Impact of Smoking on Health-Related Quality of Life: A General Population Survey in West Iran

Impact of smoking status on health-related quality of life (HRQoL) in cancer survivors

Introduction

The Health-Related Quality of Life (HRQoL) often declines among cancer survivors due to many factors. Some cancer patients who smoke before the cancer diagnosis continue this harmful habit, potentially contributing to a more significant decline in their HRQoL. Therefore, this study investigates the association between smoking status and HRQoL in cancer survivors.

Methods

We conducted a cross-sectional study utilizing self-reported cancer history from 39,578 participants of the Behavioral Risk Factor Surveillance System (BRFSS) database, leveraging 2016 and 2020 year questionaries. A multidimensional composite outcome was created to assess HRQoL, integrating four distinct dimensions - general health, mental health, physical health, and activity limitations. After accounting for the complex survey design, logistic regression models were used to analyze the association between smoking status and poor HRQoL, adjusting for demographic, socioeconomic, and health-related confounders.

Results

Our study found that, after adjusting for potential confounders, current smokers exhibited a significantly poorer HRQoL than never smokers (OR 1.65, 95%CI 1.40-1.93). Furthermore, former smokers showed a poorer HRQoL than never smokers; however, this association was not as strong as current smokers (OR 1.22, 95%CI 1.09-1.38).

Conclusion

Our findings highlight the adverse association of smoking with poor HRQoL in cancer survivors, underscoring the importance of healthcare professionals prioritizing smoking cessation and providing tailored interventions to support this goal.

The effect of exercise on health-related quality of life in persons with musculoskeletal pain: A meta-analysis of randomised control trials

OBJECTIVES

Exercise has positive effects on musculoskeletal pain. In this project, the impact of exercise was studied on improving health-related quality of life in persons with musculoskeletal pain.

METHOD

The study design was a systematic review and meta-analysis. A search was conducted to find original studies in four sources, including PubMed, Web of Science, the Cochrane Library and Scopus, and this search was limited to the original articles published until April 2021, which were in English. For each study, the effect size was calculated. The analysis was based on the random-effects method.

RESULT

Twenty-Seven randomised control trial studies were included in the meta-analysis. The total population of participants in the meta-analysis was 1927 persons. Exercise improves health-related quality of life in these persons and the hedges' g was 0.66 (95% CI = 0.38-0.94; I²  = 88.29%).

DISCUSSION

Overall, based on the findings, exercise is associated with improving the health-related quality of life of persons with musculoskeletal pain, and therefore the health implications of this finding are beneficial to the general population and professionals.

Impact of Hospitalization on the Quality of Life of Patients with Chronic Kidney Disease in Saudi Arabia

Chronic kidney disease (CKD) is a global health problem. CKD causes patients to be hospitalized for a longer time to treat the disease. The impact of the hospitalization brings major changes and affects the quality of life (QoL) of the patients. In this study, we aimed to evaluate the impact of hospitalization on the QoL of patients with CKD. A cross-sectional study was conducted at the inpatient departments (IPDs) and outpatient departments (OPDs) of selected hospitals, in the eastern region of Saudi Arabia. The kidney disease quality of life (KDQOL) scale was used for the data collection and the findings were analyzed. The hospitalized patients had a poorer QoL than the OPD patients. The physical component summary (PCS) and mental component summary (MCS) mean scores were 52.82 ± 2.32 and 52.57 ± 2.93 in IPD patients, respectively, and 63.46 ± 3.65 and 66.39 ± 0.91 in OPD patients, respectively, which was significant (p < 0.0001). The QoL of patients decreased in the end stages of CKD. A significant association was observed between gender, occupation, smoking, and the stages of CKD with the QoL of the hospitalized patients. Measures must be taken to improve the QoL of these patients at all levels.

Socioeconomic status and self-rated health in Iran: findings from a general population study

Background

There are large gaps in health and well-being among different groups of the society. Socioeconomic factors play a significant role in determining the health status of the society. The present study was conducted to examine socioeconomic inequality in health status among the adult population of Khorramabad city, the capital of Lorestan province, wester part of Iran.

Methods

A cross-sectional study was conducted on 1348 participants selected through multistage sampling. A valid and reliable questionnaire was used for data collection. The wealth index as an indicator of the socioeconomic status (SES) was used to categorize the subjects in terms of the SES. The concentration index and concentration curve was used to measure socioeconomic inequity in poor self-rated health (SRH) of population. Finally, after determine the status of inequity in poor SRH, a decomposition analysis approach was used to identify the most important determinants of this inequity.

Results

The prevalence of poor SRH was 18.91% in all subjects, 38.52% in the lowest SES group, and 11.15% in the highest SES group. The value of the concentration index for poor SRH was − 0.3243 (95% CI − 0.3996 to − 0.2490), indicating that poor SRH was more concentrated among the poor. The results of decomposition analysis showed that SES (41.2%), higher body mass index (28.6%) and lack of physical activity (26.9%) were the most important factors associated with the concentration of poor SRH in the poor groups.

Conclusion

Identification of socioeconomic factors affecting on health status is the first step for proper policymaking. Policymakers and health system managers at the national and subnational levels can use the results of this study as well as other similar domestic studies to design and implement proper interventions to promote equity and improve the health status of population.

Home medication management problems and associated factors among psychiatric patients using home care pharmacy services at government hospitals in western Malaysia

Background

Proper home medication management plays a role in improving medication adherence, preserving drug efficacy and ensuring safe medication practices, which is crucial to establish positive treatment outcomes. However, no published studies are available on home medication management among psychiatric patients. The study aimed to identify home medication management problems among psychiatric patients in Malaysia and to examine the associations of inappropriate medication storage and lack of a medication administration schedule with sociodemographic factors, disease insight, number of medications and type of home care pharmacy services (HCPS).

Methods

This multicentre cross-sectional study was conducted among psychiatric patients using HCPS in six government hospitals in western Malaysia. Data were extracted from the HCPS form used for each visit as per the protocol published by the Pharmaceutical Services Division, Ministry of Health Malaysia. A minimum sample size of 169 was needed. Proportional random sampling was applied. The associations of inappropriate medication storage and lack of medication administration schedule with study parameters were analysed using multiple logistic regressions.

Results

A total of 205 home visits were conducted with 229 home medication management problems identified; inappropriate medication storage and lack of medication administration schedule topped the list. Inappropriate medication storage was significantly associated with low income [AOR = 4.34 (95% CI 1.17:15.98), p = 0.027], alcohol consumption [AOR = 14.26 (95% CI 1.82:111.38), p = 0.011], poor insight [AOR = 2.34 (95% CI 1.08:5.06), p = 0.030] and part-time HCPS [AOR = 2.60 (95% CI 1.20:5.67), p = 0.016]. Lack of administration schedule was significantly associated with low income [AOR = 6.90 (95% CI 1.46:32.48), p = 0.014], smoking [AOR = 2.43 (95% CI 1.20:4.92), p = 0.013], poor insight [AOR = 5.32 (95% CI 2.45:11.56), p < 0.05] and part-time HCPS [AOR = 2.96 (95% CI 1.42:6.15), p = 0.004].

Conclusions

Inappropriate medication storage and a lack of a medication administration schedule are common among psychiatric patients. The study also highlighted the potential of HCPS to improve disease insight and home medication management among psychiatric patients if the service is utilized fully.

Efficacy of Vernonia cinerea (L) Less for smoking cessation: An updated meta-analysis of randomized controlled trials

Vernonia cinerea (VC) has been used for smoking cessation. A previous meta-analysis (MA) reported the efficacy of VC in smoking cessation. However, there have been updated randomized controlled trials (RCTs) on the efficacy of VC for smoking cessation, and the previous MA lacked pooled adverse events (AEs) related to VC. The objective of this study was to systematically review and perform an updated MA on the efficacy of VC for smoking cessation continuous abstinence rate (CAR), prevalence abstinence (PAR), and AE. The research articles were retrieved via electronic databases including PubMed, Science Direct, Web of Science, Thai-Journal Citation Index Center (TCI), and ThaiLis. Ten RCTs published prior to 2019 were included in this study. The number of participants in the studies ranged from 35 to 172, and the follow-up duration for the primary outcomes was 2-12 weeks. Our updated MA found that VC could significantly improve CAR2 (RR=1.54; 95% CI = 1.06, 2.23), CAR4 (RR=1.65; 95% CI = 1.25, 2.17), CAR 8 (RR=1.85; 95% CI = 1.25, 2.75), CAR12 (RR=2.56; 95% CI = 1.66, 3.95), and CAR16 (RR=2.21; 95% CI = 1.03, 4.73). Moreover, VC improved PAR2 (RR=1.47; 95% CI = 1.06, 2.04), PAR4 (RR=1.35; 95% CI = 1.02, 1.79), PAR8 (RR=1.60; 95% CI = 1.11, 2.31), and PAR12 (RR=1.70; 95% CI = 1.25, 2.30). There was no significant difference in the AE between the two groups. The study substantiates claims that VC products are effective in assisting with smoking cessation.

Associations between perceived environmental pollution and health-related quality of life in a Chinese adult population

BACKGROUND

Health-related quality of life (HRQoL) measures are being used in increasingly diverse populations. However, there have no known studies to date to examine the associations between perceived environmental pollution and HRQoL in a Chinese population. This study aimed to report the associations between air, water, noise pollution and HRQoL among Chinese adult population.

METHODS

A cross-sectional survey data was used from East Asian Social Survey 2010 with a sample of 3866 Chinese populations regarding environmental pollution. HRQoL was computed by SF-12 and reflected by physical and mental component summary score (PCS & MCS). Ordinary least regression analyses were used to examine associations between perceived environmental pollution and PCS and MCS scores. Models in SPSS PROCESS were selected to demonstrate the moderating and mediating effects.

RESULTS

Only considering one pollutant, perceived air pollution and perceived water pollution had significant associations with PCS and MCS scores. Perceived noise pollution had significant associations with PCS scores. Perceived air×noise, air×water, noise×water, and air×noise×water pollution had significant associations with PCS and MCS scores. Conditional (moderated) mediation showed that there were no moderating effects and mediating effects of perceived one pollutant on another pollutant.

CONCLUSIONS

Co-occurring perceived environmental pollution were mainly associated with progressive increase in PCS and MCS scores among the Chinese adult population. These results suggested that some effective policies should be carried out to improve environmental quality in Chinese adult population.

Comparison of Detection of Epidermal Growth Factor Receptor (EFGR) Gene Mutation in Peripheral Blood Plasma (Liquid Biopsy) with Cytological Specimens in Lung Adenocarcinoma Patients

The ctDNA plasma testing is one of the methods to examine biomarkers for lung adenocarcinoma in order to detect a mutation of epidermal growth factor receptor (EGFR) gene. The advantages of ctDNA testing over tissue biopsy and lung tumor cytology include less invasive, faster result, cheaper, and minimum risk of complication for the patient. We analyzed and compare the detection of EFGR mutation in peripheral blood plasma (liquid biopsy) with cytological specimens of patients with lung adenocarcinoma. We conducted ctDNA plasma testing in 124 lung adenocarcinoma patients who visited our hospital from January to December 2018. The ctDNA testing results were compared with the results of EGFR detection from the previous cytological specimen examination. Most of the patients were males, aged 55-59 years, nonsmokers, and had stage IVA lung adenocarcinoma, with most metastasis found in the pleura. We found a correlation between EGFR prevalence with nonsmoking status and patient's age. The ctDNA plasma testing detected 27.4% common EGFR mutation and 72.6% wild-type EGFR. The figures of EGFR mutation detection from cytological specimens were 47.6% and 52.4%, respectively. Compared to cytological specimens, the EGFR mutation detection in ctDNA had a sensitivity of 48.3%, with a specificity of 90.9%, PPV of 82.35%, NPV of 66.7%, and 70.97% concordance rate. EGFR mutation with cytological specimen examination was more accurate than ctDNA.

Socioeconomic Inequalities in Poor Health-Related Quality of Life in Kermanshah, Western Iran: A Decomposition Analysis

Background: Socioeconomic status (SES) is an important determinant of health-related quality of life (HRQoL). We aimed to quantify socioeconomic-related inequality in poor-HRQoL among adults in Kermanshah, western Iran.

Study design: A cross-sectional study.

Methods: Overall, 1730 adults (18-65 yr) were selected using convenience sampling from Kermanshah, Iran. A self-administrated questionnaire was used to collect data on socio-demographic characteristics, SES, lifestyle factors and HRQoL of participants over the period between May and Aug 2017. The concentration curve and concentration index (C) were used to illustrate and measure wealth-related inequality in poor-HRQoL. Additionally, we decomposed the C index to identify factors explaining wealthrelated inequality in poor-HRQoL.

Results: The overall prevalence of poor-HRQoL was 35.3% (95% confidence interval[CI]: 33.1%, 37.6%). The poor-HRQoL was mainly concentrated among the poor adults (C=-0.256, 95% CI: -0.325, -0.187). Poor-HRQoL was concentrated among men (C=-0.256, 95% CI: -0.345, -0.177) and women (C=-0.261, 95% CI: -0.310, -0.204). Wealth, physical inactivity, the presence of chronic health condition(s), lack of health insurance coverage were the main factors contributing to the concentration of poor-HRQoL among socioeconomically disadvantaged adults.

Conclusions: Socioeconomic-related inequalities in poor-HRQoL among adult should warrant more attention. Policies should be designed to not only improve HRQoL among adults but also reduce the prorich distribution of HRQoL among adults in Kermanshah.