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Li JWY, Yan K, Balijepalli C, Druyts E. Humanistic burden of mucopolysaccharidoses: a systematic literature review. Curr Med Res Opin 2024; 40:709-722. [PMID: 38328952 DOI: 10.1080/03007995.2024.2316213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/05/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To systematically review the literature and summarize the health-related quality-of-life (HRQoL) of patients undergoing treatment for mucopolysaccharidoses (MPS), a rare, hereditary lysosomal storage disorder. METHODS A systematic review was performed in accordance with PRISMA guidelines to identify research studies that describe the humanistic burden of MPS. A comprehensive literature search was conducted in EMBASE, MEDLINE, and eligible conferences were screened to include applicable abstracts. RESULTS Of 870 identified articles, 15 studies reported the HRQoL burden of patients with MPS undergoing or with a history of ERT and/or HSCT. These studies include patients of MPS I (n = 2), MPS II (n = 4), MPS IV (n = 6), MPS VI (n = 1), and subtype not mentioned (n = 2). Although the quality-of-life of MPS patients is influenced by time of diagnosis, pain, cognitive involvement, severity of disease, mobility, dependence, and time of treatment initiation, the HRQoL scores of MPS patients across all the scales were below the median reference population scores across all dimensions. This is seen in comparison to healthy participants but also in comparison to patients with other chronic illnesses. The multi-organ involvement, neurological impairment, pain, and morbidity associated with the condition not only affects activity of daily living but also affects social functioning, emotional status, employment status among adults, and school functioning among children. CONCLUSIONS This systematic literature review revealed the substantial humanistic burden of individuals affected by MPS as well as caregivers. Significant variation in HRQoL scores was observed, however studies indicate that the quality-of-life of MPS patients is influenced primarily by severity of disease (MPS type and phenotype), and then by time of diagnosis, pain, cognitive involvement, mobility, dependence, and time of treatment initiation. Further studies are needed to assess the global humanistic burden of MPS, particularly in MPS III, VI, VII, and IX subtypes, in adults, and for a longer follow-up period. Considering the vast array of HRQoL assessment tools available and used in this study, researchers should also consider using scales with condition-specific measures to ensure appropriate estimates of effectiveness.
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Affiliation(s)
| | - Kevin Yan
- Pharmalytics Group, Vancouver, BC, Canada
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Yamada S, Bartunek J, Povsic TJ, Cotter G, Davison BA, Edwards C, Behfar A, Metra M, Filippatos GS, Vanderheyden M, Wijns W, Terzic A. Cell Therapy Improves Quality-of-Life in Heart Failure: Outcomes From a Phase III Clinical Trial. Stem Cells Transl Med 2024; 13:116-124. [PMID: 38006196 PMCID: PMC10872684 DOI: 10.1093/stcltm/szad078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 10/13/2023] [Indexed: 11/26/2023] Open
Abstract
Patients with heart failure experience limitations in daily activity and poor quality-of-life. Prospective surveillance of health-related quality-of-life supplemented traditional death and hospitalization outcomes in the multinational, randomized, double-blinded CHART-1 clinical trial that assessed cardiopoiesis-guided cell therapy in ischemic heart failure patients with reduced left ventricular ejection fraction. The Minnesota Living with Heart Failure Questionnaire (MLHFQ), a Food and Drug Administration qualified instrument for evaluating therapeutic effectiveness, was applied through the 1-year follow-up. Cell treated (n = 109) and sham procedure (n = 140) cohorts reported improved MLHFQ scores comparable between the 2 study arms (mean treatment difference with baseline adjustment -3.2 points, P = .107). Superiority of cell treatment over sham in betterment of the MLHFQ score was demonstrated in patients with pre-existing advanced left ventricular enlargement (baseline-adjusted mean treatment difference -6.4 points, P = .009). In this highly responsive subpopulation, benefit on the MLHFQ score paralleled reduction in death and hospitalization post-cell therapy (adjusted Mann-Whitney odds 1.43, 95% CI, 1.01-2.01; P = .039). The potential of cell therapy in addressing the quality-of-life dimension of heart failure requires further evaluation for disease relief.
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Affiliation(s)
- Satsuki Yamada
- Department of Cardiovascular Medicine, Center for Regenerative Medicine, Marriott Heart Disease Research Program, Van Cleve Cardiac Regenerative Medicine Program, Mayo Clinic, Rochester, MN, USA
| | | | - Thomas J Povsic
- Program for Advanced Coronary Disease, Duke Clinical Research Institute and Duke University Medical Center, Durham, NC, USA
| | - Gad Cotter
- Momentum Research, Inc., Durham, NC, USA
- Université Paris Cité; Inserm UMR-S 942, MASCOT, Paris, France
| | - Beth A Davison
- Momentum Research, Inc., Durham, NC, USA
- Université Paris Cité; Inserm UMR-S 942, MASCOT, Paris, France
| | | | - Atta Behfar
- Department of Cardiovascular Medicine, Center for Regenerative Medicine, Marriott Heart Disease Research Program, Van Cleve Cardiac Regenerative Medicine Program, Mayo Clinic, Rochester, MN, USA
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University and Spedali Civili, Brescia, Italy
| | - Gerasimos S Filippatos
- Department of Cardiology, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece
| | | | - William Wijns
- The Lambe Institute for Translational Medicine, the Smart Sensors Laboratory and CURAM, University of Galway, Galway, Ireland
| | - Andre Terzic
- Department of Cardiovascular Medicine, Center for Regenerative Medicine, Marriott Heart Disease Research Program, Van Cleve Cardiac Regenerative Medicine Program, Mayo Clinic, Rochester, MN, USA
- Department of Molecular Pharmacology & Experimental Therapeutics, Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA
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Mi J, Ishida M, Anindya K, McPake B, Fitzgibbon B, Laverty AA, Tran-Duy A, Lee JT. Impact of health risk factors on healthcare resource utilization, work-related outcomes and health-related quality of life of Australians: a population-based longitudinal data analysis. Front Public Health 2023; 11:1077793. [PMID: 38089024 PMCID: PMC10711273 DOI: 10.3389/fpubh.2023.1077793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Background Health risk factors, including smoking, excessive alcohol consumption, overweight, obesity, and insufficient physical activity, are major contributors to many poor health conditions. This study aimed to assess the impact of health risk factors on healthcare resource utilization, work-related outcomes and health-related quality of life (HRQoL) in Australia. Methods We used two waves of the nationally representative Household, Income, and Labor Dynamics in Australia (HILDA) Survey from 2013 and 2017 for the analysis. Healthcare resource utilization included outpatient visits, hospitalisations, and prescribed medication use. Work-related outcomes were assessed through employment status and sick leave. HRQoL was assessed using the SF-6D scores. Generalized estimating equation (GEE) with logit or log link function and random-effects regression models were used to analyse the longitudinal data on the relationship between health risk factors and the outcomes. The models were adjusted for age, sex, marital status, education background, employment status, equilibrium household income, residential area, country of birth, indigenous status, and socio-economic status. Results After adjusting for all other health risk factors covariates, physical inactivity had the greatest impact on healthcare resource utilization, work-related outcomes, and HRQoL. Physical inactivity increased the likelihood of outpatient visits (AOR = 1.60, 95% CI = 1.45, 1.76 p < 0.001), hospitalization (AOR = 1.83, 95% CI = 1.66-2.01, p < 0.001), and the probability of taking sick leave (AOR = 1.31, 95% CI = 1.21-1.41, p < 0.001), and decreased the odds of having an above population median HRQoL (AOR = 0.48, 95% CI = 0.45-0.51, p < 0.001) after adjusting for all other health risk factors and covariates. Obesity had the greatest impact on medication use (AOR = 2.02, 95% CI = 1.97-2.29, p < 0.001) after adjusting for all other health risk factors and covariates. Conclusion Our study contributed to the growing body of literature on the relative impact of health risk factors for healthcare resource utilization, work-related outcomes and HRQoL. Our results suggested that public health interventions aim at improving these risk factors, particularly physical inactivity and obesity, can offer substantial benefits, not only for healthcare resource utilization but also for productivity.
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Affiliation(s)
- Jun Mi
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Marie Ishida
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Kanya Anindya
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Barbara McPake
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Bernadette Fitzgibbon
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Anthony A. Laverty
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - An Tran-Duy
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Australian Centre for Accelerating Diabetes Innovations (ACADI), Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
| | - John Tayu Lee
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Department of Primary Care and Public Health, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
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Dalziel K, van Heusden A, Sarvananthar J, Jones R, McGregor K, Huang L, Rivero-Arias O, Herdman M, Hiscock H, Devlin N. A Qualitative Investigation to Develop an Adapted Version of the EQ-5D-Y-3L for Use in Children Aged 2-4 Years. Value Health 2023; 26:1525-1534. [PMID: 37348834 DOI: 10.1016/j.jval.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 06/02/2023] [Accepted: 06/08/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVES Few preference-weighted health-related quality-of-life measures exist for children under 5 years of age. Young children are substantial consumers of healthcare services. This project aims to assess EQ-5D-Y-3L's appropriateness in children aged 2 to 4 years and to coproduce with parents a suitable adaptation. METHODS Purposive sampling at the Murdoch Children's Research Institute and Royal Children's Hospital was used to recruit parents or carers of children aged 2 to 4 years in Australia. Online focus groups were conducted consisting of 13 parents of healthy children, and 6 parents of children with moderate to severe health conditions. Parents provided feedback on each dimension of the proxy EQ-5D-Y-3L. Recordings were transcribed and thematic analysis was conducted. Qualitative findings guided the design of adaptations to the instrument. The adaptations were piloted to obtain feedback and refined to improve language translatability and comparability with other EuroQol instruments. RESULTS The adapted EQ-5D-Y-3L was considered generally acceptable by the parents. Parents provided a wide range of examples of how each domain related to their children, with varied examples provided across ages 2 to 4 years and health status. Additional or alternative wording was suggested by parents to improve the applicability of the instrument to this age group. One example of this was the change of the domain wording "walking about" to "movement"-ID5:"In this age group, movement is more important than walking." CONCLUSIONS The adapted EQ-5D-Y-3L has improved relevance for 2-4-year olds and appears easy to complete. Further testing of the adapted instrument is required to evaluate acceptability, reliability, and validity.
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Affiliation(s)
- Kim Dalziel
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia; Health Services group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
| | - Alexander van Heusden
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Janani Sarvananthar
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Renee Jones
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia; Health Services group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Kristy McGregor
- Health Services group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Li Huang
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Oliver Rivero-Arias
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, England, UK
| | | | - Harriet Hiscock
- Health Services group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Nancy Devlin
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Ghia P, Barnes G, Yang K, Tam CS, Robak T, Brown JR, Kahl BS, Tian T, Szeto A, Paik JC, Shadman M. Health-related quality-of-life in treatment-naive CLL/SLL patients treated with zanubrutinib versus bendamustine plus rituximab. Curr Med Res Opin 2023:1-7. [PMID: 37752878 DOI: 10.1080/03007995.2023.2262381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/20/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVE Zanubrutinib is a highly selective, next-generation Bruton's tyrosine kinase inhibitor. In the phase 3 SEQUOIA trial (NCT03336333), treatment with zanubrutinib resulted in significantly improved progression-free survival compared to bendamustine plus rituximab (BR) in adult patients with treatment-naïve chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) without del(17p). The current analysis compared the effects of zanubrutinib versus BR on patients' health-related quality-of-life (HRQoL). METHODS In the SEQUOIA trial, patient-reported outcomes (PROs) were assessed at baseline and every 12 weeks (3 cycles) using the EORTC QLQ-C30 and EQ-5D-5L. Descriptive analyses were performed on all the questionnaires' scales and a mixed model for repeated measures was performed using the key QLQ-C30 endpoints of global health status/QoL (GHS/QoL), physical and role functioning, and symptoms of fatigue, pain, diarrhea, and nausea/vomiting at weeks 12 and 24. RESULTS Compared with BR-treated patients, those in the zanubrutinib arm experienced greater improvements in HRQoL outcomes at both weeks 12 and 24. By week 24, mean change differences (95% confidence interval) between the arms were significant for GHS/QoL (4.9 [0.9, 9.0]), physical functioning (3.8 [0.8, 6.7]), diarrhea (-6.2 [-10.0, -2.5]), fatigue (-4.5 [-8.9, -0.1]), and nausea/vomiting (-4.5 [-8.9, -0.1]); role functioning (4.8 [-0.2, 9.7]) was marginally better in the zanubrutinib arm and there were no differences in pain symptoms (-0.4 [-4.3, 5.1]) between the arms. CONCLUSIONS During the first 24 weeks of treatment, zanubrutinib was associated with better HRQoL outcomes in patients with treatment-naive CLL/SLL without del(17p) compared to BR. TRIAL REGISTRATION The SEQUOIA trial is registered on clinicaltrials.gov as SEQUOIA trial (NCT03336333).
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Affiliation(s)
- Paolo Ghia
- Division of Experimental Oncology, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milano, Italy
| | - Gisoo Barnes
- Health Economics and Outcomes Research, BeiGene USA, Inc, San Mateo, CA, USA
| | - Keri Yang
- Health Economics and Outcomes Research, BeiGene USA, Inc, San Mateo, CA, USA
| | - Constantine S Tam
- The Alfred Hospital, Melbourne, VIC, Australia
- Monash University, Clayton, VIC, Australia
| | - Tadeusz Robak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | | | - Brad S Kahl
- Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Tian Tian
- Health Economics and Outcomes Research, BeiGene USA, Inc, San Mateo, CA, USA
| | - Andy Szeto
- Health Economics and Outcomes Research, BeiGene USA, Inc, San Mateo, CA, USA
| | - Jason C Paik
- Health Economics and Outcomes Research, BeiGene USA, Inc, San Mateo, CA, USA
| | - Mazyar Shadman
- Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
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Ernst R, Bouteleux B, Malhouitre M, Grassion L, Zysman M, Henrot P, Delorme M. The Non-Paced 3-Minute Sit-to-Stand Test: Feasibility and Clinical Relevance for Pulmonary Rehabilitation Assessment. Healthcare (Basel) 2023; 11:2312. [PMID: 37628511 PMCID: PMC10454867 DOI: 10.3390/healthcare11162312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/26/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Pulmonary rehabilitation (PR) improves health-related quality-of-life (HRQoL) in individuals with chronic obstructive pulmonary disease (COPD), notably by increasing exercise tolerance. Easy-to-implement sit-to-stand tests can facilitate the assessment of exercise tolerance in routine practice. This retrospective study conducted in a real-life setting was designed to describe the non-paced 3-min sit-to-stand test (3-STST) and to evaluate its relationship with HRQoL (VQ11 questionnaire) to identify the determinants of 3-STST performance and to analyze the evolution of 3-STST performance and HRQoL over the course of a community-based PR program. Seventy-one COPD patients (age 69 ± 10 years old; 51% with GOLD spirometric stages III-IV) were included. Mean ± SD 3-STST performance at the initial PR assessment was 43 ± 15 repetitions. This performance was significantly associated with HRQoL and other indicators of clinical severity (lung function, dyspnea, and functional capacities). During the multivariate analysis, younger age, exertional dyspnea with mMRC ≤ 1, and better HRQoL were significantly associated with better 3-STST performance. From the initial to second PR assessment, changes in 3-STST performance were significantly associated with changes in HRQoL. This study provides evidence that the non-paced 3-STST is feasible and might be clinically relevant in the assessment of patients with COPD referred for community-based PR. This test deserves to be prospectively validated.
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Affiliation(s)
| | | | | | - Léo Grassion
- Département de Pneumologie, Hôpital du Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France
| | - Maéva Zysman
- Département de Pneumologie, Hôpital du Haut-Lévêque, CHU de Bordeaux, 33604 Pessac, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, INSERM U1045, CIC1401, 33604 Pessac, France
| | - Pauline Henrot
- Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, INSERM U1045, CIC1401, 33604 Pessac, France
- Service des Explorations Fonctionnelles Respiratoires, Département de Physiologie, CHU de Bordeaux, 33604 Pessac, France
| | - Mathieu Delorme
- Resp’Air, 33400 Talence, France
- Direction des Actions Médicales, AFM-Téléthon, 91000 Evry, France
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Omran M, Johansson H, Lundgren C, Silander G, Stenmark-Askmalm M, Loman N, Baan A, Adra J, Kuchinskaya E, Blomqvist L, Tham E, Bajalica-Lagercrantz S, Brandberg Y. Whole-body MRI surveillance in TP53 carriers is perceived as beneficial with no increase in cancer worry regardless of previous cancer: Data from the Swedish TP53 Study. Cancer 2023; 129:946-955. [PMID: 36601958 DOI: 10.1002/cncr.34631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/25/2022] [Accepted: 11/30/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND To evaluate the psychosocial consequences of surveillance with whole-body MRI (WB-MRI) in individuals with the heritable TP53-related cancer (hTP53rc) syndrome, also known as the Li-Fraumeni syndrome, with regard to cancer worry, perceived benefits and risks to surveillance and overall health. PATIENTS AND METHODS Since 2016, the national Swedish TP53 Study (SWEP53) has offered surveillance with WB-MRI to all individuals with hTP53rc syndrome. Seventy-five individuals have been included in the study. Sixty consecutive participants fulfilled a base-line evaluation as well as an evaluation after 1 year with structured questionnaires including the Cancer Worry Scale (CWS), perceived benefits and risks of surveillance, and the 36-item Short Form Survey (SF-36). Individuals with or without previous personal cancer diagnosis were enrolled and results at baseline and after 1 year of surveillance were compared. For SF-36, a comparison with the normal population was also made. RESULTS Participants with previous cancer tend to worry more about cancer, but both individuals with and without cancer had a positive attitude toward surveillance with no differences regarding perceived benefits and barriers to surveillance. Participants with a previous cancer scored significantly lower on some of the SF-36 subscales, but between-group differences were found only for social functioning after 1 year. CONCLUSIONS Surveillance with WB-MRI is feasible from a psychosocial point of view both among TP53 carriers with as well as without a previous history of cancer and does not increase cancer worry in any of the groups. PLAIN LANGUAGE SUMMARY Individuals with heritable TP53-related cancer syndrome (also known as the Li-Fraumeni syndrome) have a high lifetime risk of developing cancer. These TP53 carriers are offered surveillance with whole-body MRI to detect cancer early. There are few reports of the psychosocial impact of surveillance. In this study, we wanted to evaluate cancer worry, benefits and barriers to participation, and perceived overall health. Our study shows no increase in cancer worry after 1 year of surveillance, regardless of previous cancer.
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Affiliation(s)
- Meis Omran
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.,Cancer Theme, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Hemming Johansson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Claudia Lundgren
- Department of Immunology, Genetics and Pathology, Uppsala University Hospital, Uppsala, Sweden
| | - Gustav Silander
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Marie Stenmark-Askmalm
- Division of Clinical Genetics, Department of Laboratory Medicine, Office for Medical Services, Skåne University Hospital, Lund, Sweden
| | - Niklas Loman
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Malmö, Sweden
| | - Annika Baan
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jamila Adra
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Lennart Blomqvist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Imaging and Physiology, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Emma Tham
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Svetlana Bajalica-Lagercrantz
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.,Cancer Theme, Karolinska University Hospital Solna, Stockholm, Sweden.,Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Yvonne Brandberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
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MOL TI, SCHOLTEN EW, VAN BENNEKOM CAM, VISSER JMA, RENEMAN MF, DE GROOT V, MEIJER JWG, SMEETS RJ, POST MMW. Using Self-Regulation Assessment to Explore Associations between Self-Regulation, Participation and Health-Related Quality of Life in a Rehabilitation Population. J Rehabil Med 2023; 55:jrm00369. [PMID: 36749136 PMCID: PMC9930570 DOI: 10.2340/jrm.v55.2531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 11/29/2022] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE Self-regulation, participation and health-related quality of life are important rehabilitation outcomes. The aim of this study was to explore associations between these outcomes in a multi-diagnostic and heterogenic group of former rehabilitation patients. METHODS This cross-sectional survey used the Self-Regulation Assessment (SeRA), Utrecht Scale for Evaluation of Rehabilitation-participation (USERParticipation) and the Patient-Reported-Outcome-Measurement-System (PROMIS) ability and PROMIS satisfaction with participation in social roles, and the EuroQol-5L-5D and PROMIS-10 Global Health. Regression analyses, controlling for demographic and condition-related factors, were performed. RESULTS Respondents (n = 563) had a mean age of 56.5 (standard deviation (SD) 12.7) years. The largest diagnostic groups were chronic pain disorder and brain injury. In addition to demographic and condition-related factors, self-regulation subscales explained 0-15% of the variance in participation outcome scores, and 0-22% of the variance in HRQoL outcome scores. Self-regulation subscales explained up to 22% of the variance in satisfaction subscales of participation (USER-Participation and PROMIS) and the mental health subscale of the PROMIS-10. Self-regulation subscales explained up to 11% of the restriction and frequency subscales of participation (USER-Participation) and the physical health subscale of the PROMIS-10. CONCLUSION Self-regulation is more strongly associated with outcomes such as satisfaction with participation and mental health compared with outcomes such as restrictions in participation and physical health.
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Affiliation(s)
- Tanja I. MOL
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht,University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen
| | - Eline W.M. SCHOLTEN
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht
| | - Coen A. M. VAN BENNEKOM
- Heliomare Rehabilitation Center, Research and Development, Wijk aan Zee,Amsterdam University Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam
| | - Johanna M. A. VISSER
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Centre, University Medical Centre Utrecht
| | - Michiel F. RENEMAN
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen
| | - Vincent DE GROOT
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam
| | - Jan-Willem G MEIJER
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht,De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Rob J.E.M. SMEETS
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Life Sciences and Medicine, Maastricht University, Maastricht, Netherlands,CIR Rehabilitation, Netherlands,Pain in Motion International Research Group (PiM)
| | - M. Marcel W.M. POST
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht,University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen
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Dahl AA, Bentzen AG, Fosså SD, Hess SL, Kiserud CE. A study of modifiable factors associated with health-related quality of life in long-term cervical cancer survivors. Acta Obstet Gynecol Scand 2023; 102:218-225. [PMID: 36683549 PMCID: PMC9889314 DOI: 10.1111/aogs.14490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 11/03/2022] [Accepted: 11/19/2022] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Health-related quality of life (HR-QoL) in cancer survivors is relevant for symptom relief and optimal care. The aim of this cross-sectional study of long-term cervical cancer survivors was two-fold: (a) To compare HR-QoL in long-term cervical cancer survivors with reference data; and (b) to identify modifiable factors significantly associated with low levels of generic cancer HR-QoL in long-term cervical cancer survivors using high HR-QoL as reference. MATERIAL AND METHODS Women treated for cervical cancer from 2000 through 2007 who were cancer-free and alive in 2013 received a mailed questionnaire including scales for anxiety, depression, and HR-QoL. To obtain a homogeneous sample only women with FIGO stages 1 and 2 were included. The questionnaire included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.C-30 (EORTC QLQ C-30) for generic HR-QoL. Groups with high and low HR-QoL were defined by the median score on the general HR-QoL item. Between-group differences were examined with descriptive statistics. Logistic regression analyses examined independent variables associated with low generic HR-QoL. RESULTS Complete C-30 scores were delivered by 472 long-term cervical cancer survivors. Median age at survey was 53 (interquartile range 14.9) years, and median time since diagnosis was 11 (interquartile range 3.9) years. The proportion of survivors with stage 1 disease was 83% and stage 2 was 17%. Mean generic HR-QoL scores showed minor differences between long-term cervical cancer survivors and reference data. In the multivariable analysis, only modifiable variables remained significantly associated with low generic HR-QoL namely self-rated health, probable depression, fatigue, and pain. In bivariate analyses other modifiable variables also showed significant associations with low generic HR-QoL like probable anxiety disorder, obesity, smoking, sleep disturbances, and bowel symptoms. CONCLUSIONS Clinicians should be aware that generic HR-QoL in long-term cervical cancer survivors eventually may be improved by identification and treatment of modifiable factors through the whole follow-up period.
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Affiliation(s)
- Alv A. Dahl
- National Advisory Unit for Late Effects After Cancer TreatmentOslo University Hospital, The Norwegian Radium HospitalOsloNorway
| | - Anne Gry Bentzen
- Department of OncologyUniversity Hospital of Northern NorwayTromsøNorway
| | - Sophie D. Fosså
- National Advisory Unit for Late Effects After Cancer TreatmentOslo University Hospital, The Norwegian Radium HospitalOsloNorway,Faculty of MedicineUniversity of OsloOsloNorway
| | - Siri Lothe Hess
- National Advisory Unit for Late Effects After Cancer TreatmentOslo University Hospital, The Norwegian Radium HospitalOsloNorway
| | - Cecilie E. Kiserud
- National Advisory Unit for Late Effects After Cancer TreatmentOslo University Hospital, The Norwegian Radium HospitalOsloNorway
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10
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Shaw C, Gibson W. Assessing Quality-of-Life of Patients Taking Mirabegron for Overactive Bladder. Ther Clin Risk Manag 2023; 19:27-33. [PMID: 36647532 PMCID: PMC9840370 DOI: 10.2147/tcrm.s269318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/14/2022] [Indexed: 01/11/2023] Open
Abstract
Lower urinary tract symptoms (LUTS), including urgency, frequency, and urgency incontinence, are highly prevalent in the general population and increase in prevalence with increasing age. All LUTS, but notable urgency and urgency incontinence, are associated with negative impact on quality-of-life (QoL), with multiple aspects of QoL affected. Urgency and urgency incontinence are most commonly caused by overactive bladder (OAB), the clinical syndrome of urinary urgency, usually accompanied by increased daytime frequency and/or nocturia in the absence of infection or other obvious etiology, which may be treated with conservative and lifestyle interventions, bladder antimuscarinic drugs, and, more recently, by mirabegron, a β3 agonist. This narrative review describes the impact of OAB on QoL, quantifies this impact, and outlines the evidence for the use of mirabegron in the treatment of, and improvement in QoL in, people with OAB.
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Affiliation(s)
- Christina Shaw
- Division of Geriatric Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - William Gibson
- Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada,Correspondence: William Gibson, Division of Geriatric Medicine, University of Alberta, 1-198 Clinical Sciences Building, 11350 83 Ave NW, Edmonton, Alberta, T6E 2K4, Canada, Tel +1 780 248 1969, Fax +1 780 492 2874, Email
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11
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van Wijhe M, Fogh K, Ethelberg S, Karmark Iversen K, Nielsen H, Østergaard L, Andersen B, Bundgaard H, Jørgensen CS, Scharff BFSS, Ellermann-Eriksen S, Johansen IS, Fomsgaard A, Grove Krause T, Wiese L, Fischer TK, Mølbak K, Benfield T, Folke F, Lippert F, Ostrowski SR, Koch A, Erikstrup C, Vangsted AM, Sørensen AIV, Ullum H, Skov RL, Simonsen L, Nielsen SD. Persistent Symptoms and Sequelae After Severe Acute Respiratory Syndrome Coronavirus 2 Infection Not Requiring Hospitalization: Results From Testing Denmark, a Danish Cross-sectional Survey. Open Forum Infect Dis 2022; 10:ofac679. [PMID: 36628054 PMCID: PMC9825266 DOI: 10.1093/ofid/ofac679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with persistent symptoms ("long COVID"). We assessed the burden of long COVID among nonhospitalized adults with polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection. Methods In the fall of 2020, a cross-sectional survey was performed in the adult Danish general population. This included a self-administered point-of-care test for SARS-CoV-2 antibodies, the Short Form Health Survey (SF-12), and coronavirus disease 2019 (COVID-19)-associated symptom questions. Nonhospitalized respondents with a positive SARS-CoV-2 PCR test ≥12 weeks before the survey (cases) were matched (1:10) to seronegative controls on age, sex, and body mass index. Propensity score-weighted odds ratios (ORs) and ORs for risk factors were estimated for each health outcome. Results In total, 742 cases and 7420 controls were included. The attributable risk of at least 1 long-COVID symptom was 25.0 per 100 cases (95% confidence interval [CI], 22.2-27.4). Compared to controls, cases reported worse general health (OR, 5.9 [95% CI, 5.0-7.0]) and had higher odds for a broad range of symptoms, particularly loss of taste (OR, 11.8 [95% CI, 9.5-14.6]) and smell (OR, 11.2 [95% CI, 9.1-13.9]). Physical and Mental Component Summary scores were also significantly reduced with differences of -2.5 (95% CI, -3.1 to -1.8) and -2.0 (95% CI, -2.7 to -1.2), respectively. Female sex and severity of initial infection were major risk factors for long COVID. Conclusions Nonhospitalized SARS-CoV-2 PCR-positive individuals had significantly reduced physical and mental health, and 1 in 4 reported persistence of at least 1 long-COVID symptom.
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Affiliation(s)
- Maarten van Wijhe
- Department of Science and Environment, Roskilde University, Roskilde, Denmark
| | - Kamille Fogh
- Department of Cardiology, Copenhagen University Hospital, Herlev and Gentofte, Denmark,Department of Emergency Medicine, Copenhagen University Hospital, Herlev and Gentofte, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Steen Ethelberg
- Statens Serum Institut, Copenhagen, Denmark,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Karmark Iversen
- Department of Cardiology, Copenhagen University Hospital, Herlev and Gentofte, Denmark,Department of Emergency Medicine, Copenhagen University Hospital, Herlev and Gentofte, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Nielsen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Lars Østergaard
- Statens Serum Institut, Copenhagen, Denmark,Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Berit Andersen
- Statens Serum Institut, Copenhagen, Denmark,University Research Clinic for Cancer Screening, Randers Regional Hospital, Randers, Denmark
| | - Henning Bundgaard
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | | | - Bibi F SS Scharff
- Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Svend Ellermann-Eriksen
- Statens Serum Institut, Copenhagen, Denmark,Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark
| | - Isik S Johansen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | | | - Lothar Wiese
- Department of Infectious Diseases, Zealand University Hospital, Roskilde, Denmark
| | - Thea K Fischer
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark,Department of Clinical Research, North Zealand Hospital, Hillerød, Denmark
| | - Kåre Mølbak
- Statens Serum Institut, Copenhagen, Denmark,Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - Thomas Benfield
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,Department of Infectious Diseases, Copenhagen University Hospital, Amager and Hvidovre, Hvidovre, Denmark
| | - Fredrik Folke
- Department of Cardiology, Copenhagen University Hospital, Herlev and Gentofte, Denmark,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,Copenhagen Emergency Medical Services, Copenhagen, Denmark
| | - Freddy Lippert
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,Copenhagen Emergency Medical Services, Copenhagen, Denmark
| | - Sisse R Ostrowski
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Anders Koch
- Statens Serum Institut, Copenhagen, Denmark,Department of Public Health, University of Copenhagen, Copenhagen, Denmark,Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | | | | | | | | | - Lone Simonsen
- Department of Science and Environment, Roskilde University, Roskilde, Denmark
| | - Susanne Dam Nielsen
- Correspondence: Susanne Dam Nielsen, MD, DMSc, Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark ()
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12
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Ilska M, Kołodziej-Zaleska A, Banaś-Fiebrich E, Brandt-Salmeri A, Janowska-Tyc E, Łyszczarz A, Rzewiczok J, Piela B, Cnota W. Health-Related Quality-of-Life among Pregnant Women after First, Second, and Multiple Cesarean Sections in the Perinatal Period: A Short-Term Longitudinal Study. Int J Environ Res Public Health 2022; 19:16747. [PMID: 36554628 PMCID: PMC9779739 DOI: 10.3390/ijerph192416747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/04/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
The primary objective of this study was to compare assessments of health-related quality-of-life (HRQoL) in women who had a medical qualification for cesarean section (CS), depending on the number of CSs in their medical history. A short longitudinal study was conducted among 115 women on the day before a planned cesarean section (CS)-T1, and on the third day after CS-T2. They were divided into three groups. G1: no CS (n = 17); G2: one CS (n = 34); G3: two or more CSs (n = 64). Participants completed a set of questionnaires concerning sociodemographic aspects and psychological outcomes: the HRQoL questionnaire (EQ-5D-3L). A chi-square test, McNemar's test, and repeated measures ANOVA were used to compare the three groups in T1 and T2. Regardless of the number of CSs, before a CS, women mainly experience health problems with pain and anxiety/depression, and after a CS, mostly problems with pain, usual activity, and mobility. All participants experienced an increase in the amount of health problems with mobility and pain after a CS. Women who have had two or more CSs also had problems with self-care and usual activities. Women who have had one or two CSs experienced a decrease in the general assessment of the HRQoL, which is not observed in the group of women with multiple CSs. However, the HRQoL of women in the group with multiple CSs was lower before the CS than in the other groups. The results indicated the significance of the number of CSs, not only in postoperative, but also in preoperative HRQoL.
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Affiliation(s)
- Michalina Ilska
- Institute of Psychology, University of Silesia in Katowice, Grażyńskiego Street 53, 40-126 Katowice, Poland
| | - Anna Kołodziej-Zaleska
- Institute of Psychology, University of Silesia in Katowice, Grażyńskiego Street 53, 40-126 Katowice, Poland
| | - Ewa Banaś-Fiebrich
- Clinical Department of Perinatology, Gynaecology and Obstetrics in Ruda Ślaska, Medical University of Silesia, W. Lipa Street 2, 41-703 Ruda Śląska, Poland
| | - Anna Brandt-Salmeri
- Institute of Psychology, University of Silesia in Katowice, Grażyńskiego Street 53, 40-126 Katowice, Poland
| | - Ewa Janowska-Tyc
- Clinical Department of Perinatology, Gynaecology and Obstetrics in Ruda Ślaska, Medical University of Silesia, W. Lipa Street 2, 41-703 Ruda Śląska, Poland
| | - Anna Łyszczarz
- Clinical Department of Perinatology, Gynaecology and Obstetrics in Ruda Ślaska, Medical University of Silesia, W. Lipa Street 2, 41-703 Ruda Śląska, Poland
| | - Justina Rzewiczok
- Clinical Department of Perinatology, Gynaecology and Obstetrics in Ruda Ślaska, Medical University of Silesia, W. Lipa Street 2, 41-703 Ruda Śląska, Poland
| | - Bogusława Piela
- Clinical Department of Perinatology, Gynaecology and Obstetrics in Ruda Ślaska, Medical University of Silesia, W. Lipa Street 2, 41-703 Ruda Śląska, Poland
| | - Wojciech Cnota
- Clinical Department of Perinatology, Gynaecology and Obstetrics in Ruda Ślaska, Medical University of Silesia, W. Lipa Street 2, 41-703 Ruda Śląska, Poland
- Faculty of Health Sciences in Katowice, Medical University of Silesia, 41-703 Ruda Śląska, Poland
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13
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Buesch K, Zhang R, Szczepańska K, Veličković V, Turner L, Despotović M, Đorđević B, Russell A. Burden and severity of disease of aromatic L-amino acid decarboxylase deficiency: a systematic literature review. Curr Med Res Opin 2022; 38:1871-1882. [PMID: 35485958 DOI: 10.1080/03007995.2022.2072090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The objective was to investigate the severity of aromatic L-amino acid decarboxylase deficiency (AADCd) as reported in the published literature and to collate evidence of the clinical manifestations of AADCd, and the impact of the disease on patients, caregivers, and healthcare systems. METHODS Published articles reporting severity of disease or disease impact were eligible for inclusion in this review. Articles were searched in MEDLINE, EMBASE, Cochrane CENTRAL, TRIP medical, and CRD databases in October 2021. The quality of the included studies was investigated using a modified version of the grading system of the Centre for Evidence-Based Medicine (CEBM). Descriptive data of the literature was extracted and a narrative synthesis of the results across studies was conducted. This review is reported according to the PRISMA reporting guidelines for systematic reviews. RESULTS The search identified 970 unique reports, of which 59 met eligibility criteria to be included in the review. Of these, 48 included reports provided details on the clinical manifestations of AADCd. Two reports explored the disease impact on patients, while four described the impact on caregivers. Five reports assessed the impact on healthcare systems. Individuals with AADCd experience very severe clinical manifestations regardless of motor milestones achieved, and present with a spectrum of other complications. Individuals with AADCd present with very limited function, which, in combination with additional complications, substantially impact the quality-of-life of individuals and their caregivers. The five studies which explore the impact on the healthcare system reported that adequate care of individuals with AADCd requires a vast array of medical services and supportive therapies. CONCLUSIONS Irrespective of the ambulatory status of individuals, AADCd is a debilitating disease that significantly impacts quality-of-life for individuals and caregivers. It impacts the healthcare system due to the need for complex coordinated activities of a multidisciplinary specialist team.
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Affiliation(s)
| | | | | | - Vladica Veličković
- Core Models Ltd, London, United Kingdom
- Institute of Public Health, Medical Decision Making and HTA, UMIT, Hall in Tirol, Austria
| | - Lucy Turner
- Core Models Ltd, London, United Kingdom
- Research in Health Consulting, Ottawa, Canada
| | | | - Branka Đorđević
- Core Models Ltd, London, United Kingdom
- Biochemistry Department, Faculty of Medicine, University of Nis, Nis, Serbia
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14
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Horan MR, Sim JA, Krull KR, Baker JN, Huang IC. A Review of Patient-Reported Outcome Measures in Childhood Cancer. Children (Basel) 2022; 9:children9101497. [PMID: 36291433 PMCID: PMC9601091 DOI: 10.3390/children9101497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/07/2022] [Accepted: 09/23/2022] [Indexed: 11/20/2022]
Abstract
Patient-reported outcomes (PROs) are used in clinical work and research to capture the subjective experiences of childhood cancer patients and survivors. PROs encompass content domains relevant and important to this population, including health-related quality-of-life (HRQOL), symptoms, and functional status. To inform future efforts in the application of PRO measures, this review describes the existing generic and cancer-specific PRO measures for pediatric cancer populations and summarizes their characteristics, available language translations, content coverage, and measurement properties into tables for clinicians and researchers to reference before choosing a PRO measure that suits their purpose. We have identified often unreported measurement properties that could provide evidence about the clinical utility of the PRO measures. Routine PRO assessment in pediatric cancer care offers opportunities to facilitate clinical decision-making and improve quality of care for these patients. However, we suggest that before implementing PRO measures into research or clinical care, the psychometric properties and content coverage of the PRO measures must be considered to ensure that PRO measures are appropriately assessing the intended construct in childhood cancer patients.
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Affiliation(s)
- Madeline R. Horan
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Jin-ah Sim
- School of AI Convergence, Hallym University, Chuncheon 200160, Korea
| | - Kevin R. Krull
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
- Department of Psychology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Justin N. Baker
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - I-Chan Huang
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
- Correspondence: ; Tel.: +1-(901)-595-8369
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15
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Abstract
PURPOSE To evaluate the reliability, internal consistency, and construct validity of the Swedish versions of PROMIS-29 and Functional Assessment of Chronic Illness Therapy-Dyspnea (FACIT-Dyspnea) instruments in patients with systemic sclerosis (SSc). METHODS In a cross-sectional study, consecutive SSc patients completed a paper-based survey. Internal consistency was assessed using Cronbach's alpha. Test-retest reliability was tested employing weighted Kappa (Kw) and intra-class correlation coefficient (ICC). Construct validity was evaluated by hypotheses testing using RAND-36, MRC Dyspnea score, Scleroderma Health Assessment Questionnaire (SHAQ) and clinical measurements. RESULTS Forty-nine patients (86% female; 73% limited cutaneous SSc) completed the survey. The mean disease duration was 11 years and mean SHAQ was 0.5. Internal consistency and test-retest reliability were good with the exception of PROMIS-29 anxiety. PROMIS-29, FACIT-Dyspnea, and Functional limitation showed strong correlations to corresponding RAND-36 domains (|rs|=0.67 to -0.85). Relevant PROMIS-29 domains, FACIT-Dyspnea and Functional limitation correlated strongly to SHAQ and VAS overall disease severity (|rs|=0.60 to -0.75). Ceiling effects (>15%) were found in six PROMIS-29 domains and in both FACIT-Dyspnea and Functional limitations. Four (4/5) hypotheses were confirmed. CONCLUSIONS PROMIS-29 and FACIT-Dyspnea meet the requirements for reliability and have adequate construct validity in Swedish patients with SSc.Implications for rehabilitationPROMIS-29v2 and Functional Assessment of Chronic Illness Therapy-Dyspnea (FACIT-Dyspnea) Index are patient outcome measures that gain increasing interest for the evaluation of patient with rheumatologic diseases.PROMIS-29v2 and FACIT-Dyspnea Index meet the requirements for reliability and have adequate construct validity compared to legacy measures in Swedish patients with systemic sclerosis.Translation and validation of PROMs is important for studies of rare diseases in multi-center collaborations.
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Affiliation(s)
- Dirk M Wuttge
- Department of Clinical Sciences Lund, Rheumatology, Lund University and Skåne University Hospital, Lund, Sweden
| | - John E Chaplin
- Institution of Clinical Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Gunnel Sandqvist
- Department of Clinical Sciences Lund, Rheumatology, Lund University and Skåne University Hospital, Lund, Sweden
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Andersson V, Sawatzky R, Öhlén J. Relating person-centredness to quality-of-life assessments and patient-reported outcomes in healthcare: A critical theoretical discussion. Nurs Philos 2022; 23:e12391. [PMID: 35502530 PMCID: PMC9285740 DOI: 10.1111/nup.12391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 03/22/2022] [Accepted: 04/05/2022] [Indexed: 12/24/2022]
Abstract
Engagement with the historical and theoretical underpinnings of measuring quality of life (QoL) and patient‐reported outcomes (PROs) in healthcare is important. Ideas and values that shape such practices—and in the endgame, people's lives—might otherwise remain unexamined, be taken for granted or even essentialized. Our aim is to explicate and theoretically discuss the philosophical tenets underlying the practices of QoL assessment and PRO measurement in relation to the notion of person‐centredness. First, we engage with the late‐modern history of the concept of QoL and the act of assessing and measuring it. Working with the historical method of genealogy, we describe the development of both QoL assessments and PRO measures (PROMs) within healthcare by accounting for the contextual conditions for their possibility. In this way, the historical and philosophical underpinnings of these measurement practices are highlighted. We move on to analyse theoretical and philosophical underpinnings regarding the use of PROMs and QoL assessments in clinical practice, as demonstrated in review studies thereof. Finally, we offer a critical analysis regarding the state of theory in the literature and conclude that, although improved person‐centredness is an implied driver of QoL assessments and PROMs in clinical practice, enhanced theoretical underpinning of the development of QoL assessments is called for.
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Affiliation(s)
- Viktor Andersson
- Institute of Health and Care Sciences and Centre for Person-Centred Care, and Palliative Centre, University of Gothenburg, Sahlgrenska University Hospital Region Västra Götaland, Goteborg, Sweden
| | - Richard Sawatzky
- School of Nursing, Trinity Western University, Langley, British Columbia, Canada.,Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, British Columbia, Canada.,Institute of Health and Care Sciences and Centre for Person-Centred Care, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences and Centre for Person-Centred Care, and Palliative Centre, University of Gothenburg, Sahlgrenska University Hospital Region Västra Götaland, Goteborg, Sweden
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Xie J, Wang Y, Xu Y, Fine JT, Lam J, Garrison LP. Assessing health-related quality-of-life in patients with symptomatic obstructive hypertrophic cardiomyopathy: EQ-5D-based utilities in the EXPLORER-HCM trial. J Med Econ 2022; 25:51-58. [PMID: 34907813 DOI: 10.1080/13696998.2021.2011301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIMS To assess the effects of mavacamten on health-related quality-of-life (HRQoL) in symptomatic obstructive hypertrophic cardiomyopathy (HCM) and estimate health utilities by New York Heart Association (NYHA) functional class. MATERIALS AND METHODS Patients with symptomatic obstructive HCM were randomized to 30 weeks of mavacamten or to placebo treatment, with or without beta-blocker or calcium channel blocker monotherapy, in EXPLORER-HCM (ClinicalTrials.gov identifier: NCT03470545). Health utility was measured using the EuroQoL 5-dimension 5-level (EQ-5D-5L) index score with the US value set. The 30-week changes in EQ-5D-5L index score and EuroQoL visual analog scale (EQ-VAS) score were compared between the two arms using linear regression, and the proportions of patients with a meaningful improvement were compared using logistic regression. The meaningful change thresholds were estimated using both distribution- and anchor-based approaches. Mean utilities by NYHA class were estimated for each arm using a generalized estimating equation. RESULTS Compared with placebo (N = 89), patients receiving mavacamten (N = 96) had significantly greater 30-week improvement in EQ-5D-5L index score (mavacamten = 0.084; placebo = 0.009; adjusted difference = 0.073 [95% confidence interval = 0.027-0.118]) and EQ-VAS score (mavacamten = 8.5; placebo = 0.7; adjusted difference = 7.5 [95% confidence interval = 1.8-13.2]), and a significantly higher proportion of these patients showed meaningful improvement in EQ-5D-5L index score and EQ-VAS score. Both outcomes were correlated with the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ CSS) and HCM Symptom Questionnaire Shortness-of-Breath (HCMSQ SoB) subscore, two patient-reported anchor variables. Additionally, mean utilities significantly decreased with higher NYHA functional class (values for NYHA class I, II, and III/IV - mavacamten = 0.950, 0.866, and 0.708; placebo = 0.952, 0.850, and 0.704). CONCLUSIONS Compared with placebo, mavacamten significantly improved EQ-5D-5L index score and EQ-VAS score - and thus HRQoL - among patients with symptomatic obstructive HCM. Patients with a higher NYHA functional class had a lower health utility value.
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Affiliation(s)
- Jipan Xie
- Analysis Group, Inc., Los Angeles, CA, USA
| | - Yan Wang
- Analysis Group, Inc., Los Angeles, CA, USA
| | - Yaping Xu
- MyoKardia, Inc., a wholly owned subsidiary of Bristol Myers Squibb, Brisbane, CA, USA
| | - Jennifer T Fine
- MyoKardia, Inc., a wholly owned subsidiary of Bristol Myers Squibb, Brisbane, CA, USA
| | - Jenny Lam
- Bristol Myers Squibb, Brisbane, CA, USA
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Penny JD, Jarosz P, Salerno FR, Lemoine S, McIntyre CW. Impact of Expanded Hemodialysis Using Medium Cut-off Dialyzer on Quality of Life: Application of Dynamic Patient-Reported Outcome Measurement Tool. Kidney Med 2021; 3:992-1002.e1. [PMID: 34939008 PMCID: PMC8664707 DOI: 10.1016/j.xkme.2021.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Rationale & Objective Current hemodialysis (HD) treatments have limited ability to clear larger-molecular-weight uremic toxins. Retention is associated with increased symptom burden, low health-related quality of life (HRQoL), and high mortality. Improved clearance, using novel medium cut-off dialyzers, termed expanded HD (HDx), may be associated with improved subjective experience. We have previously developed a dynamic patient-reported outcome measure (PROM) instrument to allow iterative recording to better appreciate the overall burden of disease and assess the impact of therapy changes. Study Design Single-center interventional pilot study. Setting & Participants 28 patients established on maintenance HD, London, Ontario, Canada. Intervention Initial study consisting of 2-week observation (baseline-conventional high-flux HD) followed by 12 weeks of HDx. HRQoL was assessed using the dynamic PROM instrument thrice weekly (enabled in a dedicated app as the London Evaluation of Illness [LEVIL]). Extension phase; 2-week baseline with 24 weeks of HDx and 8-week washout. Outcomes Principal aim was to establish whether HDx therapy was associated with improved HRQoL, evidence of dose-dependant response, and whether effects were durable over time, using LEVIL. Results Patients with lower LEVIL scores (<70/100) at baseline showed improvement in overall HRQoL after 8 weeks of therapy with similar carryover effect. General well-being, energy, and sleep quality were improved significantly as a consequence of HDx therapy. There were no detrimental effects of HDx detected in patients with higher baseline HRQoL. Limitations Small nonrandomized sample size. The coronavirus disease 2019 pandemic interfered with the extension phase. Conclusions Dynamic PROM assessment effectively identified patients with lower HRQoL and higher symptom burden, demonstrating durable time/dose-dependent improvements across a range of symptom domains. The use of this instrument may allow targeted selection of patients most likely to benefit from HDx therapy and assist in monitoring response and defining effect size and treatment duration to allow optimal design of further definitive randomized controlled trials of this newly introduced technology. Funding Baxter Healthcare Canada. Trial Registration ClinicalTrials.gov ID: NCT03640858.
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Affiliation(s)
- Jarrin D. Penny
- The Lilibeth Caberto Kidney Clinical Research Unit, University of Western Ontario, London, Ontario, Canada
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Patricia Jarosz
- The Lilibeth Caberto Kidney Clinical Research Unit, University of Western Ontario, London, Ontario, Canada
| | - Fabio R. Salerno
- The Lilibeth Caberto Kidney Clinical Research Unit, University of Western Ontario, London, Ontario, Canada
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Sandrine Lemoine
- The Lilibeth Caberto Kidney Clinical Research Unit, University of Western Ontario, London, Ontario, Canada
| | - Christopher W. McIntyre
- The Lilibeth Caberto Kidney Clinical Research Unit, University of Western Ontario, London, Ontario, Canada
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
- Division of Nephrology, London Health Sciences Centre, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Address for Correspondence: Christopher W. McIntyre, MD, PhD, The Lilibeth Caberto Kidney Clinical Research Unit, Victoria Hospital, London Health Sciences Centre, 800 Commissioners Road East, London, Ontario, Canada N6A 5W9.
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Ergisi M, Erridge S, Harris M, Kawka M, Nimalan D, Salazar O, Loupasaki K, Ali R, Holvey C, Coomber R, Platt M, Rucker JJ, Sodergren MH. UK Medical Cannabis Registry: an analysis of clinical outcomes of medicinal cannabis therapy for generalized anxiety disorder. Expert Rev Clin Pharmacol 2021; 15:487-495. [PMID: 34937473 DOI: 10.1080/17512433.2022.2020640] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Anxiety disorders are one of the most common reasons for seeking treatment with cannabis-based medicinal products (CBMPs). Current pharmacological treatments are variable in efficacy and the endocannabinoid system has been identified as a potential therapeutic target. This study aims to detail the changes in health-related quality-of-life (HRQoL) and clinical safety following CBMP therapy for generalised anxiety disorder. METHODS A case series of the UK Medical Cannabis Registry was performed. Primary outcomes included change from baseline in patient-reported outcome measures (the General Anxiety Disorder Scale (GAD-7), EQ-5D-5L (a measure of health-related quality of life), and Sleep Quality Scale (SQS)) at 1, 3 and 6 months. Statistical significance was defined as p<0.050. RESULTS 67 patients were treated for generalised anxiety disorder. Statistically significant improvements were observed in GAD-7, EQ-5D-5L Index Value, EQ5D Visual Analogue Scale, and SQS scores at 1, 3 and 6 months (p<0.050). 25 (39.1%) patients reported adverse events during the follow-up period. CONCLUSION This study suggests that CBMPs may be associated with improvement in HRQoL outcomes when used as a treatment for generalised anxiety disorder. These findings must be treated with caution considering limitations of study design; however this data may help inform future clinical studies and practice.
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Affiliation(s)
- Mehmet Ergisi
- Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Simon Erridge
- Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK.,Sapphire Medical Clinics, London, UK
| | - Michael Harris
- Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Michal Kawka
- Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Devaki Nimalan
- Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Oliver Salazar
- Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Katerina Loupasaki
- Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Rayyan Ali
- Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK
| | | | - Ross Coomber
- Sapphire Medical Clinics, London, UK.,St. George's Hospital NHS Trust, London, UK
| | - Michael Platt
- Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK.,Sapphire Medical Clinics, London, UK
| | - James J Rucker
- Sapphire Medical Clinics, London, UK.,Department of Psychological Medicine, Kings College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Mikael H Sodergren
- Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK.,Sapphire Medical Clinics, London, UK
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20
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Egeberg A, Anderson P, Piercy J, Massey L, Cappelleri JC, Encinas GA, Feeney C, Dibonaventura M. Symptom burden of patients with moderate-to-severe atopic dermatitis. Eur J Dermatol 2021; 31:752-8. [PMID: 34935621 DOI: 10.1684/ejd.2021.4166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with intense and persistent pruritus. OBJECTIVES To examine associations between AD symptoms and health-related quality of life (HRQoL) in adults (aged ≥18 years) with moderate-to-severe AD. MATERIALS & METHODS Patient chart and survey data from physicians within Europe were derived from the Adelphi AD Disease Specific Programme (Q3 2019-Q2 2020). HRQoL measures included Euro-Qol 5-dimension, 3-level, questionnaire; Dermatology Life Quality Index; and Work Productivity and Activity Impairment-Atopic Dermatitis questionnaire. Data were evaluated using descriptive statistics and generalized linear models. RESULTS Of 631 patients, 90.1%, 49.3%, 18.5% and 17.7% reported pruritus, sleep disruption, anxiety and depression, respectively. Adjusted analyses indicated an increased frequency of symptoms associated with worse HRQoL and greater work/activity impairments, particularly for patients with pruritus and sleep disruption. CONCLUSION Reductions in symptom frequency may have important implications for improving the overall health of patients with moderate-to-severe AD.
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21
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Kawka M, Erridge S, Holvey C, Coomber R, Usmani A, Sajad M, Platt MW, Rucker JJ, Sodergren MH. Clinical Outcome Data of First Cohort of Chronic Pain Patients Treated With Cannabis-Based Sublingual Oils in the United Kingdom: Analysis From the UK Medical Cannabis Registry. J Clin Pharmacol 2021; 61:1545-1554. [PMID: 34473850 PMCID: PMC9292210 DOI: 10.1002/jcph.1961] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/27/2021] [Indexed: 12/20/2022]
Abstract
Cannabis-based medicinal products (CBMPs) are an emerging therapeutic option in the management of primary chronic pain, using the role of the endocannabinoid system in modulating central and peripheral pain processes. Despite promising preclinical data, there is a paucity of high-quality evidence to support the use of CBMPs for chronic pain. This study aimed to investigate the health-related quality-of-life outcomes of patients with chronic pain who were prescribed CBMP oil preparations (Adven, Curaleaf International, Guernsey, UK). This study is a case series of patients from the UK Medical Cannabis Registry, who were treated with CBMP oils for an indication of chronic pain. The primary outcomes were the changes in Brief Pain Inventory short form, Short-Form McGill Pain Questionnaire-2, Visual Analog Scale Pain, General Anxiety Disorder-7, Sleep Quality Scale, and EQ-5D-5L, at 1, 3, and 6 months. One hundred ten patients were included. Significant improvements in Sleep Quality Scale, EQ-5D-5L pain and discomfort subscale, and Brief Pain Inventory Interference Subscale (P < .05) at 1, 3, and 6 months were demonstrated. There were no notable differences between cannabis-naïve and previous cannabis users in quality-of-life outcomes. The adverse event incidence was 30.0%, with most (n = 58; 92.1%) adverse events being mild or moderate in intensity. Treatment of chronic pain with Adven CBMP oils was associated with an improvement in pain-specific outcomes, health-related quality of life, and self-reported sleep quality. Relative safety was demonstrated over medium-term prescribed use. While these findings must be treated with caution considering the limitations of study design, they can inform future clinical trials.
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Affiliation(s)
- Michal Kawka
- Imperial College Medical Cannabis Research Group, Imperial College London, London, UK
| | - Simon Erridge
- Imperial College Medical Cannabis Research Group, Imperial College London, London, UK.,Sapphire Medical Clinics, London, UK
| | | | - Ross Coomber
- Sapphire Medical Clinics, London, UK.,St George's Hospital NHS Trust, London, UK
| | - Azfer Usmani
- Sapphire Medical Clinics, London, UK.,Dartford and Gravesham NHS Trust, Kent, UK
| | - Mohammad Sajad
- Sapphire Medical Clinics, London, UK.,Dudley Group of Hospitals NHS Trust, Dudley, UK
| | - Michael W Platt
- Imperial College Medical Cannabis Research Group, Imperial College London, London, UK.,Sapphire Medical Clinics, London, UK
| | - James J Rucker
- Sapphire Medical Clinics, London, UK.,Department of Psychological Medicine, Institute of Psychiatry Psychology & Neuroscience, Kings College London, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Mikael H Sodergren
- Imperial College Medical Cannabis Research Group, Imperial College London, London, UK.,Sapphire Medical Clinics, London, UK
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22
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Wedin M, Stålberg K, Marcickiewicz J, Ahlner E, Åkesson Å, Lindahl G, Wodlin NB, Kjølhede P. Impact of lymphadenectomy and lymphoedema on health-related quality of life 1 year after surgery for endometrial cancer. A prospective longitudinal multicentre study. BJOG 2021; 129:450-460. [PMID: 34437763 DOI: 10.1111/1471-0528.16870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the impact of lymphadenectomy and lymphoedema of the lower limbs (LLL) on health-related quality of life (HRQoL) 1 year after surgery for endometrial cancer (EC). DESIGN Prospective longitudinal cohort multicentre study. SETTING Departments of obstetrics and gynaecology at four university hospitals, six central hospitals and four county hospitals in Sweden. POPULATION Two-hundred-and-thirty-five women with early stage EC were included; 116 with high-risk EC underwent surgery including lymphadenectomy (+LA), and 119 with low-risk EC had surgery without lymphadenectomy (-LA). METHODS The generic SF-36 and EQ-5D-3L and the lymphoedema-specific LYMQOL questionnaire were used to assess HRQoL. LLL was assessed by systematic circumferential measurements of the legs enabling volume estimation, clinical evaluation and patient-reported perception of leg swelling. All assessments were carried out on four occasions; preoperatively, and 4-6 weeks, 6 months and 1 year postoperatively. MAIN OUTCOME MEASURE HRQoL scores. RESULTS No significant differences were seen in HRQoL between the +LA and -LA groups 1 year postoperatively. Irrespective of method of determining LLL, women with LLL were significantly more affected in the LYMQOL domains Function, Appearance/body image and Physical symptoms, but not in the domain Emotion/mood, than women without LLL. No such differences were seen in the generic HRQoL or in the LYMQOL global score between the groups with and without LLL. CONCLUSIONS Lymphadenectomy did not seem to affect generic HRQoL adversely. Irrespective of the method of measuring, LLL affected the lymphoedema-specific HRQoL negatively, mainly in physical domains, but had no impact on the generic HRQoL. TWEETABLE ABSTRACT Lymphoedema has impact on lymphoedema-specific, but not on generic, HRQoL, 1 year after surgery for EC.
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Affiliation(s)
- M Wedin
- Department of Obstetrics and Gynaecology in Linköping, Department of Biomedical and Clinical Science, Linköping University, Linköping, Sweden
| | - K Stålberg
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - J Marcickiewicz
- Department of Obstetrics and Gynaecology, Varberg Hospital, Varberg, Sweden
| | - E Ahlner
- Department of Oncology, Department of Biomedical and Clinical Science, Linköping University, Linköping, Sweden
| | - Å Åkesson
- Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - G Lindahl
- Department of Oncology, Department of Biomedical and Clinical Science, Linköping University, Linköping, Sweden
| | - N B Wodlin
- Department of Obstetrics and Gynaecology in Linköping, Department of Biomedical and Clinical Science, Linköping University, Linköping, Sweden
| | - P Kjølhede
- Department of Obstetrics and Gynaecology in Linköping, Department of Biomedical and Clinical Science, Linköping University, Linköping, Sweden
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Tola Y, Ayele G, Boti N, Yihune M, Gethahun F, Gebru Z. Health-Related Quality-of-Life and Associated Factors Among Post-Partum Women in Arba Minch Town. Int J Womens Health 2021; 13:601-611. [PMID: 34188554 PMCID: PMC8232860 DOI: 10.2147/ijwh.s295325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 05/13/2021] [Indexed: 12/03/2022] Open
Abstract
Background It is generally accepted that pregnancy and childbirth are natural physiological processes. However, these significantly affect the quality of mothers’ lives. Little is known about the level of quality-of-life and associated factors among postpartum women in Ethiopia, particularly in the study area. Methods A community-based cross-sectional study was conducted among 409 randomly selected post-partum women who were living in Arba Minch town. Systematic random sampling was employed to select the study participants. The standard quality-of-life assessment tool which is known as the short-form SF 36 tool was used to assess health-related quality-of-life. The logistic regression model was used to identify associated factors. Statistically significant variables at a p-value<0.25 in the bi-variable analysis were candidate variables for multi-variable analysis and statistical significance which was declared at a p-value<0.05. Results Among the study participants, 255 (62.3%) had lower level health-related quality-of-life (HRQoL). About 46.2% of the study participants had lower physical HRQoL and about 79% of the study participants had lower mental HRQoL. The overall mean score of HRQoL was 45.15 (±8.13). Factors associated with lower overall HRQoL were age group 17–24 years (AOR=2.73, 95% CI=1.22–6.10), no formal education [AOR 2.02, 95% CI (1.05–3.89)], and cesarean delivery (AOR=0.49, 95% CI=0.24–0.97). A factor associated with lower physical HRQoL was cesarean delivery (AOR=0.34, 95% CI=0.13–0.88). Factors associated with lower mental HRQoL were age group 17–24 (AOR=3.37, 95% CI=1.60–7.04), not receiving antenatal care (AOR=3.65, 95% CI=1.45–9.16), and having postpartum depression (AOR=2.27, 95% CI=1.30–3.93). Conclusion The results suggest that the majority of post-partum women had a lower HRQoL, particularly women’s mental health was compromised. In this study, a suggestion is made that the respective bodies need to give particular attention to mothers during the post-partum period to prevent poor quality-of-life.
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Affiliation(s)
- Yirgalem Tola
- Arba Minch Health Science College, Department of Midwifery, Arba Minch, Ethiopia
| | - Gistane Ayele
- Arba Minch University, College of Medicine & Health Sciences, School of Public Health, Arba Minch, Ethiopia
| | - Negussie Boti
- Arba Minch University, College of Medicine & Health Sciences, School of Public Health, Arba Minch, Ethiopia
| | - Manaye Yihune
- Arba Minch University, College of Medicine & Health Sciences, School of Public Health, Arba Minch, Ethiopia
| | - Firdawek Gethahun
- Arba Minch University, College of Medicine & Health Sciences, School of Public Health, Arba Minch, Ethiopia
| | - Zeleke Gebru
- Arba Minch University, College of Medicine & Health Sciences, School of Public Health, Arba Minch, Ethiopia
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24
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Panuganti BA, Jafari A, Shen S, Qualliotine JR, Schueth EA, Campbell B, Ngoitsi H, Cordes S. Predictors of Quality-of-Life Improvements Following Global Head and Neck Surgery Trips to Underserved Regions. Laryngoscope 2021; 131:2006-2010. [PMID: 33734447 DOI: 10.1002/lary.29522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/23/2021] [Accepted: 03/05/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To conduct longitudinal postoperative follow-up and discern health-related quality-of-life (HR-QoL) changes using a validated questionnaire among patients undergoing head and neck surgeries during a short-term, global surgical trip in a resource-limited setting. To identify clinicodemographic predictors of post-operative HR-QoL improvements in this setting. STUDY DESIGN Retrospective observational study with prospective follow-up. METHODS Patients undergoing surgery at Moi Teaching and Referral Hospital in Eldoret, Kenya through the authors' short-term surgical trip (STST) between 2016 and 2019 were asked to complete preoperative Short Form-36 (SF-36) HR-QoL questionnaires, and postoperative SF-36 questionnaires during subsequent follow-up. Preoperative and postoperative SF-36 domain scores, and two composite scores (mental component summary [MCS] and physical component summary [PCS]) were compared. Linear regression models were fit to identify clinicodemographic factors predictors of general health (GH), MCS, and PCS scores. RESULTS Among the 26 participating patients, significant improvements were seen in post-operative GH (mean change = 19.8) and MCS (mean change = 11.2) scores. Lower pre-operative GH, MCS, and PCS scores were predictive of greater improvement in the corresponding post-operative scores. Longer time to follow-up was associated with greater improvement in GH score. Mean follow-up interval was 23.1 months (SD = 1.8 months). CONCLUSIONS Utilizing the SF-36 questionnaire, we found that patients' perception of their general and psychosocial health improved after undergoing head and neck surgeries through a global STST. This study provides important, preliminary evidence that that elective surgeries performed in low-resource settings convey substantial benefit to patient QoL. LEVEL OF EVIDENCE 4 Laryngoscope, 131:2006-2010, 2021.
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Affiliation(s)
- Bharat A Panuganti
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A
| | - Aria Jafari
- Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A
| | - Sarek Shen
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A
| | - Jesse R Qualliotine
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California-San Diego, San Diego, California, U.S.A
| | - Elizabeth A Schueth
- Department of Otolaryngology, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A
| | - Bruce Campbell
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Henry Ngoitsi
- Moi Teaching and Referral Hospital, Moi University School of Medicine, Eldoret, Kenya
| | - Susan Cordes
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A
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Dainelli L, Luo DR, Cohen SS, Marczewska A, Ard JD, Coburn SL, Lewis KH, Loper J, Matarese LE, Pories WJ, Rothberg AE. Health-Related Quality of Life in Weight Loss Interventions: Results from the OPTIWIN Trial. Int J Environ Res Public Health 2021; 18:ijerph18041785. [PMID: 33673158 PMCID: PMC7917903 DOI: 10.3390/ijerph18041785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/02/2022]
Abstract
Obesity is highly prevalent and associated with several adverse outcomes including health-related quality-of-life (HRQoL), work productivity, and activity impairment. The objective of this study is to examine group differences in HRQoL and labor-related health outcomes among participants in the OPTIWIN program, which compared the effectiveness of two intensive behavioral weight loss interventions. Participants (n = 273) were randomized to OPTIFAST®(OP) or food-based (FB) dietary interventions for 52 weeks. HRQoL and labor-related health outcomes were measured at baseline, week 26, and week 52, using two questionnaires. At baseline, there were no differences between groups on the Impact of Weight on Quality-of-Life Questionnaire (IWQOL-Lite). At week 26, the OP group had statistically significant differences towards better HRQoL for Physical Function, Self-Esteem, and the total score compared with the FB group. At week 52, the OP group showed better HRQoL in the total score (p = 0.0012) and in all but one domain. Moreover, the adjusted change-from-baseline normalized total score at week 52 was −5.9 points (p = 0.0001). Finally, the mean IWQOL-Lite normalized score showed that HRQoL improves by 0.4442 units (p < 0.0001) per kg lost, and that greater weight reduction was positively associated with better HRQoL. No statistically significant group differences were found with the Work Productivity and Activity Impairment (General Health) (WPAI-GH) Questionnaire. HRQoL improves with highly intensive, well-structured weight loss interventions. Greater weight loss lead to larger improvements. The lack of negative effect on productivity and activity suggests that these interventions may be compatible with an active work lifestyle.
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Affiliation(s)
- Livia Dainelli
- Nestlé Research, Nestlé, 1000 Lausanne, Switzerland; (L.D.); (D.R.L.)
| | - Dan Roberto Luo
- Nestlé Research, Nestlé, 1000 Lausanne, Switzerland; (L.D.); (D.R.L.)
| | | | | | - Jamy D. Ard
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; (J.D.A.); (K.H.L.)
| | | | - Kristina H. Lewis
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA; (J.D.A.); (K.H.L.)
| | - Judy Loper
- The Central Ohio Nutrition Center, Inc., Gohanna, OH 43230, USA;
| | - Laura E. Matarese
- Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC 27101, USA; (L.E.M.); (W.J.P.)
| | - Walter J. Pories
- Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC 27101, USA; (L.E.M.); (W.J.P.)
| | - Amy E. Rothberg
- Department of Nutritional Sciences, School of Public Health and Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Harbour, MI 48109-2029, USA
- Correspondence:
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Johnston K, Stoffman JM, Mickle AT, Klaassen RJ, Diles D, Olatunde S, Eliasson L, Bahar R. Preferences and Health-Related Quality-of-Life Related to Disease and Treatment Features for Patients with Hemophilia A in a Canadian General Population Sample. Patient Prefer Adherence 2021; 15:1407-1417. [PMID: 34194224 PMCID: PMC8238543 DOI: 10.2147/ppa.s316276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/09/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Current treatments for hemophilia A in Canada include on-demand treatment as bleeds occur and regular intravenous prophylactic factor VIII (FVIII) infusions. The subcutaneous therapy emicizumab was recently approved for treatment of hemophilia A. The objective of this study was to estimate utility values associated with hemophilia A health and treatment states from a Canadian societal perspective, including preferences related to treatment efficacy and frequency and route of administration. METHODS A vignette-based time trade-off (TTO) utilities elicitation was undertaken in Canadian adults to compare preferences for six hemophilia health states describing prophylactic and on-demand treatment, with varying bleed rates and frequency of treatment administration. A convenience sample was recruited via market research panels and snowball sampling. Health state/vignette definitions were informed by clinical experience, clinical trial results regarding bleed frequency, and validated by qualitative interviews of hemophilia patients and caregivers (n=10). Utilities were estimated via an online, trained interviewer-guided, vignette-based TTO exercise, where respondents valuated health states describing hemophilia patients (adults or children) receiving subcutaneous prophylaxis, intravenous prophylaxis, and on-demand treatments. Analyses included a descriptive analysis by health state; a mixed-effects analysis of utility values adjusted for subcutaneous vs infusion-based therapies and number of bleeds; and for prophylactic regimens, an analysis of utilities by frequency of infusions or injections. RESULTS TTO interviews were conducted with 82 respondents. Mean utilities [95% CI] were highest for subcutaneous prophylaxis (0.90 [0.87-0.93]), followed by intravenous prophylaxis (0.81 [0.78-0.85]), and on-demand treatment (0.70 [0.65-0.76]). In regression analysis, subcutaneous treatment health states were associated with a utility increment of +0.1112. Additional bleeds and more frequent infusions were associated with lower utility values (-0.0027 per bleed and -0.0003 per infusion). CONCLUSION Subcutaneous prophylaxis is associated with higher utility values compared to intravenous prophylactic and on-demand treatment, while increased bleeds and infusions are associated with reduced utility.
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Affiliation(s)
- Karissa Johnston
- Broadstreet HEOR, Vancouver, BC, Canada
- School of Pharmacy, Memorial University, St John’s, NL, Canada
- Correspondence: Karissa Johnston Broadstreet Health Economics and Outcomes Research, 201–343 Railway Street, Vancouver, BCV6A 1A4, Canada Email
| | - Jayson M Stoffman
- Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Robert J Klaassen
- Department of Pediatrics, Children’s Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Demitri Diles
- Hoffmann-La Roche Limited, Mississauga, ON, L5N 5M8, Canada
| | - Shade Olatunde
- Hoffmann-La Roche Limited, Mississauga, ON, L5N 5M8, Canada
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Manh Than H, Minh Nong V, Trung Nguyen C, Phu Dong K, Ngo HT, Thu Doan T, Thu Do N, Huyen Thi Nguyen T, Van Do T, Xuan Dao C, Quang Nguyen T, Ngoc Pham T, Duy Do C. Mental Health and Health-Related Quality-of-Life Outcomes Among Frontline Health Workers During the Peak of COVID-19 Outbreak in Vietnam: A Cross-Sectional Study. Risk Manag Healthc Policy 2020; 13:2927-2936. [PMID: 33324126 PMCID: PMC7733435 DOI: 10.2147/rmhp.s280749] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 10/14/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Mental health is an important component of the protection strategy for healthcare workers (HCWs). However, it has not been well described in Vietnam during the COVID-19 outbreak. This study aims to measure the psychological distress and health-related quality-of-life among frontline healthcare workers during the peak of the outbreak in Vietnam. PATIENTS AND METHODS We conducted a cross-sectional survey on 173 health workers at two national tertiary hospitals in Hanoi, Vietnam from March to April 2020. The psychological distress was measured by the Depression, Anxiety, and Stress Scale - 21 Items (DASS-21), Impact of Event Scale - Revised (IES-R), and the Insomnia Severity Index (ISI). EQ-5D-5L was used to determine the health-related quality-of-life (HRQoL) outcomes. RESULTS Among 173 HCWs, the proportion of reported depression symptoms, anxiety symptoms, and stress was 20.2%, 33.5%, and 12.7%, respectively. The median EQ-5D-5L index score was 0.93 (IQR=0.85-0.94), and the anxiety/depression aspect had the highest reported problems. The most COVID-19-specific concerns among frontline HCWs were the reduction of income (59%) and the increase of living costs (54.3%). HCWs working in the COVID-19-designated hospital had a significantly higher rate of mental health problems and had a lower HRQoL outcome than those working in non-COVID-19-designated hospitals. Other factors associated with psychological distress and sleep problems include age, job title, income, chronic diseases status, and years of working in healthcare settings. HCWs who were ≥30 years old, had higher working years, had higher incomes, and had mental health and sleep problems were more likely to have lower HRQoL scores. CONCLUSION We reported a moderate rate of psychological distress and lower HRQoL outcomes among frontline HCWs during the COVID-19 outbreak in Vietnam. Various factors were found to be associated with mental health and HRQoL that might be useful for implementing appropriate interventions for HCWs in low-resource settings.
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Affiliation(s)
- Hung Manh Than
- Emergency Department, National Hospital for Tropical Diseases, Hanoi, Vietnam
| | - Vuong Minh Nong
- Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | - Cap Trung Nguyen
- Emergency Department, National Hospital for Tropical Diseases, Hanoi, Vietnam
| | | | - Hoa Thi Ngo
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Tra Thu Doan
- Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | - Nga Thu Do
- Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | | | - Thanh Van Do
- Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam
| | | | | | | | - Cuong Duy Do
- Center for Tropical Diseases, Bach Mai Hospital, Hanoi, Vietnam
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Ohno S, Chen Y, Sakamaki H, Matsumaru N, Tsukamoto K. Factors associated with humanistic burden and indirect cost among patients with cancer in Japan. J Med Econ 2020; 23:1570-1578. [PMID: 33074747 DOI: 10.1080/13696998.2020.1839234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIMS Patients with cancer experienced reduced health-related quality-of-life (HRQoL), increased work productivity and activity impairment (WPAI), and indirect costs. With the current emphasis on economic evaluation of health technology in Japan, it is important to understand how indirect costs correlate with HRQoL and patient characteristics. It is also crucial to assess the patient characteristics associated with the HRQoL, WPAI, and indirect costs among patients with any types of cancer. MATERIALS AND METHODS This cross-sectional study used data from the 2017 Japan National Health and Wellness Survey (NHWS). Respondents self-reported their HRQoL and WPAI by answering validated SF-12v2 and WPAI questionnaires, respectively. Indirect costs were derived using the human capital method. Correlation between HRQoL components and indirect costs were assessed using Spearman's rank-order correlation. Correlation between patient characteristics and HRQoL, WPAI, and indirect costs were analyzed using generalized linear models. RESULTS A total of 1,540 patients with any types of cancer, 254 with breast cancer, and 144 with colorectal cancer were included in the analyses. There was significant negative correlation between the indirect costs and HRQoL components among patients with any types of cancer. Patients with lower comorbid burden, higher household income, employed, married, or living with partner, never smokers, and exercised tended to have higher HRQoL. Being never smokers, having lower comorbid burden, normal weight, and exercised were associated with lower WPAI measures. Additionally, patients who were older, not married, not obese, and not smoking tended to incur lower indirect costs. CONCLUSIONS The negative correlation between HRQoL and indirect costs among patients with cancer emphasized the needs to improve health outcomes and reduce indirect costs of patients. The factors associated with cancer burden identified in this study provide insights to allow targeted intervention to improve HRQoL and lessen the WPAI and indirect cost among cancer patients in Japan.
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Affiliation(s)
- Shinya Ohno
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
- Chugai Pharmaceutical Co., Ltd, Tokyo, Japan
| | - Yirong Chen
- Health Division, Kantar, Singapore, Singapore
| | - Hiroyuki Sakamaki
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan
| | - Naoki Matsumaru
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Katsura Tsukamoto
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
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Yoshino Y, Kitazawa T, Ota Y. Clinical Efficacy of Baloxavir Marboxil in the Treatment of Seasonal Influenza in Adult Patients: A Prospective Observational Study. Int J Gen Med 2020; 13:735-741. [PMID: 33061543 PMCID: PMC7534846 DOI: 10.2147/ijgm.s273266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Baloxavir marboxil, a recently developed antiviral drug, has been used to treat influenza in some countries including Japan. The aim of this study was to determine the clinical efficacy of the drug, which currently remains unclear. PATIENTS AND METHODS Overall, 43 adult patients with seasonal influenza who visited the outpatient clinic of Teikyo University Hospital in Tokyo during the winter of 2018-2019 were enrolled. Of them, 14, 13, and 16 were prescribed baloxavir marboxil (40 or 80 mg once), oseltamivir (75 mg twice daily for 5 days), and laninamivir (40 mg once), respectively. A questionnaire was used to collect data about symptoms, and the Medical Outcome Study 8-Items Short Form Health Survey was employed to examine health-related quality-of-life (HRQOL) before and 7 days after admission. The main study endpoints included time to defervescence and the extent of improvement in HRQOL after treatment initiation. The data were analyzed with Welch's t-test and Fisher's exact test using StatFlex version 6. RESULTS No significant differences in clinical background characteristics were observed among the patients. The mean time to defervescence in the baloxavir group (median [interquartile range]; 1.0 [1.0-2.0] days) was significantly shorter than that in the laninamivir group (2.0 [1.5-3.5] days; p=0.0322). No significant differences in mean time to defervescence, change in HRQOL, and time for resolution of other symptoms were observed between the groups. CONCLUSION The results suggest that baloxavir marboxil has a better antipyretic effect than oseltamivir and laninamivir. Moreover, baloxavir marboxil might be clinically more valuable than the other two drugs owing to higher medication adherence among patients.
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Affiliation(s)
- Yusuke Yoshino
- Department of Internal Medicine, Teikyo University School of Medicine, Itabashi, Tokyo, Japan
| | - Takatoshi Kitazawa
- Department of Internal Medicine, Teikyo University School of Medicine, Itabashi, Tokyo, Japan
| | - Yasuo Ota
- Department of Internal Medicine, National Hospital Organization Higashi Saitama Hospital, Hasuda, Saitama, Japan
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Abstract
STUDY DESIGN Longitudinal cohort. OBJECTIVES The Hospital Anxiety and Depression Scale (HADS) was developed to provide clinicians a reliable, valid, and practical tool to identify and quantify the anxiety and depression in medical patients. Several studies have shown that patients with chronic low back pain may have subclinical depression and impairments in mental health and that these in turn may lead to less than optimal results after lumbar spine surgery. The purpose of this study is to determine if there are associations between preoperative HADS and differences in pre- and postoperative health-related quality-of-life (HRQOLs) scores after spine surgery. METHODS From a single center, a consecutive series of patients completed the HADS, Oswestry Disability Index (ODI), Short Form-36 (SF-36), EuroQOL-5D (EQ-5D), and Visual Analog Scale (VAS) for back and leg pain. Except for HADS, the patients completed the same HRQOLs 1 year after surgery. RESULTS Of 308 eligible cases, 208 (68%) had follow-up data available and were included in the analysis. Patients in the HADS-Anxiety (HADS-A) Abnormal category had the worst preoperative HRQOLs but had the greatest improvement in 1-year postoperative scores. Except for VAS Leg Pain, preoperative HRQOLs were better in patients in the HADS-Depressed (HADS-D) Normal category. Patients in the HADS-D Abnormal category had statistically significantly greater improvement in 1-year postoperative EQ-5D and ODI scores when compared with the other cohorts. CONCLUSION Worse HADS-A and HADS-D scores are associated with worse preoperative HRQOL scores in patients with lumbar degenerative disorders scheduled for spine surgery. However, similar improvements in HRQOLs can be expected 1 year postoperative regardless of the patients' HADS scores.
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Affiliation(s)
- Leah Y. Carreon
- Middelfart Hospital, Middelfart, Denmark,Leah Y. Carreon, Center for Spine Surgery and
Research, Middelfart Hospital, Ostre Hougvej 55, 5500 Middelfart, Denmark.
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Yu L, Huang X, Gale RP, Wang H, Jiang Q. Variables associated with patient-reported symptoms in persons with chronic phase chronic myeloid leukemia receiving tyrosine kinase inhibitor therapy. Medicine (Baltimore) 2019; 98:e18079. [PMID: 31770225 PMCID: PMC6890299 DOI: 10.1097/md.0000000000018079] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the variables associated with patient-reported symptoms and the impact of symptoms on health-related quality-of-life (HRQoL) in patients with chronic myeloid leukemia (CML) receiving tyrosine kinase inhibitors (TKIs). METHODS Anonymous Chinese-language questionnaires were distributed to adults with chronic-phase CML (CML-CP) receiving TKIs therapy >3 months regarding symptoms' incidence, severity, and HRQoL. The multivariate cumulative logistic regression model was built to identify variables associated with the symptoms. General Linear Model was used to model the relationship between symptoms and HRQoL using stepwise-forward algorithm. RESULTS A total of 1142 respondents were included in this study. The top 10 common TKI-related symptoms were fatigue, periorbital and lower limb edema, chest distress and shortness of breath, memory deterioration, skin color change, alopecia, muscle cramp, weight gain and musculoskeletal pain, and itchy skin. One hundred forty-one (50%) females ≤50 years reported menstrual disorders. Female, married, therapy duration 1 to 3 years, and foreign generic TKIs were associated with increased symptoms' frequency and severity. In contrast, receiving nilotinib or dasatinib, and achieving a complete cytogenetic response but not complete molecular response were associated with fewer and milder symptoms. Chest distress and shortness of breath and loss of appetite were associated with both lower physical component summary (PCS) and mental component summary (MCS) scores; fatigue, musculoskeletal pain, dizziness and abdominal pain, were associated with lower PCS score; anxiety-depression, was associated with lower MCS score in multivariate analyses. CONCLUSIONS Demographic and social variables, type of TKI-therapy, therapy duration, and depth of response were associated with patient-reported symptoms in persons with chronic phase CML. Certain symptoms have adverse impact on HRQoL.
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Affiliation(s)
- Lu Yu
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Xiaojun Huang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China
| | - Robert Peter Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, UK
| | - Haibo Wang
- Peking University Clinical Research Institute, Beijing
| | - Qian Jiang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing, China
- Collaborative Innovation Center of Haematology, Soochow University, Suzhou, China
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Podzamczer D, Rozas N, Domingo P, Miralles C, den Eynde EV, Romero A, Deig E, Knobel H, Pasquau J, Antela A, Clotet B, Geijo P, de Castro ER, Casado MA, Muñoz A, Casado A, For The Pro-Str Study Group. Real World Patient-reported Outcomes in HIV-infected Adults Switching to EVIPLERA®, Because of a Previous Intolerance to cART. PRO-STR Study. Curr HIV Res 2019; 16:425-435. [PMID: 30760189 PMCID: PMC6700757 DOI: 10.2174/1570162x17666190212163518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 12/29/2022]
Abstract
Background: To investigate the impact of switching from stable Combined Antiretroviral Therapy (cART) to single-tablet regimen (RPV/FTC/TDF=EVIPLERA®/COMPLERA®) on patient-reported outcomes in HIV-infected adults who cannot tolerate previous cART, in a real-world setting. Methods: PRO-STR is a 48-week observational, prospective, multicenter study. Presence and magnitude of symptoms (main endpoint), health-related quality-of-life (HRQoL), adherence, satisfaction with treatment and patient preferences were assessed. Results: Three hundred patients with 48-week follow-up, who switched to EVIPLERA® (mean age: 46.6 years; male: 74.0%; 74.7% switched from a non-nucleoside reverse-transcriptase-inhibitor, 25.3% from a protease inhibitor + ritonavir) were included. There was no statistical difference in median CD4+ cell count (baseline: 678.5 cells/mm3; 48-week: 683.0 cells/mm3) neither in virological suppression (≤50 copies/mL) (baseline: 98.3%; 48-week: 95.3%). The most frequent reasons for switching were neuropsychiatric (62.3%), gastrointestinal (19.3%) and biochemical/metabolic (19.3%) events. Only 7.7% of patients permanently discontinued therapy. At 48-week, all outcomes showed an improvement compared to baseline. Overall, there was a significant decrease (p-value≤0.05) in number and magnitude of symptoms, while HRQoL, satisfaction and adherence improved significantly. Most patients prefered EVIPLERA® than previous cART. According to the type of intolerance, HRQoL was improved, but only significantly in patients with neuropsychiatric and gastrointestinal symptoms. Adherence improved significantly in patients with metabolic disturbances and satisfaction with EVIPLERA® was higher in the three groups. Conclusion: Switching to EVIPLERA® from non-nucleoside reverse-transcriptase-inhibitor or protease inhibitor-based regimens due to toxicity, improved the presence/magnitude of symptoms, HRQoL, and preference with treatment. EVIPLERA® maintained a virological response, CD4+ cell count and maintained or improved adherence.
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Affiliation(s)
- D Podzamczer
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - N Rozas
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - P Domingo
- Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
| | - C Miralles
- Hospital Xeral de Vigo, Pontevedra, Spain
| | | | - A Romero
- Hospital de Especialidades de Puerto Real, Cadiz, Spain
| | - E Deig
- Hospital General de Granollers, Barcelona, Spain
| | - H Knobel
- Hospital del Mar, Barcelona, Spain
| | - J Pasquau
- Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - A Antela
- Complejo Hospitalario Universitario de Santiago, A Coruna, Spain
| | - B Clotet
- Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - P Geijo
- Hospital Virgen de la Luz, Cuenca, Spain
| | | | - M A Casado
- Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain
| | - A Muñoz
- Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain
| | - A Casado
- Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain
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Yu SY, Fan BF, Yang F, DiBonaventura M, Chen YX, Li RY, King-Concialdi K, Kudel I, Hlavacek P, Hopps M, Udall M, Sadosky A, Cappelleri JC. Patient and economic burdens of postherpetic neuralgia in China. Clinicoecon Outcomes Res 2019; 11:539-550. [PMID: 31564930 PMCID: PMC6731977 DOI: 10.2147/ceor.s203920] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 06/20/2019] [Indexed: 01/02/2023] Open
Abstract
Background Little is known about the patient-reported and economic burdens of postherpetic neuralgia (PHN) among China’s urban population. Methods This noninterventional study was conducted among adults ≥40 years with PHN who were seeking medical care at eight urban hospitals in China. At one study site, patients completed a questionnaire evaluating the patient-reported disease burden (N=185). The questionnaire consisted of validated patient-reported outcomes including the Brief Pain Inventory (BPI), 5-dimension, 3-level EuroQol (EQ-5D-3L), Medical Outcomes Study Sleep Scale, and Work Productivity and Activity Impairment Questionnaire for Specific Health Problems. Questions on non-pharmacologic therapy and out-of-pocket (OOP) expenses were also included. At all study sites, physicians (N=100) completed a structured review of patient charts (N=828), which was used to derive health care resource utilization and associated costs from the societal perspective. Annual costs in Chinese Yuan Renminbi (RMB) for the year 2016 were converted to US dollars (US$). Results Patients (N=185, mean age 63.0 years, 53.5% female) reported pain of moderate severity (mean BPI score 4.6); poor sleep quantity (average of 5.3 hrs per night) and quality; and poorer health status on the EQ-5D-3L relative to the general Chinese population. Respondents also reported average annual OOP costs of RMB 16,873 (US$2541) per patient, mainly for prescription PHN medications (RMB 8990 [US$1354]). Substantial work impairment among employed individuals resulted in annual indirect costs of RMB 28,025 (US$4221). In the chart review, physicians reported that patients (N=828) had substantial health resource utilization, especially office visits; 98% had all-cause and 95% had PHN-related office visits. Total annual direct medical costs were RMB 10,002 (US$1507), mostly driven by hospitalizations (RMB 8781 [US$1323]). Conclusion In urban China, PHN is associated with a patient-reported burden, affecting sleep, quality-of-life, and daily activities including work impairment, and an economic burden resulting from direct medical costs and indirect costs due to lost productivity. These burdens suggest the need for appropriate prevention and management of PHN.
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Affiliation(s)
- Sheng-Yuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Bi-Fa Fan
- Department of Pain Medicine, Pain Management Centre, China-Japan Friendship Hospital, Beijing, People's Republic of China
| | - Fei Yang
- Department of Neurology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | | | - Yu-Xuan Chen
- Pfizer China , Beijing, People's Republic of China
| | - Ruo-Yu Li
- Department of Dermatology, Peking University First Hospital, Beijing, People's Republic of China
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Kharroubi SA, Beyh Y. The importance of accounting for the uncertainty around the preference-based health-related quality-of-life measures value sets: a systematic review. J Med Econ 2019; 22:671-683. [PMID: 30841768 DOI: 10.1080/13696998.2019.1592178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Preference-based measures of health-related quality-of-life including, but not limited to, the EQ-5D, HUI2 and the SF-6D have been increasingly used in calculations of quality-adjusted life years for cost effectiveness analyses. However, the uncertainty around the measures' value sets is commonly ignored in economic evaluation. There are several types of uncertainties, including methodological, structural, and parameter uncertainties, with the latter being the focus of this review paper. The objective is to highlight the gap in the literature regarding the existence of uncertainty in the value sets, focusing mainly on the EQ-5D and SF-6D. To the best of the authors' knowledge, this is the first systematic review revolving around uncertainty. After searching extensively for studies involving uncertainties in all preference-based measures, the results showed that uncertainty has been approached through different means, while parameter uncertainty has been ignored in most, if not all, cases. These findings suggest that uncertainty should be accounted for when using preference-based measures in economic evaluations. Ignoring this additional information could impact misleadingly on policy decisions.
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Affiliation(s)
- Samer A Kharroubi
- a Faculty of Agricultural and Food Science , American University of Beirut , Beirut , Lebanon
| | - Yara Beyh
- a Faculty of Agricultural and Food Science , American University of Beirut , Beirut , Lebanon
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von Tresckow B, Fanale M, Ardeshna KM, Chen R, Meissner J, Morschhauser F, Moskowitz C, Zinzani PL, Giezek H, Balakumaran A, Vo TT, Raut M, Brice P. Patient-reported outcomes in KEYNOTE-087, a phase 2 study of pembrolizumab in patients with classical Hodgkin lymphoma. Leuk Lymphoma 2019; 60:2705-2711. [PMID: 31012356 DOI: 10.1080/10428194.2019.1602262] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In KEYNOTE-087, pembrolizumab had a 69% overall response rate and acceptable safety in patients with relapsed/refractory classical Hodgkin lymphoma (rrHL). We assessed health-related quality of life (HRQoL) in KEYNOTE-087. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30) and the EuroQoL Five Dimensions Questionnaire 3-level version (EQ-5D) were administered to 206 patients across three cohorts defined by lymphoma progression after: (1) autologous stem cell transplantation (ASCT) and subsequent brentuximab vedotin (BV) (n = 69); (2) salvage chemotherapy and BV (n = 79); and (3) ASCT without post-transplantation BV (n = 58). Compliance/completion rates were ≥90% at week 12 and ≥70% at week 24. QLQ-C30 global health status/QoL and EQ-5D visual analog scale scores showed mean increases from baseline in overall health at all assessed timepoints. With few exceptions, mean improvements from baseline to weeks 12 and 24 in QLQ-C30 functional and symptom scores occurred in all cohorts.Clinicaltrials.gov identifier: NCT02453594.
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Affiliation(s)
- Bastian von Tresckow
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Michelle Fanale
- Department of Lymphoma and Myeloma, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | | | - Robert Chen
- Department of Hematology, City of Hope National Medical Center, Duarte, CA, USA
| | - Julia Meissner
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Craig Moskowitz
- Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Pier Luigi Zinzani
- Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy
| | | | | | - Thao T Vo
- Merck & Co., Inc, Kenilworth, NJ, USA
| | | | - Pauline Brice
- Hematology Department, AP-HP Hopital Saint-Louis, Paris, France
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Abstract
OBJECTIVE We explored the effectiveness of preventive home visits on the health-related quality-of-life (HRQoL) and mortality among independently community-dwelling older adults. DESIGN A randomised controlled trial. SUBJECTS Independently home-dwelling older adults 75 years and older, consisting of 211 in the intervention and 211 in the control group. SETTING Hyvinkää town municipality, Finland. MAIN OUTCOME MEASURES We used the change in HRQoL measured by the 15D scale as our primary outcome. Mortality at two years was retrieved from central registers. RESULTS At the one-year time point, the HRQoL according to the 15D scores deteriorated in the control group, whereas we found no change in the intervention group. The difference between the 15D score changes between the groups was -0.015 (95% CI -0.029 to -0.0016; p = 0.028, adjusted for age, sex, and baseline value). At the two-year time point as the visits ended, that difference diminished. There was no difference in mortality between the groups during the 24-month follow-up. CONCLUSION Preventive home visits implemented by a multidisciplinary team with CGA appear to help slow down the decline in HRQoL among older adults, although the effect diminishes when the visits end. Key points We are exploring preventive home visits as means to support the health-related quality-of-life (HRQoL) of home-dwelling older adults Multiprofessional preventive home visits in this intervention study helped to maintain the HRQoL when measured using 15D The effects on HRQoL diminished when the intervention ended, so could further benefits be attained with a longer intervention?The clinical trial registration number: ACTRN12616001411437.
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Affiliation(s)
- Heini Liimatta
- Hyvinkää City Health Centre, Hyvinkää, Finland;
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland;
- CONTACT Heini Liimatta , Hyvinkää City Health Center, Sandelininkatu 1, 05800Hyvinkää, Finland
| | | | | | - Kaisu H. Pitkala
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland;
- Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
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Salminen KS, Suominen MH, Soini H, Kautiainen H, Savikko N, Saarela RKT, Muurinen S, Pitkala KH. Associations between Nutritional Status and Health-Related Quality of Life among Long-Term Care Residents in Helsinki. J Nutr Health Aging 2019; 23:474-478. [PMID: 31021365 DOI: 10.1007/s12603-019-1182-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We evaluated the associations between nutritional status and health-related quality-of-life (HRQoL) among older long-term care residents in Helsinki. DESIGN AND PARTICIPANTS All 3767 older (≥65 years) long-term care residents in Helsinki in 2017 were invited to participate in this cross-sectional study. After refusals and exclusions of residents without sufficient information, 2160 residents remained. MEASUREMENTS Data on characteristics, nutritional status (Mini Nutritional Assessment, MNA) and HRQoL (15D) were collected by trained nurses. RESULTS Of the participants, 64% were at-risk of malnutrition and 18% suffered from malnutrition. Residents in the "malnourished" group were more dependent in activities of daily living (ADL) functioning, suffered more often from dementia, had lower cognitive level, used less medications, and were eating more often inadequately. HRQoL was statistically significantly associated with MNA total score in both female and male residents. There was a curvilinear correlation between MNA and 15D score in females: 0.50 (95% CI 0.46 to 0.53) and males: 0.56 (95% CI 0.50 to 0.61). In partial correlation analysis, all dimensions of 15D, except for sleeping and breathing, were positively associated with MNA score. In these analyses no significant differences emerged between males and females when the results were adjusted for age and dementia. CONCLUSIONS Nutrition plays an important role in HRQoL among older long-term care residents.
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Affiliation(s)
- K S Salminen
- Karoliina Sofia Salminen, Helsingin Yliopisto, Helsinki, Finland,
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Kearney S, Raffini LJ, Pham TP, Lee XY, von Mackensen S, Landorph A, Takedani H, Oldenburg J. Health-related quality-of-life and treatment satisfaction of individuals with hemophilia A treated with turoctocog alfa pegol (N8-GP): a new recombinant extended half-life FVIII. Patient Prefer Adherence 2019; 13:497-513. [PMID: 31040652 PMCID: PMC6460998 DOI: 10.2147/ppa.s196103] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Prophylactic treatment regimens lead to improvements in health-related quality-of-life (HRQoL) among individuals with hemophilia. Turoctocog alfa pegol (N8-GP) provides the benefit of extending the duration of protection from bleeding and reducing the number of injections, which is expected to impact HRQoL and treatment satisfaction (TS). AIM To investigate the HRQoL and TS of patients with severe hemophilia A from two phase III trials evaluating the safety and efficacy of N8-GP. METHODS HRQoL was assessed using the Haemo-QoL (reported by children and their parents) and Haem-A-QoL (reported by adults). TS was assessed using Hemo-Sat. Domain and total scores for all questionnaires ranged from 0 to 100, with lower scores indicating a better HRQoL or TS. A negative change in score indicates an improvement in HRQoL/TS. RESULTS Mean changes in HRQoL scores were reported for 14 children aged 4-7 years, 21 children aged 8-11 years, 10 adolescents aged 13-16 years, and 163 adults (17 years and above). Mean changes in children/adolescents-reported Haemo-QoL total score were -14.0 for ages 4-7 years, -3.6 for ages 8-11 years, and -0.1 for ages 13-16 years. Mean changes in parent-reported Haemo-QoL total scores were -11.5 for 4-7 years, -8.6 for ages 8-11 years, and -4.0 for 13-16 years. Adults' mean change in Haem-A-QoL total score was -3.1 for those receiving on-demand treatment and -2.3 for those receiving prophylaxis treatment. High levels of TS with N8-GP were reported by parents of children/adolescents and the adults at the end of the trial. CONCLUSION While most patients reported a relatively good baseline HRQoL when entering the respective trials, the HRQoL of patients was either maintained or further improved when treated with N8-GP. Adults and parents of children and adolescents reported a high level of treatment satisfaction with N8-GP.
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Affiliation(s)
- Susan Kearney
- Center for Bleeding and Clotting Disorders, Children's Hospital Minnesota, Minneapolis, MN, USA
| | - Leslie J Raffini
- Division of Hematology, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Tan P Pham
- Mapi (an Icon plc company), Boston, MA, USA
| | - Xin Ying Lee
- Global Biopharm Patient Access, Biopharm Operations, Novo Nordisk A/S, Copenhagen, Denmark
| | - Sylvia von Mackensen
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany,
| | - Andrea Landorph
- Medical & Science, Biopharm Operations, Novo Nordisk A/S, Copenhagen, Denmark
| | - Hideyuki Takedani
- Department of Joint Surgery, Research Hospital of the Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Johannes Oldenburg
- Institute of Experimental Haematology and Transfusion Medicine, University Clinic Bonn, Bonn, Germany
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Abstract
AIMS This study aimed to characterize the burden of Parkinson's disease (PD) by examining health-related quality-of-life (HRQoL), impairments to work productivity and daily activities, healthcare resource use, and associated costs among Japanese patients with PD. MATERIALS AND METHODS This retrospective cross-sectional study used data from the 2009-2014 Japan National Health and Wellness Survey (NHWS) (n = 144,692). HRQoL (Short Form 36-Item Health Survey version 2), impairments to work productivity and daily activities (Work Productivity and Activity Impairment Questionnaire), healthcare resource utilization, and annual costs were compared between respondents with PD (n = 133) and controls without PD (n = 144,559). The effect of PD on outcomes was estimated using propensity score weighting and multivariable regression models. RESULTS HRQoL was lower in patients with PD compared to the control group, with reduced physical (41.3 vs 51.3) and mental (35.7 vs 45.4) component summary scores and health state utility scores (0.62 vs 0.77; p < .001 for all). Patients with PD also reported higher levels of absenteeism (19.3% vs 3.3%), presenteeism (45.2% vs 18.5%), overall work impairment (52.8% vs 20.3%), and activity impairment (49.6% vs 20.8%) than controls without PD (p < .001 for all). In addition, patients with PD had higher healthcare resource utilization, direct (¥3,856,921/$37,994 vs ¥715,289/$7,046), and indirect (¥2,573,938/$25,356 vs ¥902,534/$8,891) costs compared with controls without PD (p < .001 for both). LIMITATIONS Data were cross-sectional and did not allow for causal inferences. Although the NHWS demographically represents the Japanese adult population, it is unclear whether it adequately represents the adult population with PD in Japan. CONCLUSIONS PD was associated with poorer HRQoL, greater work productivity loss, and higher direct and indirect costs. The findings suggest that an unmet need exists among patients with PD in Japan. Improving PD treatment and management could benefit both patients and society.
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Affiliation(s)
- Kaoru Yamabe
- a Takeda Pharmaceutical Company Limited , Tokyo , Japan
| | | | | | - Chris Pashos
- c Takeda Pharmaceuticals International Co. , Cambridge , MA , USA
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Evans R, Brutsche M, Busca R, Deslee G, de Soyza A, Fellrath JM, Franzen D, Hartman J, Mealing S, Morton T, Munavvar M, Sculpher M, Shah P, Slebos DJ, Durand-Zaleski I. Quantifying patient centered outcomes associated with the use of bilateral endobronchial coil treatment in patients with severe emphysema. Curr Med Res Opin 2018; 34:1927-1932. [PMID: 29625529 DOI: 10.1080/03007995.2018.1462784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To determine the impact of endobronchial coils on health-related quality-of-life (HRQoL). This paper utilizes trial data to identify the predictors of HRQoL in patients with severe emphysema, and subsequently estimates the impact of a new treatment on HRQoL (measured by utilities). These utility estimates are used to generate indicative long-term QALY estimates for a range of clinically plausible scenarios as a precursor to cost-effectiveness analyses. METHODS Patient level HRQoL data from RENEW and the National Emphysema Treatment Trial (NETT) were combined and mapped to generic EuroQol 5-dimension health utility questionnaire (EQ-5D) values using a published algorithm. Multilevel statistical models were developed using treatment, time, response, and baseline characteristics (EQ-5D, age, gender, FEV1, lung RV) to predict EQ-5D over time. Lifetime QALY estimates were generated using published survival data from NETT (assuming no impact of treatment on mortality) and four clinically plausible response profiles. Each response profile was combined with assumptions around treatment impact (constant or time varying). RESULTS After controlling for baseline characteristics, both treatment and response had a statistically significant impact (p < .001) on utility (+0.101 and +0.061, respectively). When combined with selected baseline characteristics and time, Coils and Standard of Care (SoC) generated more QALYs than SoC alone in all scenarios, with incremental lifetime benefit ranging from 0.29-0.55 QALYs. CONCLUSIONS Coils and SoC resulted in statistically significant improvements in HRQoL compared to SoC alone in patients with severe emphysema.
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Affiliation(s)
| | | | | | - Gaetan Deslee
- d University Hospital, INSERM UMRS 903 , Reims , France
| | | | | | | | - Jorine Hartman
- h University Medical Center , Groningen , The Netherlands
| | - Stuart Mealing
- i York Health Economics Consortium , North Yorkshire , UK
| | - Tim Morton
- j Decision Resources Group Bicester , Oxfordshire , UK
| | | | | | - Pallav Shah
- m Royal Brompton & Harefield NHS Foundation Trust , and Imperial College , London , UK
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Marschner N, Wilke J, Reschke D, Kaiser F, Schmoor C, Grugel R, Boller E. A brief instrument to measure health-related quality-of-life in patients with bone metastasis: validation of the German version of Bone Metastases Quality-of-Life-10 (BOMET-QoL-10). J Med Econ 2018; 21:920-929. [PMID: 29874105 DOI: 10.1080/13696998.2018.1484750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
AIMS This prospective, epidemiologic study was designed to translate the original Spanish Bone Metastases Quality-of-Life-10 (BOMET-QoL-10) questionnaire and undertake a validation of the translated German version of BOMET-QoL-10 in Germany to assess health-related quality-of-life (HRQoL) in patients with bone metastases (BM). METHODS The translation process included forward and backward translations, and a linguistic validation. Patients aged ≥18 years with histological confirmation of cancer, diagnosed with BM, life expectancy ≥6 months, and fluency in German were eligible for this study (enrolled consecutively in 33 outpatient centers in Germany). Patients were given the German version of BOMET-QoL-10, together with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire QLQ-C30 and EORTC QLQ-BM22 questionnaires at inclusion, 6 weeks, 3 months, and 6 months after inclusion. A debriefing questionnaire was administered at inclusion to determine patient acceptability and understanding. RESULTS Data include 364 patients with BM (median age = 68 years; females = 71.7%). The BOMET-QoL-10 is brief and clear (median completion time = 5 minutes; >90% of patients completed the questionnaire without assistance). The BOMET-QoL-10 forms only one overall scale. All 10 items showed a substantial correlation with the first factor (factor loading, range = 0.58-0.86). BOMET-QoL-10 exhibits high internal consistency and reproducibility (Cronbach's alpha = 0.91; intra-class correlation coefficient = 0.76). BOMET-QoL-10 showed significant correlations (range = 0.69-0.79) both with EORTC QLQ-C30 and EORTC QLQ-BM22 within the functioning (physical, social, interference) and symptom (fatigue, pain) scales, displayed significant sensitivity to change in EORTC QLQ-BM22 scores, and proved the potential ability to detect change in HRQoL in patients with different disease status. LIMITATIONS There was a high proportion of females in this study, which might represent a limitation. CONCLUSIONS The German version of BOMET-QoL-10 is a valid, reliable, brief, and clear instrument able to measure HRQoL in patients with BM.
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Affiliation(s)
- Norbert Marschner
- a Outpatient Center for Interdisciplinary Oncology and Hematology , Freiburg , Germany
| | - Jochen Wilke
- b Specialized Medical Practice for Hematology and Internal Oncology , Fürth , Germany
| | - Daniel Reschke
- c Outpatient Center for Oncology Oldenburg , Oldenburg , Germany
| | | | - Claudia Schmoor
- e Clinical Trials Unit , Faculty of Medicine and Medical Centre , University of Freiburg , Freiburg , Germany
| | - Renate Grugel
- f iOMEDICO , Clinical Epidemiology and Biostatistics , Freiburg , Germany
| | - Emil Boller
- f iOMEDICO , Clinical Epidemiology and Biostatistics , Freiburg , Germany
- g CERES GmbH Evaluation & Research , Lörrach , Germany
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Matthys H, Funk P. Pelargonium sidoides preparation EPs 7630 in COPD: health-related quality-of-life and other patient-reported outcomes in adults receiving add-on therapy. Curr Med Res Opin 2018; 34:1245-1251. [PMID: 29231073 DOI: 10.1080/03007995.2017.1416344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Patient-reported outcomes (PRO) such as health-related quality-of-life (HRQoL) belong to the most important criteria for the evaluation of medical therapies in clinical trials or practice-based benefit assessments. This study, therefore, revisited results of an earlier published clinical trial investigating the effects of the herbal drug preparation from the roots of Pelargonium sidoides EPs 7630, administered as add-on therapy in patients suffering from chronic obstructive pulmonary disease (COPD), with respect to HRQoL and other PRO. METHODS A total of 199 adults diagnosed with COPD stages II/III and receiving standard treatment according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) were randomly assigned to add-on therapy with EPs 7630 or placebo for 24 weeks. HRQoL (disease-specific St. George's Respiratory Questionnaire, SGRQ; current HRQoL state according to the EuroQuol visual analog scale, EQ VAS) and PRO (Integrative Medicine Outcomes Scale, IMOS; Integrative Medicine Patient Satisfaction Scale, IMPSS; symptom severity score of cough, sputum production and sternal pain while coughing; duration of inability to work) were assessed at each study visit or documented daily by the patient in a patient diary, respectively. RESULTS At week 24, all HRQoL and PRO measures showed a more pronounced improvement under EPs 7630 than under placebo (EQ VAS, p < .001; SGRQ total score, p < .001; symptom severity score of cough, sputum production, and sternal pain while coughing, p = .021; duration of inability to work, p = .004; two-sided t-test each; IMOS, p < .001, IMPSS, p < .001, two-sided Mantel-Haenszel test each). Moreover, the difference seen for the SGRQ exceeded the SGRQ minimal clinically important difference (MCID) threshold of 4 points. CONCLUSIONS Add-on therapy with EPs 7630 led to an improvement in HRQoL and other PRO in adult patients with COPD compared to placebo while showing a good long-term tolerability.
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Affiliation(s)
- Heinrich Matthys
- a Medical Director Emeritus, Department of Pneumology , University Hospital at Freiburg University , Freiburg , Germany
| | - Petra Funk
- b Clinical Research Department, Dr. Willmar Schwabe GmbH & Co. KG , Karlsruhe , Germany
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Abstract
OBJECTIVES The effects of acute coronary syndrome (ACS) events on health-related quality-of-life (HRQoL) and the time dependency of these effects are unknown. This study aimed to characterize health utilities in ACS patients to aid development of future economic models estimating the cost per quality-adjusted life-year impact of ACS events and potential treatments. METHODS Multi-center, non-interventional, longitudinal evaluation of health utility in patients experiencing ACS or stroke events. EuroQol-5 dimension 3 level (EQ-5D-3L) surveys were sent to patients (≥18 years) from three UK centers, 1 month after hospital discharge for myocardial infarction (MI), unstable angina (UA), or stroke. Patient demographics, lifestyle, and baseline utility score were collected in the first survey. Follow-up surveys were sent at 6, 12, 18, and 24 months to prospectively capture utility and subsequent health events. Two methods of patient identification were adopted-prospective, where the patient's qualifying events occurred after the study index date, and retrospective, where the patient's qualifying event occurred prior to the study index date. General healthy population utility values were assumed for pre-event HRQoL. RESULTS Between January 2011 and March 2014, 2,103 prospectively (n = 1,350)/retrospectively (n = 753) identified patients (mean age = 68.3 years; 67.9% male) responded: MI = 55.9% (n = 1,176), UA = 42.7% (n = 898), stroke = 1.4% (n = 29); 24% had type 2 diabetes. Post-event utility values were lower than general healthy population values, although significant differences in utility between subsequent 6 (n = 1,031, change = -0.002), 12 (n = 1,096, change = -0.008), 18 (n = 1,246, change = -0.007), and 24 (n = 1,277, change = -0.004) month timepoints were not detected. Through multivariate regression analyses, wheelchair use, current smoking, and secondary mental and joint health events were associated with the greatest statistically significant utility decrements. CONCLUSIONS This study indicates that health utility decreases following a cardiovascular event and, although some improvement occurs over the subsequent 24 months, general healthy population utility is not necessarily attained.
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Affiliation(s)
| | - Phil McEwan
- b Health Economics and Outcomes Research Ltd , Cardiff , UK
| | - Joshua Ray
- c F. Hoffmann-La Roche , Basel , Switzerland
| | - Irwin Tran
- d Roche Products Ltd , Welwyn Garden City , UK
| | | | - Steven Martin
- e Peterborough and Stamford Hospitals NHS Foundation Trust , Peterborough , UK
| | | | - Ameet Bakhai
- g Royal Free London NHS Foundation Trust , Barnet , UK
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Oremus M, Sharafoddini A, Morgano GP, Jin X, Xie F. A Computer-Assisted Personal Interview App in Research Electronic Data Capture for Administering Time Trade-off Surveys (REDCap): Development and Pretest. JMIR Form Res 2018; 2:e3. [PMID: 30684429 PMCID: PMC6334703 DOI: 10.2196/formative.8202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 12/01/2017] [Accepted: 12/06/2017] [Indexed: 11/25/2022] Open
Abstract
Background The time trade-off (TTO) task is a method of eliciting health utility scores, which range from 0 (equivalent to death) to 1 (equivalent to perfect health). These scores numerically represent a person’s health-related quality of life. Software apps exist to administer the TTO task; however, most of these apps are poorly documented and unavailable to researchers. Objective To fill the void, we developed an online app to administer the TTO task for a research study that is examining general public proxy health-related quality of life estimates for persons with Alzheimer’s disease. This manuscript describes the development and pretest of the app. Methods We used Research Electronic Data Capture (REDCap) to build the TTO app. The app’s modular structure and REDCap’s object-oriented environment facilitated development. After the TTO app was built, we recruited a purposive sample of 11 members of the general public to pretest its functionality and ease of use. Results Feedback from the pretest group was positive. Minor modifications included clarity enhancements, such as rearranging some paragraph text into bullet points, labeling the app to delineate different question sections, and revising or deleting text. We also added a research question to enable the identification of respondents who know someone with Alzheimer’s disease. Conclusions We developed an online app to administer the TTO task. Other researchers may access and customize the app for their own research purposes.
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Affiliation(s)
- Mark Oremus
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Anis Sharafoddini
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Gian Paolo Morgano
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Xuejing Jin
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Program for Health Economics and Outcome Measures, Hamilton, ON, Canada
| | - Feng Xie
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Program for Health Economics and Outcome Measures, Hamilton, ON, Canada.,Centre for Evaluation of Medicines, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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Abstract
CONCLUSIONS Improvement in sleep, emotional distress, and health-related quality-of-life (QoL) accompanied the improvement in dizziness symptoms after vestibular rehabilitation. Persistent sleep disturbance could prevent improvements in self-perceived handicap due to chronic dizziness and anxiety. OBJECTIVE The present study investigated prospectively the effects of intervention for dizziness (vestibular rehabilitation) on sleep disturbance, and the relationship between improvements in dizziness symptoms and improvements in sleep disturbance after the intervention. METHODS The participants of this study were 127 chronic dizziness inpatients with comorbid sleep disturbance (Pittsburgh sleep quality index [PSQI-J] global score ≥6). Participants completed the Dizziness Handicap Inventory (DHI, three sub-scales: Physical, Emotional, and Functional), PSQI-J, Hospital Anxiety and Depression Scale (HADS), and SF-8 (health-related QoL), and underwent gravity center fluctuation measurement before (time 1) and 1 month after (time 2) an in-hospital rehabilitation program. RESULTS All measured variables were significantly improved at time 2, compared to time 1. At time 2, 80.31% of patients still reported sleep disturbance. Analysis of covariance showed that chronic dizziness patients with sleep disturbance at time 2 had significantly higher DHI total, DHI-physical, and HADS-anxiety scores at time 2 than patients without sleep disturbance at time 2, after adjusting for these scores at time 1.
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Xu N, Li Z, Wei F, Liu X, Jiang L, Meng N, Jiang P, Yu M, Wu F, Dang L, Zhou H, Li Y, Liu Z. A Cross-sectional Study on the Symptom Burden of Patients With Spinal Tumor: Validation of the Chinese Version of the M.D. Anderson Symptom Inventory-Spine Tumor Module. J Pain Symptom Manage 2017; 53:605-613. [PMID: 28042067 DOI: 10.1016/j.jpainsymman.2016.10.360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/28/2016] [Accepted: 10/07/2016] [Indexed: 11/12/2022]
Abstract
CONTEXT Tumors involving the spine are associated with unique symptoms affecting both patient survival and health-related quality of life. Currently, there is no disease-specific instrument in Chinese to assess the symptom burden of these patients. OBJECTIVES The objective of this study was to translate and validate a Chinese version of the M.D. Anderson Symptom Inventory-Spine Tumor Module (MDASI-SP-C) to assess the symptom burden of Chinese-speaking patients with spinal tumors. METHODS MDASI-SP-C was forward-and-backward translated according to standard protocols and administered to patients fulfilling study criteria at a major referral center of spine tumor between November 2014 and September 2015. The generic instruments of Short Form 36 Quality of Life Questionnaire (SF-36), Functional Assessment of Cancer Therapy-General Version (FACT-G), and Karnofsky Performance Scale were used along with MDASI-SP-C. Prevalence and severity distribution of each item were analyzed. Psychometric assessment and hierarchical cluster analysis were performed for the translated instrument. RESULTS One hundred forty-two patients were enrolled. High interdependency and relatively low intra-cluster distances were identified. Cronbach's alpha of the entire instrument, the symptom severity subscale, and the interference subscale was 0.93, 0.91, and 0.92, respectively. Principal axis factoring resulted in a four-factor solution, which was reduced to a three-factor (general symptoms, spine-specific symptoms, and gastrointestinal symptoms) solution on account of clinical interpretation. Correlation coefficients between MDASI-SP-C items and their corresponding domains in SF-36 and/or FACT-G were all greater than 0.3. MDASI-SP-C was able to distinguish patients with different Karnofsky Performance Scale levels. CONCLUSION MDASI-SP-C demonstrated satisfactory psychometric properties and could be used to better assess the symptom burden of Chinese-speaking patients with spine tumors for improved management of their medical needs.
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Affiliation(s)
- Nanfang Xu
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Zhehuang Li
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Feng Wei
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Xiaoguang Liu
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Liang Jiang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Na Meng
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Ping Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Miao Yu
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Fengliang Wu
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Lei Dang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Hua Zhou
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Yan Li
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Zhongjun Liu
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.
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Abstract
CONCLUSIONS The comorbidity of sleep disturbance with chronic dizziness in women was related to the intensity of distress and interference with their lives due to dizziness, although it was not related to objective variables of dizziness. In addition, the presence of sleep disturbance was associated with severe anxiety and depression, and low health-related quality-of-life (QoL). OBJECTIVES This study investigated the effect of sleep disturbance in patients with chronic dizziness on symptoms of dizziness, handicaps due to dizziness, health-related QoL, and emotional distress. METHOD The participants of this study were 252 in-patients with chronic dizziness. Participants completed questionnaires containing the Dizziness Handicap Inventory (DHI, three sub-scales: Physical [DHI-P], Emotional [DHI-E], and Functional [DHI-F] scores), Pittsburgh sleep quality index (PSQI-J), Hospital Anxiety and Depression Scale (HADS), and Medical Outcomes Study 8-items Short Form Health Survey (SF-8, health-related QoL). The participants then underwent gravity center fluctuation measurement as an objective indicator of the severity of dizziness. RESULTS The prevalence of sleep disturbance (PSQI-J global score ≧6) was 65.1% in these participants. Two-way ANOVA of the DHI scores showed significant interaction between sleep disturbance and sex in DHI total, DHI-E score, and DHI-F score, indicating that these scores were higher in women with sleep disturbance. Regarding DHI-P score, only the main effect of sex was significant (women > men). Sleep disturbance had no significant effect on objective indicators of severity of dizziness. Patients with sleep disturbance had significantly higher HADS scored and a lower SF-8 scored than patients without sleep disturbance.
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Panico A, Messina G, Lupoli GA, Lupoli R, Cacciapuoti M, Moscatelli F, Esposito T, Villano I, Valenzano A, Monda V, Messina A, Precenzano F, Cibelli G, Monda M, Lupoli G. Quality of life in overweight (obese) and normal-weight women with polycystic ovary syndrome. Patient Prefer Adherence 2017; 11:423-429. [PMID: 28280314 PMCID: PMC5338969 DOI: 10.2147/ppa.s119180] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is characterized by phenotypic heterogeneity and has a wide variety of consequences. Approximately half of women with PCOS are overweight or obese, and their obesity may be a contributing factor to PCOS pathogenesis through different mechanisms. The aim of this study was to evaluate if PCOS alone affects the patients' quality of life and to what extent obesity contributes to worsen this disease. DESIGN To evaluate the impact of PCOS on health-related quality-of-life (HRQoL), 100 Mediterranean women with PCOS (group A), 50 with a body mass index (BMI) >25 kg/m2 (group A1) and 50 with BMI <25 kg/m2 (group A2), were recruited. They were evaluated with a specific combination of standardized psychometric questionnaires: the Symptom Checklist-90 Revised, the 36-Item Short-Form Health Survey, and the Polycystic Ovary Syndrome Questionnaire. The patients were compared with a normal-weight healthy control group of 40 subjects (group B). Another control group of 40 obese healthy women (group C) was used to make a comparison with PCOS obese patients (A1). RESULTS Our results showed a considerable worsening of HRQoL in PCOS patients (A) compared with controls (B). In addition, patients with PCOS and BMI >25 (A1) showed a significant and more marked reduction in scores, suggesting a lower quality of life, compared with controls (B) and with normal-weight PCOS patients (A2). CONCLUSION PCOS is a complex disease that alone determines a deterioration of HRQoL. The innovative use of these psychometric questionnaires in this study, in particular the PCOS questionnaire, has highlighted that obesity has a negative effect on HRQoL. It follows that a weight decrease is associated to phenotypic spectrum improvement and relative decrement in psychological distress.
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Affiliation(s)
- Annalisa Panico
- Department of Clinical Medicine and Surgery, University of Napoli Federico II, Naples, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
- Correspondence: Giovanni Messina, Department of Clinical and Experimental Medicine, University of Foggia, Via L Pinto, 71122 Foggia, Italy, Tel +39 81 566 5804, Fax +39 81 566 5844, Email
| | - Gelsy Arianna Lupoli
- Department of Clinical Medicine and Surgery, University of Napoli Federico II, Naples, Italy
| | - Roberta Lupoli
- Department of Clinical Medicine and Surgery, University of Napoli Federico II, Naples, Italy
| | - Marianna Cacciapuoti
- Department of Clinical Medicine and Surgery, University of Napoli Federico II, Naples, Italy
| | - Fiorenzo Moscatelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Teresa Esposito
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Ines Villano
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Anna Valenzano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Vincenzo Monda
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Antonietta Messina
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Francesco Precenzano
- Department of Mental and Physical Health, and Preventive Medicine, Child and Adolescent Neuropsychiatry Unit, Second University of Naples, Naples, Italy
| | - Giuseppe Cibelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Marcellino Monda
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Giovanni Lupoli
- Department of Clinical Medicine and Surgery, University of Napoli Federico II, Naples, Italy
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Abstract
CONCLUSIONS The results suggest that gender-specific differences in health-related quality-of-life (HRQoL) exist in patients with larynx carcinoma. In previous studies these differences might have been concealed by predominantly male subject groups. Future studies should consider a gender-specific analysis that suits the patient's idiosyncrasies associated with laryngeal cancer. OBJECTIVES There is little research concerning gender differences in quality-of-life (QoL) in patients with larynx carcinoma. Since laryngeal cancer is predominantly found in males, most studies examining HRQoL are based on a mainly male subject group. HRQoL needs to be assessed to determine the impact of disease and treatment and to evaluate possible treatment regimes. This study examined gender differences concerning HRQoL in 53 patients using EORTC QLQ-C30, and QLQ-H&N35 questionnaires. METHODS Patients treated with larynx carcinoma were given two questionnaires to assess HRQoL. The questionnaires were analyzed for each sex separately, as well as for the entire population. RESULTS Female patients report significantly worse HRQoL than males. Age could not be identified as a significant predictor for HRQoL when males and females were analyzed together, and does not significantly predict HRQoL in men. However, age was found to be a significant predictor for HRQoL when only females were analyzed.
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50
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Abstract
PURPOSE Transcatheter aortic valve implantation (TA-TAVI) is a well-established treatment for aortic valve stenosis in high-risk patients and indications have been continuously expanding to also include intermediate-risk patients. However, in low-risk patients, experiences are still sparse and although clinical outcomes have been shown favorable results, HRQoL has remained unexplored. The aim of this report was to describe the long-term health-related quality-of-life (HRQoL) in low-risk patients randomized to TA-TAVI or surgical aortic valve replacement (SAVR). METHODS In a prospective, randomized trial, patients with aortic valve stenosis were randomized to either TA-TAVI or SAVR. TA-TAVI was performed through a mini thoracotomy with the introduction of prosthesis via the apex of the heart and antegradely advancement over the pre-dilated native valve. SAVR was performed during cardiopulmonary bypass with resection of the native valve and replacement with a prosthesis valve through a median sternotomy. Afterwards, patients were followed yearly with echocardiography and HRQoL assessment. RESULTS A total of 58 patients were included; 29 patients for TA-TAVI and 29 patients for SAVR. The only difference in HRQoL was found in the physical component summary after 1 year; 44 ± 9 in the TA-TAVI group compared with 36 ± 9 in the SAVR group, p = .03. There were no differences in any of the remaining timepoints in neither physical nor mental component summary, p = .19 and p = .98, respectively, and there were no differences in survival during the 5 years. CONCLUSIONS In low-risk patients with aortic valve stenosis undergoing TA-TAVI, no differences appeared in HRQoL compared with SAVR during a 5-year follow-up period.
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Affiliation(s)
- Christian E Rex
- a Deparment of Cardiothoracic & Vascular Surgery , Aarhus University Hospital , Aarhus , Denmark.,b Deparment of Clinical Medicine , Aarhus University Hospital , Aarhus , Denmark
| | - Johan Heiberg
- a Deparment of Cardiothoracic & Vascular Surgery , Aarhus University Hospital , Aarhus , Denmark.,b Deparment of Clinical Medicine , Aarhus University Hospital , Aarhus , Denmark
| | - Kaj-Erik Klaaborg
- a Deparment of Cardiothoracic & Vascular Surgery , Aarhus University Hospital , Aarhus , Denmark.,b Deparment of Clinical Medicine , Aarhus University Hospital , Aarhus , Denmark
| | - Vibeke E Hjortdal
- a Deparment of Cardiothoracic & Vascular Surgery , Aarhus University Hospital , Aarhus , Denmark.,b Deparment of Clinical Medicine , Aarhus University Hospital , Aarhus , Denmark
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