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Menon JC, John D, Sreedevi A, Janakiram C, R A, S S, M S A, Numpeli M, Gopal B, B A R, P K S, Lakshmanasamy R, Kunwar A. Improving medication adherence among persons with cardiovascular disease through m-health and community health worker-led interventions in Kerala; protocol for a type II effectiveness-implementation research-(SHRADDHA-ENDIRA). Trials 2024; 25:437. [PMID: 38956612 PMCID: PMC11221042 DOI: 10.1186/s13063-024-08244-0] [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: 05/09/2024] [Accepted: 06/11/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of mortality worldwide, and at present, India has the highest burden of acute coronary syndrome and ST-elevation myocardial infarction (MI). A key reason for poor outcomes is non-adherence to medication. METHODS The intervention is a 2 × 2 factorial design trial applying two interventions individually and in combination with 1:1 allocation ratio: (i) ASHA-led medication adherence initiative comprising of home visits and (ii) m-health intervention using reminders and self-reporting of medication use. This design will lead to four potential experimental conditions: (i) ASHA-led intervention, (ii) m-health intervention, (iii) ASHA and m-health intervention combination, (iv) standard of care. The cluster randomized trial has been chosen as it randomizes communities instead of individuals, avoiding contamination between participants. Subcenters are a natural subset of the health system, and they will be considered as the cluster/unit. The factorial cluster randomized controlled trial (cRCT) will also incorporate a nested health economic evaluation to assess the cost-effectiveness and return on investment (ROI) of the interventions on medication adherence among patients with CVDs. The sample size has been calculated to be 393 individuals per arm with 4-5 subcenters in each arm. A process evaluation to understand the effect of the intervention in terms of acceptability, adoption (uptake), appropriateness, costs, feasibility, fidelity, penetration (integration of a practice within a specific setting), and sustainability will be done. DISCUSSION The effect of different types of intervention alone and in combination will be assessed using a cluster randomized design involving 18 subcenter areas. The trial will explore local knowledge and perceptions and empower people by shifting the onus onto themselves for their medication adherence. The proposal is aligned to the WHO-NCD aims of improving the availability of the affordable basic technologies and essential medicines, training the health workforce and strengthening the capacity of at the primary care level, to address the control of NCDs. The proposal also helps expand the use of digital technologies to increase health service access and efficacy for NCD treatment and may help reduce cost of treatment. TRIAL REGISTRATION The trial has been registered with the Clinical Trial Registry of India (CTRI), reference number CTRI/2023/10/059095.
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Affiliation(s)
- Jaideep C Menon
- Adult Cardiology, AIMS, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Denny John
- Ramaiah University of Applied Sciences, Bengaluru, India
| | - Aswathy Sreedevi
- Community Medicine, AIMS, Amrita Vishwa Vidyapeetham, Kochi, India.
| | - Chandrasekhar Janakiram
- Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Akshaya R
- Community Medicine, AIMS, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Sumithra S
- StJohn's Research Institute, Bangalore, India
| | | | | | - Bipin Gopal
- NCD, DHS, Govt of Kerala, Kerala, Thiruvananthapuram, India
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Nguyen TTB, Hsu YY. Features, measurements, determinants, treatments, and outcomes of musculoskeletal symptoms in postmenopausal women: A scoping review. Geriatr Nurs 2024; 58:416-429. [PMID: 38901307 DOI: 10.1016/j.gerinurse.2024.05.038] [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: 01/30/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND The literature lacks a consistent review of musculoskeletal symptoms in postmenopausal women. AIM To identify features, measurements, determinants, treatments, and outcomes of musculoskeletal symptoms in postmenopausal women. METHOD A scoping review was completed using six databases: Embase, Medline, Cochrane, CINAHL, Web of Science, and Scopus up to December 2022. Sixty-three articles were identified. RESULTS Musculoskeletal symptoms in postmenopausal women include somatic symptoms of non-specific origin, upper and lower limb symptoms, spinal pain, and decline in physical performance. Measurements were categorized into four groups: musculoskeletal symptoms for menopause, general musculoskeletal symptoms, menopause-specific quality of life, and general quality of life questionnaires. The determinants were grouped into four themes: demographics, physical determinants, psychosocial determinants, and lifestyle. Pharmacological interventions, supplementation options, and exercise regimens exist for postmenopausal women with musculoskeletal symptoms. CONCLUSION A comprehensive policy is needed to address musculoskeletal symptoms in postmenopausal women, promoting diverse treatments for improved quality of life.
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Affiliation(s)
- Tram Thi Bich Nguyen
- National Cheng Kung University, No.1, University Road, Tainan City 701, Taiwan; Duy Tan University, 120 Hoang Minh Thao, Da Nang, 550000, Viet Nam
| | - Yu-Yun Hsu
- National Cheng Kung University, No.1, University Road, Tainan City 701, Taiwan.
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DE Lorenzo R, Cinel E, Cilla M, Compagnone N, Ferrante M, Falbo E, Patrizi A, Castellani J, Magnaghi C, Calvisi SL, Arcidiacono T, Lanzani C, Canti V, Mazza MG, Martinenghi S, Vitali G, Benedetti F, Ciceri F, Conte C, Rovere Querini P. Physical and psychological sequelae at three months after acute illness in COVID-19 survivors. Panminerva Med 2023; 65:312-320. [PMID: 34060280 DOI: 10.23736/s0031-0808.21.04399-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) may leave behind an altered health status early after recovery. We evaluated the clinical status of COVID-19 survivors at three months after hospital discharge. METHODS In this prospective observational cohort study, hospitalized patients aged ≥18 years, evaluated at one (M1) and three (M3) months post-discharge were enrolled. 251 patients (71.3% males, median [IQR] age 61.8 [53.5-70.7] years) were included. Median (IQR) time from discharge to M3 was 89 (79.5-101) days. Primary outcome was residual respiratory dysfunction (RRD), defined by tachypnea, moderate to very severe dyspnea, or peripheral oxygen saturation ≤95% on room air at M3. RESULTS RRD was found in 30.4% of patients, with no significant difference compared with M1. Chronic obstructive pulmonary disease and length of stay were independent predictors of RRD at multivariable logistic regression (OR [95% CI]: 4.13 [1.17-16.88], P=0.033; OR [95% CI]: 1.02 [1.00-1.04], P=0.047, respectively). Obesity and C-reactive protein levels upon admission were additional predictors at regression tree analysis. Impaired quality of life (QoL) was reported by 53.2% of patients. Anxiety and insomnia were each present in 25.5% of patients, and PTSD in 22.4%. No difference was found between M1 and M3 in QoL, anxiety or PTSD. Insomnia decreased at M3. Current major psychiatric disorder as well as anxiety, insomnia and PSTD at M1 independently predicted PTSD at M3. CONCLUSIONS Clinical damage may persist at three months after discharge in COVID-19 survivors. Post-recovery follow-up is an essential component of patient management.
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Affiliation(s)
| | - Elena Cinel
- Vita-Salute San Raffaele University, Milan, Italy
| | - Marta Cilla
- Vita-Salute San Raffaele University, Milan, Italy
| | | | | | | | | | | | - Cristiano Magnaghi
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Stefania L Calvisi
- Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Teresa Arcidiacono
- Unit of Nephrology, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Chiara Lanzani
- Unit of Nephrology, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Valentina Canti
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Mario G Mazza
- Unit of Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Sabina Martinenghi
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Giordano Vitali
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Francesco Benedetti
- Unit of Psychiatry and Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Caterina Conte
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Hospital, Milan, Italy
| | - Patrizia Rovere Querini
- Vita-Salute San Raffaele University, Milan, Italy -
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Hospital, Milan, Italy
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Shah D, Lokapur M, Kumar N, Shah H. A review of chronic pain with depression and/or anxiety comorbidities in the Indian population. INDIAN JOURNAL OF PAIN 2023. [DOI: 10.4103/ijpn.ijpn_26_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
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Khatak S, Gupta M, Grover S, Aggarwal N. Depression among Peri- and Post-Menopausal Women during COVID-19 Pandemic in Chandigarh, North India: A Study from Community. J Midlife Health 2022; 13:233-240. [PMID: 36950212 PMCID: PMC10025817 DOI: 10.4103/jmh.jmh_92_22] [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: 05/13/2022] [Revised: 10/08/2022] [Accepted: 10/31/2022] [Indexed: 01/28/2023] Open
Abstract
Background Peri- and post-menopausal women are vulnerable to suffer from mental health problems including depression, anxiety, and stress, which might have increased during the COVID-19 pandemic. Objective To estimate the prevalence of depression and associated factors among peri- and post-menopausal women during the COVID-19 pandemic in Chandigarh. Materials and Methods A community-based cross-sectional study was conducted among 200 urban peri- and post-menopausal women of age 40-60 years in Chandigarh, from May to June 2021. Patient Health Questionnaire-9, Generalized Anxiety Disorder 7, and EuroQol-5D validated tools were used to screen depression, anxiety, and quality of life (QOL). Fear of COVID-19 scale was developed as part of this study was used to assess the fear related to COVID-19 infection. Data analysis was done using the Statistical Package for the Social Sciences (SPSS) software version 26.0. Binary multivariate logistic regression model was used to identify the predictors. Results The prevalence of depression was 39% and anxiety 29.5% among peri-and post-menopausal women. The fear of COVID-19 infection (adjusted odds ratio [aOR] 8.43, confidence interval [CI]: 1.99-35.64; aOR 10.54, CI: 2.76-40.24) and sleeplessness (aOR 13.29, CI: 3.22-54.82) were the significant (P < 0.005) predictors of depression and anxiety, respectively. Fearful peri- and post-menopausal women (aOR 5.94, CI: 2.68-13.13) and widow status (aOR 7.08, CI: 1.10-45.28) were the significant (P < 0.005) predictors of poor QOL. Conclusions The prevalence of depression was high among peri- and post-menopausal women during the COVID-19 pandemic. Fear of getting COVID-19 infection was significantly associated with depression, anxiety, and poor QOL.
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Affiliation(s)
- Sukriti Khatak
- Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Madhu Gupta
- Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Neelam Aggarwal
- Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Sen RK, Shetti V, Mukhopadhyay R, Tripathy SK, Saini G, Dip SK, Raman N, Rana M, Vashishta K, Sharma SK. Satisfaction and Health-Related Quality of Life Following Hip and Knee Arthroplasty Surgeries in Indian Patients: A Cross-Sectional Study. Indian J Orthop 2022; 56:918-926. [PMID: 35547347 PMCID: PMC9043070 DOI: 10.1007/s43465-021-00589-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 12/04/2021] [Indexed: 02/08/2023]
Abstract
Introduction Recently, the patient-reported outcome measures (PROMs) have been considered as the most important assessment tool for surgical outcome evaluation in arthroplasty. However, no study from the Indian subcontinent has evaluated the PROM in the total hip (THA) and knee (TKA) arthroplasties. Materials and Methods This cross-sectional study evaluated the health-related quality of life (HRQoL) of 1244 North Indian patients following primary THA and TKA who had at least one-year follow-up. This study included 617 patients with 664 THA and 627 patients with 1152 TKA. The patients were asked to answer the EQ-5D-5L questionnaires and EQ-VAS in their own languages. The EQ-5D-5L values were used to derive level frequency scores (LFS) with validated Indian norms of EuroQoL. Results Ninety percent of THA and 82% of TKA patients rated excellent HRQoL using EQ-VAS. The regression analysis revealed age, gender, etiology and brand of prosthesis had a significant impact on EQ-5D-5L following THA. However, gender and simultaneous bilateral surgery were found to be important predictors of outcome in TKA. The mean value of LFS for THA was 0.95 ± 0.12 and TKA was 0.88 + 0.24 (p < 0.001). However, There was no difference in LFS between THA and TKA when only elderly patients (> 60 years) were considered (p = 0.168). Conclusion THA patients reported better HRQoL than TKA in the Indian subcontinent. One of the factors for a better outcome in hip arthroplasty was the relatively younger age of the patients. Patients above 60 years of age reported similar levels of statisfactior in both THA and TKA. Supplementary Information The online version contains supplementary material available at 10.1007/s43465-021-00589-x.
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Affiliation(s)
- Ramesh K. Sen
- Institute of Orthopaedics, Max Hospital Mohali, Punjab, 160055 India
| | - Veeresh Shetti
- Institute of Orthopaedics, Max Hospital Mohali, Punjab, 160055 India
| | - Reet Mukhopadhyay
- Institute of Orthopaedics, Max Hospital Mohali, Punjab, 160055 India
| | | | - Gaurav Saini
- Institute of Orthopaedics, Max Hospital Mohali, Punjab, 160055 India
| | - Sagar Kadam Dip
- Institute of Orthopaedics, Max Hospital Mohali, Punjab, 160055 India
| | - Neha Raman
- Institute of Orthopaedics, Max Hospital Mohali, Punjab, 160055 India
| | - Monica Rana
- Institute of Orthopaedics, Max Hospital Mohali, Punjab, 160055 India
| | - Kamini Vashishta
- Institute of Orthopaedics, Max Hospital Mohali, Punjab, 160055 India
| | - Suresh Kumar Sharma
- Department of Statistics and Ex-Coordinator, Centre for Systems Biology and Bioinformatics, Panjab University, Chandigarh, 160014 India
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Tripathy S, Kar N, Acharya SP, Singh SK. ICU Memories and Patient Outcomes in a Low Middle-Income Country: A Longitudinal Cohort Study. Crit Care Med 2021; 49:e978-e988. [PMID: 33938712 DOI: 10.1097/ccm.0000000000005074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To study memories of ICU following discharge, their associations, and impact on mental health and quality of life in a low- and middle-income country. DESIGN Prospective observational cohort; data on memories (pain, fear, nightmare, factual), clinical and demographic variables, anxiety-depression, posttraumatic stress symptoms, and quality of life were collected 0, 7, 14, 30, 90, and 180 days post discharge. Home visits for assessment minimized loss to follow-up. Linear mixed-models and regression analyses were used to estimate adjusted effects of memories controlling for age, sex, time, and severity of illness. SETTING Twenty-five bedded ICU of a tertiary care center in East India. PATIENTS Adult ICU survivors between January 2017 and July 2018 able to communicate their memories. INTERVENTIONS Not applicable. MEASUREMENTS AND MAIN RESULTS Final sample consisted of 322 patients who completed 180 days follow-up. Pain, fear, factual, and nightmare memories dropped from 85%, 56%, 55%, and 45% at discharge to less than or equal to 5% at 180 days. Patients with gaps in ICU memory had worse anxiety-depression, posttraumatic stress symptoms, and quality of life at all follow-up points. Sedation (odds ratio, 0.54; CI, 0.4-0.7), steroids (odds ratio, 0.47; CI, 0.3-0.8), benzodiazepines (odds ratio, 1.74; CI, 1-3.04), and mechanical ventilation (odds ratio, 0.43; CI, 0.2-0.8) were independently associated with gaps in memory. Non-ICU factor such as substance addiction (odds ratio, 5.38; CI, 2-14) was associated with memories affecting mental health and quality of life. CONCLUSIONS Gaps in memory and various memory types were common after ICU admission, whose prevalence waned over time. Compared with nightmares and fearful memories, gaps in memories were most strongly associated with poor mental health and quality of life. Identifying patients with gaps in memories might be an objective way of planning interventions to improve their long-term outcomes.
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Affiliation(s)
- Swagata Tripathy
- Department of Anesthesia and Critical Care, AIIMS Bhubaneswar, Odisha, India
- Department of Psychiatry, Black County Healthcare NHS Foundation Trust, Wolverhampton, United Kingdom
- Department of Psychiatry, AIIMS Bhubaneswar, Odisha, India
| | - Nilamadhab Kar
- Department of Psychiatry, Black County Healthcare NHS Foundation Trust, Wolverhampton, United Kingdom
| | | | - Santosh Kumar Singh
- Department of Psychiatry, Black County Healthcare NHS Foundation Trust, Wolverhampton, United Kingdom
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Wulandari L, Soegiarto G, Febriani A, Fatmawati F, Amran WS. Comparison between Vinorelbine–Carboplatin and Vinorelbine–Cisplatin in Stage III–IV EGFR Mutations-Negative NSCLC. ASIAN JOURNAL OF ONCOLOGY 2021. [DOI: 10.1055/s-0041-1730255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Abstract
Introduction There are a substantial number of lung cancer patients with negative mutations in Indonesia. This type of cancer is deemed to be the major contributor of lung cancer patient’s death. However, reseaerch related to therapy using vinorelbine combined with platinum-based compounds is still scarce in Indonesia. The aim of this study was to compare the efficacy and tolerability between vinorelbine and carboplatin with vinorelbin and cisplatin in stage III-IV epidermal growth factor receptor (EGFR) mutations-negative non-small cell lung cancer (NSCLC).
Methods The participants were divided into two groups—group I(vinorelbine–carboplatin) and group II (vinorelbine–cisplatin). The participants were assessed based on several measurement criteria. Not only Eq-5D was performed, but the body weight and response evaluation criteria for solid tumors (RECIST) were also examined. The participants received chemotherapy for four cycles (1 cycle = 21 days).
Results The quality of life was considered stable in 60% of group I and 60% of group II (p = 0.255). In both groups, 46.67% of participants had an increased body weight, while the other 20.00% was stable (p = 1.000). In terms of RECIST evaluation after the second cycle, 80.00% of group I and 86.67% of group II were considered to have a stable disease, with 20% of group I and none of group II had partial response (p = 0.027). However, after the fourth cycle, there were no significant difference between the groups (p = 0.734).
Conclusion In EGFR mutation-negative NSCLC patients, the combination of vinorelbine and carboplatin showed comparable outcomes to vinorelbine and cisplatin chemotherapy with no significant differences.
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Affiliation(s)
- Laksmi Wulandari
- Division of Thoracic Oncology, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga—Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Gatot Soegiarto
- Division of Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga—Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Anna Febriani
- Division of Thoracic Oncology, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga—Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Farah Fatmawati
- Division of Thoracic Oncology, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga—Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Wirya Sastra Amran
- Department of Pulmonology and Respiratory Medicine, Universitas Airlangga, Faculty of Medicine—Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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Cheng LJ, Tan RLY, Luo N. Measurement Properties of the EQ VAS Around the Globe: A Systematic Review and Meta-Regression Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1223-1233. [PMID: 34372988 DOI: 10.1016/j.jval.2021.02.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 01/21/2021] [Accepted: 02/19/2021] [Indexed: 05/26/2023]
Abstract
OBJECTIVES This study aimed to synthesize and evaluate published evidence on the measurement properties of the EQ VAS, a component of all EQ-5D questionnaires. METHODS This systematic review followed the Consensus-Based Standards for the Selection of Health Measurement Instruments guidelines. Five electronic databases were searched for EQ-5D-3L and EQ-5D-5L validation articles published from January 1, 2009, to November 5, 2019. Evidence for construct validity, test-retest reliability, and responsiveness was extracted from individual studies before being aggregated for evaluation of the populations represented by the studied samples. Multivariable logistic meta-regression was conducted to explore the effects of potential covariates on construct validity. RESULTS A total of 50 articles containing 488 studies, using samples drawn from 12 different populations, were identified. Generally, the quality of evidence was high for construct validity studies (n = 397) but only moderate for both test-retest reliability studies (n = 21) and responsiveness studies (n = 70). "Sufficient" construct validity of EQ VAS was found in 8 of 12 populations, "sufficient" test-retest reliability was found in 3 of 11 populations, and "sufficient" responsiveness was found in 5 of 12 populations. Meta-regression analyses suggested that construct validity studies from the Asian-Pacific region were more likely to show a negative rating compared with studies from Europe and North America. CONCLUSION The EQ VAS exhibits "sufficient" construct validity, "inconsistent" test-retest reliability, and "inconsistent" responsiveness across a broad range of populations. Additional studies are needed to explore the suboptimal validity of the EQ VAS in the Asian-Pacific region, whereas more high-quality validation studies are needed to assess its reliability and responsiveness.
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Affiliation(s)
- Ling Jie Cheng
- Nursing Research Unit, Department of Nursing, Khoo Teck Puat Hospital, Yishun Health Campus, National Healthcare Group, Singapore; Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Rachel Lee-Yin Tan
- Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Nan Luo
- Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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Senthilkumar A, Subitha L, Saravanan E, Giriyappa DK, Satheesh S, Menon V. Depressive Symptoms and Health-Related Quality of Life in Patients with Cardiovascular Diseases Attending a Tertiary Care Hospital, Puducherry-A Cross-Sectional Study. J Neurosci Rural Pract 2021; 12:376-381. [PMID: 33927527 PMCID: PMC8064843 DOI: 10.1055/s-0041-1724227] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background
Globally, coronary artery disease (CAD) was the leading cause of health losses. The emergence of revascularization has brought a major change in the management of CAD. Depression and cardiovascular diseases (CVD) are the two highly prevalent noncommunicable diseases (NCD), which lead to poor quality of life and high socio-economic loss for the patient. The rate of depressive episodes was higher in CAD population in comparison to population with other heart problems.
Objectives
The primary objective of the current study is to determine the proportion of those with depressive symptoms through Patient Health Questionnaire-9 (PHQ-9) among CAD patients in a tertiary care public hospital.
Methods
It was a cross-sectional analytical design, which assess the percentage of patients with depressive symptoms among CAD patients, using a pretested, semistructured questionnaire. The PHQ-9 and EuroQoL five-dimensional three-level (EQ-5D-3L) questionnaire, a quality-of-life instrument (five items), were used, which was validated in the Tamil version.
Statistical Analysis
Categorical variables was expressed as proportion. We used Chi-square as a statistical test to calculate the
p
value and risk estimation with 95% CI.
Results
Out of 541 patients, 159 (30%) patients had mild-to-moderate depressive symptoms, of which 144 (89%) participants were greater than 50 years. In EQ-5D-3L, around one-third of the participants reported pain or discomfort and anxiety or depression.
Conclusion
The study concludes that the assessment of health-related quality of life (HRQoL) is becoming increasingly important in the management of CAD patients. Studies have shown that depression predicts subsequent quality of life, while others have shown that HRQoL is a risk factor for ongoing depression. Treatment of depression may improve subsequent physical HRQoL; hence, it is vital to address both during their follow-up to improve outcomes among patients with CAD.
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Affiliation(s)
- Arokiasamy Senthilkumar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Puducherry, India
| | - Lakshminarayanan Subitha
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Puducherry, India
| | - Essakky Saravanan
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Puducherry, India
| | - Dinesh Kumar Giriyappa
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Puducherry, India
| | - Santhosh Satheesh
- Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Puducherry, India
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Puducherry, India
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Jimam NS, Ismail NE, Dayom WD. Evaluation of Psychometric Quality of EQ-5D-5L Scale for Assessing Health-Related Quality of Life of Malaria Patients. Value Health Reg Issues 2020; 22:15-22. [DOI: 10.1016/j.vhri.2019.08.478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/06/2019] [Accepted: 08/21/2019] [Indexed: 11/30/2022]
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Weru J, Gatehi M, Musibi A. Randomized control trial of advanced cancer patients at a private hospital in Kenya and the impact of dignity therapy on quality of life. BMC Palliat Care 2020; 19:114. [PMID: 32703307 PMCID: PMC7379366 DOI: 10.1186/s12904-020-00614-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 07/05/2020] [Indexed: 01/29/2023] Open
Abstract
Background Palliative care is a modality of treatment that addresses physical, psychological and spiritual symptoms. Dignity therapy, a form of psychotherapy, was developed by Professor Harvey Chochinov, MD in 2005.The aim of the study was to assess the effect of one session of dignity therapy on quality of life in advanced cancer patients. Methods This was a randomized control trial of 144 patients (72 in each arm) randomized into group 1 (intervention arm) and group 2 (control arm). Baseline ESAS scores were determined in both arms following which group 1 received Dignity therapy while Group 2 received usual care only. Data collected was presented as printed (Legacy) documents to group 1 participants. These documents were a summary of previous discussions held. Post intervention ESAS scores were obtained in both groups after 6 weeks. Analysis was based on the intention to treat principle and descriptive statistics computed. The main outcome was symptom distress scores on the ESAS (summated out of 100 and symptom specific scores out of 10). The student T-test was used to test for difference in ESAS scores at follow up and graphs were computed for common cancers and comorbidities. Results Of the 144 (72 patients in each arm) patients randomized, 70%were female while 30% were male with a mean age of 50 years. At 6 weeks, 11 patients were lost to follow up, seven died and 126 completed the study. The commonly encountered cancers were gastrointestinal cancers (43%, p = 0.29), breast cancer (27.27% p = 0.71) and gynaecologic cancers (23% p = 0.35). Majority of the patients i.e. 64.3% had no comorbidities. The primary analysis results showed higher scores for the DT group (change in mean = 1.57) compared to the UC group (change in mean = − 0.74) yielding a non-statistically significant difference in change scores of 1.44 (p = 0.670; 95% CI − 5.20 to 8.06). After adjusting for baseline scores, the mean (summated) symptom distress score was not significant (GLM p = 0.78). Dignity therapy group showed a trend towards statistical improvement in anxiety (p = 0.059). The largest effects seen were in improvement of appetite, lower anxiety and improved wellbeing (Cohen effect size 0.3, 0.5 and 0.31 respectively). Conclusion Dignity therapy showed no statistical improvement in overall quality of life. Symptom improvement was seen in anxiety and this was a trend towards statistical significance (p = 0.059). Trial registration Trial registration number PACTR201604001447244 retrospectively registered with Pan African Clinical trials on 28th January 2016.
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Affiliation(s)
- John Weru
- Palliative care, AKUHN, Nairobi, Kenya.
| | | | - Alice Musibi
- Oncology, Kenyatta National Hospital, Nairobi, Kenya
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Tripathy S, Acharya SP, Singh S, Patra S, Mishra BR, Kar N. Post traumatic stress symptoms, anxiety, and depression in patients after intensive care unit discharge - a longitudinal cohort study from a LMIC tertiary care centre. BMC Psychiatry 2020; 20:220. [PMID: 32398018 PMCID: PMC7216410 DOI: 10.1186/s12888-020-02632-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 04/28/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Data on intensive care unit (ICU) related psychiatric morbidity from Low Middle-Income Countries are sparse. We studied the ICU related posttraumatic stress symptoms (PTSS), anxiety, and depression symptoms in a cohort of patients from Eastern India. METHODS We included adults admitted more than 24 h to a mixed ICU. PTSS, anxiety, and depression symptoms were assessed by telephonic or face to face interviews by using the Impact of Events-r (IES-r) and Hospital anxiety and depression (HADS), respectively, at 0, 7,14, 30, 90 and 180 days from ICU discharge. The loss to follow up was minimal. Demographic, socioeconomic, quality of life (QOL), and critical care related variables were studied. RESULTS Of 527 patients, 322 (59.4%) completed 6 months' follow up. The majority were male (60%), mechanically ventilated > 48 h (59.4%), mean age of 48 (+/- 16), mean acute physiology and chronic health evaluation II (APACHE II) at admission 9.4 (+/- 4.6), median length of stay 3 (2-28 days). The rates of ICU related clinical PTSS was < 1 and < 3% for anxiety/depression at any point of follow up. Data were analyzed by linear mixed (random effects) models. There was a significant drop in all scores and association with repeated measures over time. Poor QOL at discharge from the ICU showed significant association with PTSS, anxiety, and depression (β = - 2.94, - 1.34, - 0.7 respectively) when corrected for gender and education levels. Younger age, greater severity of illness, and prior stressful life experiences predicted worse PTSS (β = - 0.02, 0.08, 3.82, respectively). Benzodiazepines and lower sedation scores (better alertness) predicted lower depression symptoms. (β = - 0.43, 0.37 respectively). CONCLUSION ICU related psychiatric morbidity rates in our population are low compared with reported rates in the literature. Poor QOL at ICU discharge may predict worse long-term mental health outcomes. Further research on the impact of ICU and sociocultural factors on mental health outcomes in patients from different backgrounds is needed. The study was registered at CTRI/2017/07/008959.
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Affiliation(s)
- Swagata Tripathy
- Department Anesthesia & Intensive Care, Bhubaneswar, India
- All India Institute of Medical Sciences, Bhubaneswar, India
| | | | - Santosh Singh
- All India Institute of Medical Sciences, Bhubaneswar, India
| | - Suravi Patra
- All India Institute of Medical Sciences, Bhubaneswar, India
- Department of Psychiatry, Bhubaneswar, India
| | | | - Nilamadhab Kar
- Black County Partnership NHS Foundation Trust, Wolverhampton, UK
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Tripathy S, Myatra SN. Are the instruments for quality of life assessment comparable between cultures? No. Intensive Care Med 2020; 46:1746-1748. [PMID: 32221650 DOI: 10.1007/s00134-020-06007-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/09/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Swagata Tripathy
- Department of Anesthesia and Intensive Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
| | - Sheila Nainan Myatra
- Department of Anesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
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Jagnoor J, Prinja S, Nguyen H, Gabbe BJ, Peden M, Ivers RQ. Mortality and health-related quality of life following injuries and associated factors: a cohort study in Chandigarh, North India. Inj Prev 2019; 26:315-323. [PMID: 31273029 DOI: 10.1136/injuryprev-2019-043143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/24/2019] [Accepted: 05/29/2019] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Injuries are among the 10 leading causes of deaths worldwide. In recent years, the quality and reporting of injury mortality has improved but little or no data are available on the morbidity burden and impact of non-fatal injuries in India. This study evaluates health recovery status postinjury, identifying predictors of recovery in North India. METHODS Prospective cohort study recruiting patients from one tertiary-level and two secondary-level hospitals in North India between April and June 2014 hospitalised due to any injury. Health-related quality of life was assessed at baseline and at 1-month, 2-month, 4-month and 12-month postinjury using the EuroQol five-dimensional (EQ-5D-5L) questionnaire. Multivariable linear regressions with generalised estimating equations were used to examine the relationship between sociodemographic and injury-related factors with the EQ-5D-5L single utility score and the visual analogue scale (VAS) score. RESULTS A total of 2416 eligible patients aged ≥18 years were enrolled in the study. Of these, 2150 (74%) completed baseline and all four follow-up EQ-5D-5L questionnaires. Almost 7% (n=172) patients died by the first follow-up and the overall mortality at 12 months was 9% (n=176). Both EQ-5D-5L utility and VAS scores dropped significantly at 1-month postinjury but gradually improved at 2, 4 and 12 months. Severe injuries, defined as those requiring a hospital stay of ≥7 days, were associated with lower utility scores at 1-month, 2-month and 4-month follow-ups (p<0.001). CONCLUSION This is the first study to examine health outcomes following injuries in India. The findings highlight the need to understand the social, psychological and biological factors influencing recovery outcomes. High mortality following discharge emphasises the need to invest in secondary and tertiary injury prevention in India.
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Affiliation(s)
- Jagnoor Jagnoor
- Injury Division, The George Institute for Global Health, New Delhi, India .,School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Shankar Prinja
- School of Public Health, Post Graduate Institute of Medical Education and Research School of Public Health, Chandigarh, Punjab, India
| | - Ha Nguyen
- Injury Division, The George Institute for Global Health, Sydney, New South Wales, Australia.,John Walsh Centre for Rehabilitation Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Belinda J Gabbe
- Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Margaret Peden
- The George Institute for Global Health UK, Oxford, Oxfordshire, UK
| | - Rebecca Q Ivers
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Injury Division, The George Institute for Global Health, Sydney, New South Wales, Australia
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Saptaningsih AB, Setiawan D, Rivany R, Aryandono T, Atthobari J, Dwiprahasto I. The Development of Quality of Life Questionnaire for Indonesian Breast Cancer Patients: INA-BCHRQoL. Asian Pac J Cancer Prev 2018; 19:1269-1275. [PMID: 29801412 PMCID: PMC6031842 DOI: 10.22034/apjcp.2018.19.5.1269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction: The breast cancer related incidence and mortality rate in Indonesia are included in the top 10 and top 5 highest in the world. A country-specific Health Related Quality of Life measurement tool is required to help clinician observe and improve the management of the disease. Methods: We developed the questionnaire, namely Indonesian Breast Cancer Health Related Quality of Life (INA-BCHRQoL) by incorporating not only the generic variables such as physical, psychological, and social; but also spiritual variable which is suitable for Indonesian population. The questionnaire was validated to the same population using the value of corrected item-total correlation and the value of Cronbach Alpha. Results: Fourty three questions were considerably valid and reliable on evaluating the HRQoL of early state of breast cancer patients in Indonesia as the value of Cronbach Alpha for physical, cognitive, social and spiritual domain were higher than 0.8 and the corrected item-total correlation were also higher than 0.3. Each domain of the questionnaire was not influenced by the treatment options. Twenty four early stage breast cancer (10 FAC based chemotherapy and 14 Taxan based chemotherapy) were enrolled in the main study and the score of HRQOL obtained from INA-BCHRQoL were considerably high. Conclussion: The INA-BCHRQoL questionnaire can be implemented as a valid and reliable tool to assess quality of life in early stage breast cancer patients in Indonesia.
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Health-Related Quality of Life of Patients with HPV-Related Cancers in Indonesia. Value Health Reg Issues 2018; 15:63-69. [DOI: 10.1016/j.vhri.2017.07.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 06/27/2017] [Accepted: 07/27/2017] [Indexed: 12/13/2022]
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Downey L, Rao N, Guinness L, Asaria M, Prinja S, Sinha A, Kant R, Pandey A, Cluzeau F, Chalkidou K. Identification of publicly available data sources to inform the conduct of Health Technology Assessment in India. F1000Res 2018; 7:245. [PMID: 29770210 PMCID: PMC5930391 DOI: 10.12688/f1000research.14041.2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2018] [Indexed: 11/20/2022] Open
Abstract
Background: Health technology assessment (HTA) provides a globally-accepted and structured approach to synthesising evidence for cost and clinical effectiveness alongside ethical and equity considerations to inform evidence-based priorities. India is one of the most recent countries to formally commit to institutionalising HTA as an integral component of the heath resource allocation decision-making process. The effective conduct of HTA depends on the availability of reliable data. Methods: We draw from our experience of collecting, synthesizing, and analysing health-related datasets in India and internationally, to highlight the complex requirements for undertaking HTA, and explore the availability of such data in India. We first outlined each of the core data components required for the conduct of HTA, and their availability in India, drawing attention to where data can be accessed, and different ways in which researchers can overcome the challenges of missing or low quality data. Results: We grouped data into the following categories: clinical efficacy; cost; epidemiology; quality of life; service use/consumption; and equity. We identified numerous large local data sources containing epidemiological information. There was a marked absence of other locally-collected data necessary for informing HTA, particularly data relating to cost, service use, and quality of life. Conclusions: The introduction of HTA into the health policy space in India provides an opportunity to comprehensively assess the availability and quality of health data capture across the country. While epidemiological information is routinely collected across India, other data inputs necessary for HTA are not readily available. This poses a significant bottleneck to the efficient generation and deployment of HTA into the health decision space. Overcoming these data gaps by strengthening the routine collection of comprehensive and verifiable health data will have important implications not only for embedding economic analyses into the priority setting process, but for strengthening the health system as a whole.
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Affiliation(s)
- Laura Downey
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, UK.,International Decision Support Initative, London, W2 1NY, UK
| | - Neethi Rao
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, UK.,International Decision Support Initative, London, W2 1NY, UK
| | - Lorna Guinness
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, UK.,International Decision Support Initative, London, W2 1NY, UK
| | - Miqdad Asaria
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, UK.,International Decision Support Initative, London, W2 1NY, UK
| | - Shankar Prinja
- Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Anju Sinha
- Indian Council of Medical Research, New Delhi, 110029, India
| | - Rajni Kant
- Indian Council of Medical Research, New Delhi, 110029, India
| | - Arvind Pandey
- National Institute of Medical Statistics , New Delhi, 110058, India
| | - Francoise Cluzeau
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, UK.,International Decision Support Initative, London, W2 1NY, UK
| | - Kalipso Chalkidou
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, UK.,International Decision Support Initative, London, W2 1NY, UK.,Centre for Global Development , London, SW1Y 4TE, UK
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Downey L, Rao N, Guinness L, Asaria M, Prinja S, Sinha A, Kant R, Pandey A, Cluzeau F, Chalkidou K. Identification of publicly available data sources to inform the conduct of Health Technology Assessment in India. F1000Res 2018; 7:245. [PMID: 29770210 PMCID: PMC5930391 DOI: 10.12688/f1000research.14041.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2018] [Indexed: 07/30/2023] Open
Abstract
Background: Health technology assessment (HTA) provides a globally-accepted and structured approach to synthesising evidence for cost and clinical effectiveness alongside ethical and equity considerations to inform evidence-based priorities. India is one of the most recent countries to formally commit to institutionalising HTA as an integral component of the heath resource allocation decision-making process. The effective conduct of HTA depends on the availability of reliable data. Methods: We draw from our experience of collecting, synthesizing, and analysing health-related datasets in India and internationally, to highlight the complex requirements for undertaking HTA, and explore the availability of such data in India. We first outlined each of the core data components required for the conduct of HTA, and their availability in India, drawing attention to where data can be accessed, and different ways in which researchers can overcome the challenges of missing or low quality data. Results: We grouped data into the following categories: clinical efficacy; cost; epidemiology; quality of life; service use/consumption; and equity. We identified numerous large local data sources containing epidemiological information. There was a marked absence of other locally-collected data necessary for informing HTA, particularly data relating to cost, service use, and quality of life. Conclusions: The introduction of HTA into the health policy space in India provides an opportunity to comprehensively assess the availability and quality of health data capture across the country. While epidemiological information is routinely collected across India, other data inputs necessary for HTA are not readily available. This poses a significant bottleneck to the efficient generation and deployment of HTA into the health decision space. Overcoming these data gaps by strengthening the routine collection of comprehensive and verifiable health data will have important implications not only for embedding economic analyses into the priority setting process, but for strengthening the health system as a whole.
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Affiliation(s)
- Laura Downey
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, UK
- International Decision Support Initative, London, W2 1NY, UK
| | - Neethi Rao
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, UK
- International Decision Support Initative, London, W2 1NY, UK
| | - Lorna Guinness
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, UK
- International Decision Support Initative, London, W2 1NY, UK
| | - Miqdad Asaria
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, UK
- International Decision Support Initative, London, W2 1NY, UK
| | - Shankar Prinja
- Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Anju Sinha
- Indian Council of Medical Research, New Delhi, 110029, India
| | - Rajni Kant
- Indian Council of Medical Research, New Delhi, 110029, India
| | - Arvind Pandey
- National Institute of Medical Statistics , New Delhi, 110058, India
| | - Francoise Cluzeau
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, UK
- International Decision Support Initative, London, W2 1NY, UK
| | - Kalipso Chalkidou
- Institute of Global Health Innovation, Imperial College London, London, W2 1NY, UK
- International Decision Support Initative, London, W2 1NY, UK
- Centre for Global Development , London, SW1Y 4TE, UK
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Gasparik AI, Mihai G, Beaudart C, Bruyere O, Pop RM, Reginster JY, Pascanu IM. Psychometric performance of the Romanian version of the SarQoL®, a health-related quality of life questionnaire for sarcopenia. Arch Osteoporos 2017; 12:103. [PMID: 29139012 DOI: 10.1007/s11657-017-0397-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 10/31/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED Our study assessed the psychometric properties of the Romanian SarQoL® questionnaire. Normal distribution and high internal consistency were found. Sarcopenic subjects reported a reduced global quality of life compared to non-sarcopenics. The Romanian version of the SarQoL® questionnaire, conceptually and literally equivalent with the source instrument, is qualified in terms of psychometric properties. PURPOSE/INTRODUCTION We have recently provided a translated and culturally tailored version of the first quality of life (QoL) questionnaire specific for sarcopenia, the SarQoL®, in Romanian language. The aim of this study was to assess the psychometric performances of the translated questionnaire. METHODS A total of 100 volunteers were enrolled in the study. Sarcopenia was diagnosed according to the algorithm proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). To test the psychometric performance, discriminative power, internal consistency, floor and ceiling effects, and construct validity analyses were made. We assessed the correlation between SarQoL® and similar/different domains of other two QoL questionnaires. RESULTS Sarcopenic subjects reported a reduced global QoL compared to non-sarcopenic individuals. Significantly (p = 0.018) higher total scores for non-sarcopenic subjects compared to those of sarcopenics indicate a good discriminative power of the Romanian questionnaire. Sarcopenic individuals had significantly lower scores in almost all domains. The Cronbach's alpha value of 0.946 indicates a high internal consistency. No floor or ceiling effects were found. A strong positive correlation was also found between similar domain scores from SF-36 and EQ-5D questionnaires with the Total SarQoL® score. Moreover, lower scores of quality of life have been shown to be significantly associated with lower muscle strength, in univariate analyses, and lower gait speed, both in univariate and multivariate analyses. CONCLUSIONS Our results indicate that the Romanian version of the SarQoL® questionnaire, qualified in terms of psychometric properties, could be a useful tool to assess the sarcopenia-related QoL among frail Romanian individuals.
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Affiliation(s)
- Andrea Ildiko Gasparik
- Public Health and Health Management, Department of University of Medicine and Pharmacy Tîrgu Mures, Gheorghe Marinescu Street No.38, Tîrgu Mures, Mures, Romania
| | - Gabriela Mihai
- Endocrinology Department, University of Medicine and Pharmacy Tîrgu Mures, Gheorghe Marinescu Street No. 38, Tîrgu Mures, Mures, Romania.
| | - Charlotte Beaudart
- Department of Public Health, Epidemiology and Health Economics, University of Liege, Liège, Belgium
- Quartier Hôpital, University of Liege, Avenue Hippocrate, 13 Bât B23, 4000, Liège, Belgium
| | - Olivier Bruyere
- Department of Public Health, Epidemiology and Health Economics, University of Liege, Liège, Belgium
- Quartier Hôpital, University of Liege, Avenue Hippocrate, 13 Bât B23, 4000, Liège, Belgium
| | - Raluca-Monica Pop
- Endocrinology Department, University of Medicine and Pharmacy Tîrgu Mures, Gheorghe Marinescu Street No. 38, Tîrgu Mures, Mures, Romania
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liege, Liège, Belgium
- Quartier Hôpital, University of Liege, Avenue Hippocrate, 13 Bât B23, 4000, Liège, Belgium
| | - Ionela Maria Pascanu
- Endocrinology Department, University of Medicine and Pharmacy Tîrgu Mures, Gheorghe Marinescu Street No. 38, Tîrgu Mures, Mures, Romania
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Schensul SL, Ha T, Schensul JJ, Vaz M, Singh R, Burleson JA, Bryant K. The Role of Alcohol on Antiretroviral Therapy Adherence Among Persons Living With HIV in Urban India. J Stud Alcohol Drugs 2017; 78:716-724. [PMID: 28930059 PMCID: PMC5675422 DOI: 10.15288/jsad.2017.78.716] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The purpose of this study was to estimate the prevalence of alcohol use among men living with HIV on antiretroviral therapy (ART) and examine the association of alcohol use and psychosocial variables on ART adherence. The study was a cross-sectional survey supplemented by medical records and qualitative narratives as a part of the initial formative stage of a multilevel, multicentric intervention and evaluation project. METHOD A screening instrument was administered to men living with HIV (n = 3,088) at four ART Centers using the Alcohol Use Disorders Identification Test-consumption questions (AUDIT-C) to determine alcohol use for study eligibility. Alcohol screening data were triangulated with medical records of men living with HIV (n = 15,747) from 13 ART Centers to estimate alcohol consumption among men on ART in greater Mumbai. A survey instrument to identify associations between ART adherence and alcohol, psychosocial, and contextual factors was administered to eligible men living with HIV (n = 361), and in-depth interviews (n = 55) were conducted to elucidate the ways in which these factors are manifest in men's lives. RESULTS Nearly one fifth of men living with HIV on ART in the Mumbai area have consumed alcohol in the last 30 days. Non-adherence was associated with a higher AUDIT score, consumption of more types of alcohol, and poorer self-ratings on quality of life, depression, and external stigma. The qualitative data demonstrate that non-adherence results from avoiding the mixing of alcohol with medication, forgetfulness when drinking, and skipping medication for fear of disclosure of HIV status when drinking with friends. CONCLUSIONS As the demand for ART expands, Indian government programs will need to more effectively address alcohol to reduce risk and maintain effective adherence.
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Affiliation(s)
- Stephen L. Schensul
- Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, Connecticut,Correspondence may be sent to Stephen L. Schensul at the Department of Community Medicine and Health Care, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030, or via email at:
| | - Toan Ha
- Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, Connecticut
| | | | | | - Rajendra Singh
- International Center for Research on Women, Asia Regional Office, Mumbai, India
| | - Joseph A. Burleson
- Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Kendall Bryant
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
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Health-Related Quality of Life of the General German Population in 2015: Results from the EQ-5D-5L. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040426. [PMID: 28420153 PMCID: PMC5409627 DOI: 10.3390/ijerph14040426] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 03/16/2017] [Accepted: 04/13/2017] [Indexed: 11/16/2022]
Abstract
The EQ-5D-5L is a widely used generic instrument to measure health-related quality of life. This study evaluates health perception in a representative sample of the general German population from 2015. To compare results over time, a component analysis technique was used that separates changes in the description and valuation of health states. The whole sample and also subgroups, stratified by sociodemographic parameters as well as disease affliction, were analyzed. In total, 2040 questionnaires (48.4% male, mean age 47.3 year) were included. The dimension with the lowest number of reported problems was self-care (93.0% without problems), and the dimension with the highest proportion of impairment was pain/discomfort (71.2% without problems). Some 64.3% of the study population were identified as problem-free. The visual analog scale (VAS) mean for all participants was 85.1. Low education was connected with significantly lower VAS scores, but the effect was small. Depression, heart disease, and diabetes had a strong significant negative effect on reported VAS means. Results were slightly better than those in a similar 2012 survey; the most important driver was the increase in the share of the study population that reported to be problem-free. In international comparisons, health perception of the general German population is relatively high and, compared with previous German studies, fairly stable over recent years. Elderly and sick people continue to report significant reductions in perceived health states.
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Ganguly A, Ramarao K, Mohapatra S, Rath S. Transconjunctival dacryocystorhinostomy: An aesthetic approach. Indian J Ophthalmol 2017; 64:893-897. [PMID: 28112129 PMCID: PMC5322703 DOI: 10.4103/0301-4738.198855] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To report the anatomical and cosmetic outcome of transconjunctival dacryocystorhinostomy (TDCR) in an Asian Indian population. METHODS TDCR was initially performed in cadaver eyes followed by patients with primary acquired nasolacrimal duct obstruction (NLDO). This was a prospective noncomparative case series of all consecutive TDCRs performed between April 2013 and June 2015. Outcome measures were anatomical patency, epiphora, presence of diplopia, aesthetic outcome, and health status. RESULTS A total of 17 (18 eyes) patients with a mean age 43.9 ± 11.8 years (range, 32-75) were included in the study. Eight were males, and one patient underwent TDCR in both eyes. TDCR was successfully performed in 15/18 (82%) eyes under local anesthesia. Procedure converted to transcutaneous external DCR in two and dacryocystectomy in one patient each. Mean duration of surgery was 52.6 (range, 29-110) min. Anatomical patency and relief from epiphora was achieved in all (15/15) eyes after TDCR at a median follow-up of 15.5 months. At final follow-up, objective assessment of the cosmetic outcome graded the surgical scar at the lateral canthus as invisible in all except one and conjunctival fornix as visible only after eyelid eversion in all patients. Disturbance of the medial fat pad was not seen in any patient. A questionnaire-based health status evaluation showed marked improvement in anxiety/depression before and after TDCR with an overall well-being score of 88 on a scale of 0-100 (worst-best) after TDCR. CONCLUSIONS TDCR offers a promising aesthetic approach in patients with primary acquired NLDO and gives excellent functional and cosmetic outcome.
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Affiliation(s)
- Anasua Ganguly
- Department of Ophthalmic Plastic and Reconstructive Surgery, Orbit and Ocular Oncology, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Kesarpu Ramarao
- Department of Anatomy, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Samir Mohapatra
- Department of Ophthalmic Plastic and Reconstructive Surgery, Orbit and Ocular Oncology, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Suryasnata Rath
- Department of Ophthalmic Plastic and Reconstructive Surgery, Orbit and Ocular Oncology, L V Prasad Eye Institute, Bhubaneswar, Odisha, India
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