Quality of Life Research最新文献

Purpose: Thrombotic cardiovascular diseases profoundly impact patients' health-related quality of life (HRQoL). However, patient-reported outcome (PRO) instruments that are disease-specific or antithrombotic-treatment focused, developed according to US Food and Drug Administration (FDA) guidance on PROs, and can be used in clinical trials, are lacking. The aim of this study was to understand concepts important to patients diagnosed with coronary artery disease (CAD) or acute coronary syndrome (ACS), atrial fibrillation (AF), or stroke who require antithrombotic treatment for reducing risk of future thrombotic events (indications being evaluated for an investigational new drug), identify PROs that measure relevant symptoms and impacts, and determine acceptability of PROs from a health technology assessment (HTA) perspective.

Methods: A landscape review, conducted between January 2009 and October 2020, included a search of qualitative literature (OVID), a review of PRO instruments using multiple sources (e.g., OVID and clinical trials databases), and a survey of HTA decisions for antithrombotic medications.

Results: The qualitative literature review identified 27 publications used to develop a high-level conceptual summary of symptoms and HRQoL impacts reported by patients. The instrument landscape review indicated that generic PROs have been utilized for thrombotic indications, but disease-specific, fit-for-purpose instruments are lacking, and the HTA review revealed that although HTA agencies discussed PRO instruments, evidence of specific recommendations was not found.

Conclusion: To ensure patients' experiences, perspectives, and priorities are incorporated into drug development and evaluation, a core set of PROs for thrombotic indications that meet health authority guidance and are acceptable to HTA agencies is needed.

Purpose: To explore the characteristic quality of health profiles of children with paediatric acquired brain injury (pABI), and to investigate whether improvement in executive function (EF) following cognitive rehabilitation is associated with improvement in health-related quality of life (HRQOL).

Method: A study of secondary endpoints in a blinded, parallel-randomised controlled trial with children (ages 10-17 years) with pABI and executive dysfunction. Data was obtained from 73 children-parent dyads. Explorative analyses were conducted comparing baseline with 8-week post-intervention, and 6-month follow-up data. Outcome measures included the EQ-5D-Y-3L health dimensions and the visual analogue scale (VAS).

Results: At baseline and 6-month follow-up, mean (SD) VAS were 76.22 (17.98) and 79.49 (19.82) on the parent-report, and 77.19 (16.63) and 79.09 (17.91) on the self-report, respectively. Comparing children who improved EF to those who did not improve/worsened, no significant improvement was found for the VAS (parent-report) over time (BRIEF-BRI: F = 2.19, p = 0.12, BRIEF-MI: F = 2.23, p = 0.12) for either group. A significant main effect by group was found for BRIEF-MI (F = 4.02, p = 0.049), but no time*group interaction (F = 0.414, p = 0.662).

Conclusion: The children and their parents reported only minor problems across EQ-5D-Y-3L dimensions and evaluated overall health as relatively good. Participants with a clinically significant change in the metacognitive aspect of EF had higher HRQOL. Cognitive interventions aiming to ameliorate deficits in EF in pABI may be beneficial to improve HRQOL.

Introduction: This study assessed the influence of intrapersonal (one's own emotions) and interpersonal (emotions of others) emotional competence (EC) of informal caregivers on their quality of life (QoL) at the beginning of cancer care.

Methods: Participants completed two questionnaires assessing their intrapersonal and interpersonal EC (S-PEC) as well as their QoL (SF-36) at the beginning of treatments. Multivariate ANCOVA regression analyses were then performed to explore the influence of EC on QoL.

Results: The questionnaires were completed by 203 caregivers. As expected, intrapersonal EC was associated with a better QoL in all sub-dimensions (p < 0.01). More surprisingly, interpersonal EC was associated with worse QoL in terms of physical role (- 8.97 [95% CI - 16.74; - 1.19]), emotional role (- 8.37 [95% CI - 16.27; - 0.48]), and general health (- 4.50 [95% CI - 8.08; - 0.92]).

Conclusion: Intrapersonal EC should be improved for better QoL of caregivers of cancer patients. However, the more caregivers are attentive to the emotions of others (e.g., by identifying, understanding, listening and helping to manage emotions), the more their physical and psychological state has an impact on their daily life and their perceived health is impaired.

Purpose: Adults with arthritis experience poor health-related quality of life (HRQOL), though research often focuses on single HRQOL outcomes or summary scores. We aimed to identify HRQOL profiles in adults with different arthritis types and determine risk and protective factors.

Methods: Data including PROMIS-29 Profile v2.1 and PROMIS Short Form v2.0 - Emotional Support 4a were collected through a national foundation's online survey of adults with arthritis in the U.S. We used latent profile analysis (LPA) to characterize the heterogeneity in arthritis patients by clustering them into HRQOL profiles, based on statistical model fit and clinical interpretability. We fit a multinomial logistic regression model with HRQOL profile assignment as the outcome to determine associations with protective and risk factors.

Results: We included 25,305 adults with arthritis. The LPA results favored a five-HRQOL profile solution (entropy = 0.83). While some profiles displayed better HRQOL in some domains, 93% of the sample displayed impacted pain and physical functioning. One profile (20%) displayed mean T-scores nearly 2 standard deviations below the population mean. Despite poor physical HRQOL outcomes, one profile (10%) displayed average mental health. All demographic and clinical factors contributed significantly to the model, including risk factors (arthritis types, work status) and protective factors (more emotional support, starting exercise).

Conclusion: We identified profiles with consistently impacted HRQOL in arthritis, though one displayed average mental health functioning despite poor physical functioning. These results highlight the value of considering the patient's HRQOL experience alongside treatment options, and the potentially positive impact of non-pharmacological interventions.

Purpose: To develop the Norwegian value set for the EQ-5D-5L based on interviews with a representative sample of the Norwegian adult population.

Methods: Random and quota sampling were used to recruit the sample of adults (age> 18 years) representative of the Norwegian general population. Data collection followed EQ-VT 2.1 undertaken before and after the COVID-19 pandemic from November 2019 to December 2022, using PC-assisted and video conferencing interviews, respectively. Each respondent valued 10 health states using composite time trade-off (cTTO) and 7 health states using a discrete choice experiment (DCE). Different statistical models were assessed for logical consistency and predictive accuracy using cTTO and DCE data alone or in combination as hybrid models.

Results: Of the 1,321 respondents, 1,237 met inclusion criteria. All statistical models demonstrated logical consistency. The weighted hybrid model combining both cTTOand DCE data was preferred and had the highest predictive accuracy. Predicted values ranged from -0.453 to 1, and the dimension of anxiety/depression was the most highly valued by respondents, followed by pain/discomfort, self-care, mobility, and usual activities. These findings are not dissimilar to those for most Western European countries, and regression coefficients are closest to those for other Scandinavian countries.

Conclusion: This study provides the Norwegian value set for the EQ-5D-5L based on health state values obtained from members of the adult general population in Norway. This is an important contribution to economic evaluation and the broader application ofthe EQ-5D-5L in Norway including clinical and health services research, and quality measurement.

Purpose: Assessing socioeconomic status (SES), mental health, and health-related quality of life (HRQoL) in young children is crucial for making informed health care decisions and identifying areas of intervention. The present study aimed to investigate potential associations between SES, mental health, and HRQoL in 5-7-year-old children.

Method: The present study included mother-reported health assessments for 621 children aged 5-7 years in Grade 1 collected between 2019 and 2023 as part of the Starting Right™ project. Online questionnaires were used to support public health nurses in assessing children's health status. HRQoL (KIDSCREEN-27, 5 subscales) and mental health [Strength and Difficulties Questionnaire (SDQ), 4 subscales] were assessed. Sociodemographic characteristics, sex, maternal education, and income were obtained from Statistics Norway. The data were analyzed using multiple robust regression.

Results: Mother-reported mean scores for the KIDSCREEN-27 were within the normal range compared with European norms (8-11 years). However, for each KIDSCREEN-27 dimension, there were individuals whose mothers reported scores that were substantially lower than average. Having mental health problems, defined as being in the 80th and 90th percentiles of the SDQ Total problem score, was associated with 2.1-10.7-point lower KIDSCREEN-27 scores (p < 0.001-0.021), which was most noticeable in the KIDSCREEN-27 school environment subscale. Weak but significant positive associations were found between SES and HRQoL.

Conclusion: Our results provide important insights into the associations between SES, mental health, and HRQoL in young children. Given the strong association between mental health problems and HRQoL in Grade 1 children, the assessment of both is essential, so that early interventions, an improved caring environment, and nurturing support can be initiated.

Purpose: Social factors are associated with mental health and wellbeing. However, few studies have examined genetic and environmental influences on social factors themselves, limiting current understanding of influences on aspects of the social environment. Most studies which have identified links between social factors and mental health are also limited by the possible influence of unmeasured genetic and environmental confounding. In this study, we investigated the genetic and environmental underpinnings of multiple social factors (relationship satisfaction, loneliness, attachment, trust, relationship disruptions), and their associations with life satisfaction measured concurrently and six years later, after accounting for shared genetic and environmental confounding.

Methods: Data from a population-based sample of adult twins (N = 1987) and two measurement timepoints were used for the primary analyses. We used multivariate Cholesky models to estimate genetic and environmental influences across five social factors. Subsequently, we conducted co-twin control analyses to examine associations between social factors and wellbeing after controlling for shared genetic and environmental confounding.

Results: Heritability estimates for the social factors ranged from 24 to 42%. Genetic correlations across social factors were substantial, indicative of considerable genetic overlap. Associations between wellbeing and relationship satisfaction, loneliness, anxious and avoidant attachment, trust, and disruptions in relationships in the past year were attenuated in co-twin control analyses but remained statistically significant. Relationship satisfaction, loneliness, and attachment avoidance were also associated with wellbeing measured six years later in estimates which controlled for shared genetic and environmental confounding.

Conclusion: Our findings provide evidence that multiple social factors are associated with wellbeing after accounting for potential confounding by shared genetic and/or environmental factors. These findings highlight the importance of multiple aspects of the social environment for wellbeing in older adulthood. Future studies should examine the directionality in associations between social factors and mental health and assess these relationships beyond older adulthood.

Purpose: The aim was to compare quality of life (QoL) of patients with testosterone recovery (TR) to patients without TR after the completion of either 18- or 36-month androgen deprivation therapy (ADT) for prostate cancer.

Methods: From a Phase III trial, we selected all 630 randomised patients with testosterone measured at baseline (during screening, before randomisation) and follow-up and who completed baseline, 6-month and, at least, one further QoL questionnaire in follow-up (EORTC 30 - PR25). We estimated means and standard deviation of items and scales for each group at each time point. We analyzed items and scales scores with general linear model with repeated measures to evaluate changes between patients with or without TR to a normal level. p-values were adjusted for multiple comparisons with Benjamini-Hochberg's false discovery rate procedure (p_adj). A p_adj < 0.05 was considered significant and mean differences of 10 points or more considered clinically relevant.

Results: 494 patients retained for analysis (median follow-up 16.2 years). A significantly higher number of patients (177/314 vs 79/180, p = 0.008) recovered a normal testosterone level in a significantly shorter time [median (IQR): 3.06 (2.55-3.65) vs 5.00 years (4.5-5.96), p < 0.001] in the 18- vs the 36-month cohort. Patients with TR had a significantly better QoL: 37/55 items and 14/21 scales (p_adj<0.05) in the 18-month and 25/55 items and 13/21 scales in the 36-month cohort. Moreover, 9 items and one scale reached clinical relevance in the 18-month cohort and 7 items and one scale in the 36-month cohort.

Conclusions: TR is associated with significant regaining in QoL. A faster and significantly higher TR is seen in the shorter ADT schedule.

Background: Obstructive Sleep Apnoea (OSA) is a chronic condition which is associated with extreme daytime sleepiness, cognitive impairment, and other comorbidities and, hence, decreased quality of life (QoL). EQ-5D is one of the most widely used preference-based measures of QoL in patients with different diseases worldwide. This study aims to review the EQ-5D utility value of OSA across primary studies and perform a meta-analysis to derive pooled utility scores for OSA.

Methods: A systematic review and meta-analysis of the EQ-5D scores of OSA patients adhering to PRISMA guidelines was conducted. Studies reporting EQ-5D utility scores among adult OSA patients were systematically searched across PubMed-Medline, Scopus, and Embase. Selected studies were systematically reviewed and we have assessed the studies for their quality. Meta-analysis was performed using a random-effect model with subgroup analysis to explore heterogeneity.

Results: The search yielded 9,121 articles, of which twenty-eight studies were included in the synthesis. The pooled mean EQ-5D utility score was 0.73 (0.69 to 0.78) with high heterogeneity (I² = 99.6%). The pooled EQ-5D VAS score was 67.14 (63.97 to 70.32) with high heterogeneity (I² = 87.04%). Subgroup analyses indicated significant variability in utility scores across different countries, age groups, and disease severities. The variation of utility values for OSA was influenced by the characteristics of patients, the living environment, and the EQ-5D value set.

Conclusion: The synthesis revealed that the QoL is significantly lower in OSA, and the aggregated quantitative estimates of EQ-5D utility scores are essential inputs for economic evaluations.