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Zhou R, Zheng YJ, Wang BJ, Patrick DL, Edwards TC, Yun JY, Zhou J, Gu RJ, Miao BH, Wang HM. Development and validation of the patient-reported outcome for older people living with HIV/AIDS in China (PROHIV-OLD). Health Qual Life Outcomes 2024; 22:30. [PMID: 38561752 PMCID: PMC10986109 DOI: 10.1186/s12955-024-02243-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The involvement of quality of life as the UNAIDS fourth 90 target to monitor the global HIV response highlighted the development of patient-reported outcome (PRO) measures to help address the holistic needs of people living with HIV/AIDS (PLWHA) beyond viral suppression. This study developed and tested preliminary measurement properties of a new patient-reported outcome (PROHIV-OLD) measure designed specifically to capture influences of HIV on patients aged 50 and older in China. METHODS Ninety-three older people living with HIV/AIDS (PLWHA) were interviewed to solicit items and two rounds of patient cognitive interviews were conducted to modify the content and wording of the initial items. A validation study was then conducted to refine the initial instrument and evaluate measurement properties. Patients were recruited between February 2021 and November 2021, and followed six months later after the first investigation. Classical test theory (CTT) and item response theory (IRT) were used to select items using the baseline data. The follow-up data were used to evaluate the measurement properties of the final instrument. RESULTS A total of 600 patients were recruited at the baseline. Of the 485 patients who completed the follow-up investigation, 483 were included in the validation sample. The final scale of PROHIV-OLD contained 25 items describing five dimensions (physical symptoms, mental status, illness perception, family relationship, and treatment). All the PROHIV-OLD dimensions had satisfactory reliability with Cronbach's alpha coefficient, McDonald's ω, and composite reliability of each dimension being all higher than 0.85. Most dimensions met the test-retest reliability standard except for the physical symptoms dimension (ICC = 0.64). Confirmatory factor analysis supported the structural validity of the final scale, and the model fit index satisfied the criterion. The correlations between dimensions of PROHIV-OLD and MOS-HIV met hypotheses in general. Significant differences on scores of the PROHIV-OLD were found between demographic and clinical subgroups, supporting known-groups validity. CONCLUSIONS The PROHIV-OLD was found to have good feasibility, reliability and validity for evaluating health outcome of Chinese older PLWHA. Other measurement properties such as responsiveness and interpretability will be further examined.
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Affiliation(s)
- Rui Zhou
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, 310058, Hangzhou, China
| | - Ying-Jing Zheng
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, 310058, Hangzhou, China
| | - Bei-Jia Wang
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, 310058, Hangzhou, China
| | - Donald L Patrick
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Todd C Edwards
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Jing-Yi Yun
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, 310058, Hangzhou, China
| | - Jie Zhou
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, 310058, Hangzhou, China
| | - Ren-Jun Gu
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, 310058, Hangzhou, China
| | - Bing-Hui Miao
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, 310058, Hangzhou, China
| | - Hong-Mei Wang
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, 310058, Hangzhou, China.
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Eke AC, Gebreyohannes RD, Powell AM. Understanding clinical outcome measures reported in HIV pregnancy studies involving antiretroviral-naive and antiretroviral-experienced women. THE LANCET. INFECTIOUS DISEASES 2023; 23:e151-e159. [PMID: 36375478 PMCID: PMC10040432 DOI: 10.1016/s1473-3099(22)00687-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/02/2022] [Accepted: 10/04/2022] [Indexed: 11/13/2022]
Abstract
HIV infection is a clinically significant public health disease and contributes to increased risk of maternal and fetal morbidity and mortality. HIV pregnancy studies use outcome measures as metrics to show how people with HIV feel, function, or survive. These endpoints are crucial for tracking the evolution of HIV illness over time, assessing the effectiveness of antiretroviral therapy (ART), and comparing outcomes across studies. Although the need for ideal outcome measures is widely acknowledged, selecting acceptable outcome measures for these HIV pregnancy studies can be challenging. We discuss the many outcome measures that have been implemented over time to assess HIV in pregnancy studies, their benefits, and drawbacks. Finally, we offer suggestions for improving the reporting of outcome measures in HIV in pregnancy studies. Medical professionals can best care for pregnant women living with HIV receiving ART by having a thorough understanding of these outcome metrics.
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Affiliation(s)
- Ahizechukwu C Eke
- Division of Maternal Foetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Rahel D Gebreyohannes
- Department of Obstetrics and Gynaecology, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
| | - Anna M Powell
- Department of Gynaecology & Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Wen H, Yang Z, Zhu Z, Han S, Zhang L, Hu Y. Psychometric properties of self-reported measures of health-related quality of life in people living with HIV: a systematic review. Health Qual Life Outcomes 2022; 20:5. [PMID: 35012574 PMCID: PMC8744327 DOI: 10.1186/s12955-021-01910-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/14/2021] [Indexed: 01/31/2023] Open
Abstract
Objective To identify and assess the psychometric properties of patient-reported outcome measures (PROMs) of health-related quality of life (HRQoL) in people living with HIV (PLWH). Methods Nine databases were searched from January 1996 to October 2020. Methodological quality was assessed by using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) Risk of Bias Checklist. We used the COSMIN criteria to summarize and rate the psychometric properties of each PROM. A modified Grading, Recommendations, Assessment, Development, and Evaluation (GRADE) system was used to assess the certainty of evidence. Results Sixty-nine studies reported on the psychometric properties of 30 identified instruments. All studies were considered to have adequate methodological quality in terms of content validity, construct validity, and internal consistency. Limited information was retrieved on cross-cultural validity, criterion validity, reliability, hypothesis testing, and responsiveness. High-quality evidence on psychometric properties was provided for the Medical Outcomes Study HIV Health Survey (MOS-HIV), the brief version of the World Health Organization's Quality of Life Instrument in HIV Infection (WHOQoL-HIV-BREF), 36-Item Short Form Survey (SF-36), Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQoL-HIV), and WHOQoL-HIV. Conclusions The findings from the included studies highlighted that among HIV-specific and generic HRQoL PROMs, MOS-HIV, WHOQoL-HIV-BREF, SF-36, MQoL-HIV, and WHOQoL-HIV are strongly recommended to evaluate HRQoL in PLWH in research and clinics based on the specific aims of assessments and the response burden for participants. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01910-w.
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Affiliation(s)
- Huan Wen
- Fudan University School of Public Health, Shanghai, China
| | - Zhongfang Yang
- School of Nursing, Fudan University, Shanghai, China.,Fudan University Centre for Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, 305 Fenglin Rd, Shanghai, 200032, China
| | - Zheng Zhu
- School of Nursing, Fudan University, Shanghai, China. .,Fudan University Centre for Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, 305 Fenglin Rd, Shanghai, 200032, China.
| | - Shuyu Han
- Peking University School of Nursing, Beijing, China
| | - Lin Zhang
- Shanghai Public Health Clinical Center, Shanghai, China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, China. .,Fudan University Centre for Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, 305 Fenglin Rd, Shanghai, 200032, China.
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Marques-Gomes J, Salt MJ, Pereira-Neto R, Barteldes FS, Gouveia-Barros V, Carvalho A, d'Arminio-Monforte A, De-la-Torre-Rosas A, Harris A, Esteves C, Maor C, Mora C, Oliveira C, Sousa C, Richman DD, Martinez E, Cota-Medeiros F, Gramacho F, Behrens GMN, Gonçalves G, Farinha H, Nabais I, Vaz-Pinto I, Sierra-Madero J, Sousa-Gago J, Thornhill J, Vera J, Erceg-Tusek M, Tavares M, Vasconcelos M, Fernandes N, Gianotti N, Langebeek N, Anjos P, Couto R, Fernandes R, Rajasuriar R, Serrão R, Watson S, Branco T, Teixeira T, Soriano V. Development of the HIV360 international core set of outcome measures for adults living with HIV: A consensus process. HIV Med 2021; 23:639-649. [PMID: 34964226 DOI: 10.1111/hiv.13221] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/26/2021] [Accepted: 12/06/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES HIV outcomes centre primarily around clinical markers with limited focus on patient-reported outcomes. With a global trend towards capturing the outcomes that matter most to patients, there is agreement that standardizing the definition of value in HIV care is key to their incorporation. This study aims to address the lack of routine, standardized data in HIV care. METHODS An international working group (WG) of 37 experts and patients, and a steering group (SG) of 18 experts were convened from 14 countries. The project team (PT) identified outcomes by conducting a literature review, screening 1979 articles and reviewing the full texts of 547 of these articles. Semi-structured interviews and advisory groups were performed with the WG, SG and people living with HIV to add to the list of potentially relevant outcomes. The WG voted via a modified Delphi process - informed by six Zoom calls - to establish a core set of outcomes for use in clinical practice. RESULTS From 156 identified outcomes, consensus was reached to include three patient-reported outcomes, four clinician-reported measures and one administratively reported outcome; standardized measures were included. The WG also reached agreement to measure 22 risk-adjustment variables. This outcome set can be applied to any person living with HIV aged > 18 years. CONCLUSIONS Adoption of the HIV360 outcome set will enable healthcare providers to record, compare and integrate standardized metrics across treatment sites to drive quality improvement in HIV care.
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Affiliation(s)
- João Marques-Gomes
- Nova School of Business and Economics, Carcavelos, Portugal.,Nova Medical School, Nova University Lisbon, Lisbon, Portugal
| | | | | | | | | | - Alexandre Carvalho
- Braga Public Hospital, Braga, Portugal.,School of Medicine, Minho University, Braga, Portugal
| | - Antonella d'Arminio-Monforte
- Institute of Infectious and Tropical Diseases - Department of Health Sciences, ASST Santi Paolo e Carlo University Hospital, Milan, Italy
| | | | - Amy Harris
- Aneurin Bevan University Health Board, NHS Wales, Newport, UK.,Pharmacy Department, Royal Gwent Hospital, Newport, UK
| | - Catarina Esteves
- Portuguese Association for the Clinical Study of AIDS (APECS), Lisbon, Portugal.,HIV-AIDS Functional Unit, Cascais Hospital Dr. José de Almeida, Cascais, Portugal
| | | | | | - Carla Oliveira
- Santo António Hospital, Porto University Hospital Centre, Porto, Portugal
| | | | - Douglas D Richman
- Center for AIDS Research, University of California San Diego, La Jolla, California, USA
| | | | - Fábio Cota-Medeiros
- Northern Lisbon University Hospital Centre, Lisbon, Portugal.,Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Filipa Gramacho
- Northern Lisbon University Hospital Centre, Lisbon, Portugal
| | - Georg M N Behrens
- Department for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Graça Gonçalves
- Northern Lisbon University Hospital Centre, Lisbon, Portugal
| | - Helena Farinha
- Pharmacy Department, Egas Moniz Hospital, Western Lisbon Hospital Centre, Lisbon, Portugal.,Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
| | - Isabel Nabais
- Northern Lisbon University Hospital Centre, Lisbon, Portugal.,Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Inês Vaz-Pinto
- HIV-AIDS Functional Unit, Cascais Hospital Dr. José de Almeida, Cascais, Portugal.,HIV Disease Study Group, Portuguese Society of Internal Medicine (NEDVIH-SPMI), Lisbon, Portugal
| | - Juan Sierra-Madero
- National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | - Joaquim Sousa-Gago
- Nova Medical School, Nova University Lisbon, Lisbon, Portugal.,Oeiras Mental Health Unit, Western Lisbon Hospital Centre, Lisbon, Portugal
| | - John Thornhill
- British HIV Association, London, UK.,Department of Medicine, Imperial College London, London, UK.,Barts Health NHS Trust, London, UK
| | - José Vera
- HIV Disease Study Group, Portuguese Society of Internal Medicine (NEDVIH-SPMI), Lisbon, Portugal.,Barreiro-Montijo Hospital Centre, Barreiro, Portugal
| | - Maja Erceg-Tusek
- Croatian Association for HIV and Viral Hepatitis (HUHIV), Zagreb, Croatia
| | | | - Miguel Vasconcelos
- Division of Intervention in Addictive Behaviours and Dependencies (DICAD), Regional Health Administration of Lisbon and Tagus Valley, Lisbon, Portugal
| | | | - Nicola Gianotti
- Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Raquel Couto
- Vila Nova de Gaia-Espinho Hospital Centre, Vila Nova de Gaia, Portugal
| | | | - Reena Rajasuriar
- Faculty of Medicine, University of Malaya, Kuala Lampur, Malaysia
| | | | | | - Teresa Branco
- Portuguese Association for the Clinical Study of AIDS (APECS), Lisbon, Portugal.,Fernando Fonseca Hospital, Amadora, Portugal
| | - Tiago Teixeira
- Infectious Diseases Department, Vila Nova de Gaia-Espinho Hospital Centre, Vila Nova de Gaia, Portugal
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Fauzi A, Anggraini N, Fatkhurohman N. Self-management: A comprehensive approach to improve quality of life among people living with HIV in Indonesia. BELITUNG NURSING JOURNAL 2021; 7:395-401. [PMID: 37496503 PMCID: PMC10367977 DOI: 10.33546/bnj.1554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/22/2021] [Accepted: 08/28/2021] [Indexed: 07/28/2023] Open
Abstract
Background People living with HIV (PLWH) today have to deal with a chronic condition that requires efficient self-management due to increased longevity. Self-management interventions have been shown to improve physical and psychological symptoms as well as clinical results in chronic diseases. However, few studies have investigated the effect of self-management on quality of life (QOL) among PLWH in Indonesia. Objective To examine the effect of a self-management program on QOL among PLWH in Indonesia. Methods This was a quasi-experimental study with a comparison group in a general hospital in Jakarta, Indonesia. Of the 114 recruited PLWH, 57 were assigned to the intervention group and 57 to the comparison group. The self-management group attended a four-week program workshop. The intervention consisted of five sessions: need assessment and goal setting, maintaining a healthy lifestyle, educational participation to increase communication and self-esteem, and evaluation. The comparison group received standard educational material throughout the leaflet regarding HIV prevention. The post-test assessment was conducted immediately after intervention (T1) and two months (T2) after the intervention in both groups. QOL was measured using the World Health Organization Quality of Life (WHOQOL)-HIV brief Bahasa version. The estimations were obtained using fixed-effect regressions. The differences between T0, T1, and T2 for the intervention and comparison groups were evaluated and compared using the DI Differences method (DID). Results The self-management program improved outcomes relative to the comparison group at T1: 1) overall QOL score increased 8.7% (95% CI 0.021-0.149), 2) physical domain saw a modest increased 8.8% (95% CI 0.017-0.125), 3) psychological domain increased 23.5 % (95% CI 0.085-0.689), and 4) environmental domain showed a modest increase of 18.7% (95% CI 0.053-0.371). At T2, the total QOL score and the physical, psychological, and environmental dimensions were significantly improved compared to the comparison group. Conclusion The self-management program appears to improve the QOL of the life of PLWH. Nurses are advised to provide PLWH with self-management training. Future research on self-management intervention would need to be refined further to ensure that each community achieves consistent intervention outcomes.
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