Health-related quality of life and treatment satisfaction of patients with cardiovascular disease in Ethiopia

Evaluating health-related quality of life in Ethiopia: protocol for systematic review and meta-analysis of EQ-5D-based studies

INTRODUCTION

Understanding the broad aspect of health-related quality of life (HRQoL) is essential to knowing how health problems affect individuals' overall well-being. Evaluating HRQoL is very important in Ethiopia's diverse healthcare setting. This protocol describes a meta-analysis and systematic review that uses the EQ-5D instrument to examine HRQoL in Ethiopia.

METHODS

The study will follow Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines, conducting a systematic literature search across PubMed, Web of Science, Embase, Cochrane library and Scopus using keywords like 'quality of life', 'QoL', 'health-related quality of life', 'HRQoL', 'EQ-5D', 'EQ-5D-3L', 'EQ-5D-5L', 'EuroQol', 'five dimensions' and/or 'Ethiopia'. The STATA will be used to pool the mean EQ-5D utility and EQ-VAS scores for a specific disease using the random-effect (Der Simonian-Laird estimator method) and fixed-effect (inverse variance method) models. The quality assessment tool for observational cohort and cross-sectional studies developed by the National Heart, Lung and Blood Institute will be used for quality assessment.

ETHICS AND DISSEMINATION

Publicly accessible previously published articles will be included in the research. Therefore, doing this study does not require ethical approval. The protocol offers transparency and adherence to research standards because it is registered on PROSPERO (ID: CRD42024505028). Peer-reviewed publications and conference presentations are dissemination plans.

PROSPERO REGISTRATION NUMBER

CRD42024505028.

Health-related quality of life and its associated factors among hemophilia patients: experience from Ethiopian Hemophilia Treatment Centre

BACKGROUND

Hemophilia is a rare genetic condition that is often overlooked and underdiagnosed, particularly in low-income countries. Long-term spontaneous joint bleeding and soft tissues can have a significant negative impact on a patient's health-related quality of life (HRQoL). The objective of this study was to assess HRQoL and its associated factors in Ethiopian patients with hemophilia.

METHODS

A cross-sectional survey was conducted among patients with hemophilia at Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia. Patients were recruited consecutively during follow-up visits. The European Quality of Life Group's 5-Domain Questionnaires at five levels (EQ-5D-5L) and Euro Quality of Life Group's Visual Analog Scale (EQ-VAS) instruments were used to assess HRQoL. The EQ-5D-5L utility score was computed using the disutility coefficients. We applied the Krukal-Wallis and Mann-Whitney U tests to determine the differences in EQ-5D-5L and EQ-VAS utility scores between patient groups. A multivariate Tobit regression model was used to identify factors associated with HRQoL. Statistical analyses were performed using STATA version 14 and statistical significance was determined at p < 0.05.

RESULTS

A total of 105 patients with hemophilia participated in the study, with a mean (standard deviation (SD) age of 21.09 (± 7.37] years. The median (IQR) EQ-5D-5L utility and EQ-VAS scores were 0.86 (0.59-0.91) and 75 (60.0-80.0), respectively. Age was significantly negatively associated with the EQ-5D-5L utility index and EQ-VAS (β = -0.020, 95 CI = -0.034, -0.007) and β = -0.974, 95% CI = -1.72, 0.225), respectively. The duration since hemophilia diagnosis (β-0.011, 95% CI, 0.001-0.023) and living out of Addis Ababa (β = -0.128, 95% CI, -0.248-, -0.007) were also significantly negatively associated with the EQ-5D-5L utility index..

CONCLUSION

The median EQ-5D-5L utility and EQ-VAS scores of patients with hemophilia were 0.86 (0.59-0.91) and 75 (60.0-80.0), respectively. Older age, living far from the Hemophilia Treatment Center (HTC), and longer duration since diagnosis were significantly negatively associated with HRQoL. HRQoL may be improved by providing factor concentrates, decentralizing HTCs in different parts of the country, increasing awareness of bleeding disorders among health professionals, and providing psychosocial support to affected patients.

Health-related quality of life and its influencing factors among people with heart failure in Ethiopia: using the revised Wilson and Cleary model

Heart failure is a challenging public health problem associated with poor health-related quality of life (HRQoL). Data on the quality of life of people with heart failure are limited in Ethiopia. This study aimed to assess the HRQoL and its influencing factors in people with heart failure in Ethiopia. A hospital-based, cross-sectional study design was conducted in the cardiac outpatient clinics of two tertiary-level hospitals in Addis Ababa, Ethiopia. Data were collected from people with heart failure who met the inclusion criteria using an interviewer-administered questionnaire. The HRQoL was measured using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). A multiple linear regression model was fitted to identify factors that influenced HRQoL. All statistical analyses were conducted using STATA version 17 software. A total of 383 people with heart failure participated in the study. The mean age of the participants was 55 years. The MLHFQ score was 48.03±19.73, and 54% of participants had poor HRQoL. Multiple linear regression analysis revealed that age (β= 0.12, 95% CI 0.11, 0.28), diabetes mellitus comorbidity (β= 4.47, 95% CI 1.41, 7.54), social support score (β= - 1.48, 95% CI - 1.93, - 1.03), and depression score (β = 1.74, 95% CI 1.52, 1.96) were significant factors influencing overall HRQoL (p < 0.05). This study found that people in Ethiopia with heart failure had poor HRQoL, influenced by several factors. The findings can help health professionals identify appropriate interventions to improve the HRQoL of people with heart failure.