted in median 14 min (IQR 10–15). Median adherence to the intervention was 96% (IQR 84–100). QoL at 365 days was predefined as a main secondary and at 730 days as another secondary endpoint in PHARM‐CHF. QoL was measured by the Minnesota Living with Heart Failure Questionnaire; and for 111 patients (n = 47 in the pharmacy care group and n = 64 in the usual care group), data were available at baseline, and after 365 and 730 days (mean age 74 years; 41% female). Improvement in QoL was numerically higher in the pharmacy care group after 365 days and was significantly better after 730 days (difference in total scores −7.7 points [−14.5 to −1.0]; P = 0.026) compared to the usual care group. In all subgroups examined, this treatment effect was preserved. Improvements in the physical and emotional dimensions were numerically higher in the pharmacy care group after 365 days and were significantly better after 730 days: −4.0 points [−6.9 to −1.2]; P = 0.006, and −1.9 points [−3.7 to −0.1]; P = 0.039, respectively. Conclusions A pharmacy‐based interdisciplinary intervention was well received by the patients and suggests clinically important improvements in QoL.
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Affiliation(s)
- Martin Schulz
- Department of Medicine, ABDA - Federal Union of German Associations of Pharmacists, Berlin, Germany.,Institute of Pharmacy, Freie Universität Berlin, Berlin, Germany
| | - Nina Griese-Mammen
- Department of Medicine, ABDA - Federal Union of German Associations of Pharmacists, Berlin, Germany
| | - Pia M Schumacher
- Department of Medicine, ABDA - Federal Union of German Associations of Pharmacists, Berlin, Germany
| | - Stefan D Anker
- Division of Cardiology and Metabolism, Department of Cardiology (CVK) and Berlin-Brandenburg Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) Partner Site Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Friedrich Koehler
- Centre for Cardiovascular Telemedicine, Department of Cardiology and Angiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Ruckes
- Interdisciplinary Centre for Clinical Trials, University Medical Centre Mainz, Mainz, Germany
| | | | - Rolf Wachter
- Department of Cardiology, University Hospital, Leipzig University, Leipzig, Germany
| | - Dietmar Trenk
- Department of Clinical Pharmacology, University Heart Centre Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | - Michael Böhm
- Department of Internal Medicine III - Cardiology, Angiology and Intensive Care Medicine, University Hospital of Saarland, Saarland University, Homburg/Saar, Germany
| | - Ulrich Laufs
- Department of Cardiology, University Hospital, Leipzig University, Leipzig, Germany
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The impact of adverse events on health-related quality of life among patients receiving treatment for drug-resistant tuberculosis in Johannesburg, South Africa. Health Qual Life Outcomes 2019; 17:94. [PMID: 31151398 PMCID: PMC6545023 DOI: 10.1186/s12955-019-1155-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/07/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adverse events (AEs) are common during treatment of drug-resistant tuberculosis (DR-TB). Little is known about the health-related quality of life (HRQoL) of patients receiving treatment for DR-TB or the effect of AEs on HRQoL. METHODS We conducted a cross-sectional study among adult patients with laboratory-confirmed rifampicin resistant tuberculosis (TB) on DR-TB treatment at a public-sector outpatient DR-TB clinic in Johannesburg, South Africa between 02/2015-01/2018. Data on HRQoL using the Medical Outcomes Short Form-36 (SF-36) questionnaire and self-reported AEs were collected by trained interviewers through face-to-face interviews. We report averages for the eight major domains and mental (MCS) and physical health (PCS) component summary scores, stratified by whether AEs were reported in the last four weeks. For comparative purposes, we enrolled two other patient groups and included data on a separate group of healthy adults. RESULTS We enrolled 149 DR-TB patients (median age 36 years IQR 29-43, 55% male, 77.9% HIV-positive, 81% on ART, 61.8% on a standard long-course regimen and 44.3% on DR-TB treatment for less than 6 months). 58/149 (38.9%) patients reported a total of 122 AEs in the preceding 4 weeks, of these the most common were joint pain (n = 22), peripheral neuropathy (n = 16), hearing loss (n = 15), nausea and vomiting (n = 12) and dizziness or vertigo (n = 11). SF-36 domains and summary scores (MCS and PCS) were lower in those who reported an AE compared to those who did not, and both were lower than healthy adults. Compared to those who did not report an AE, patients who reported AEs were more likely to have a low MCS (aRR 2.24 95% CI 1.53-3.27) and PCS (aRR 1.52 95% CI 1.07-2.18) summary score. HRQoL was lower among those on DR-TB treatment for 6 months or less. CONCLUSION Results show that DR-TB had a substantial impact on patients' quality of life, but that AEs during the early months on treatment may be responsible for reducing HRQoL even further. Our findings highlight the negative effects of injectable agents on HRQoL. Patients require an integrative patient-centered approach to deal with DR-TB and HIV and the potential overlapping toxicities which may be worsened by concurrent treatment.
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