老年人急性住院后与健康相关的生活质量:随机对照试验的纵向分析。

IF 3.3 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Quality of Life Research Pub Date : 2024-08-01 Epub Date: 2024-06-17 DOI:10.1007/s11136-024-03689-x
Eirin Guldsten Robinson, Hanna Gyllensten, Anne Gerd Granas, Kjell H Halvorsen, Beate Hennie Garcia
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引用次数: 0

摘要

目的:描述年龄≥70岁的老年人自急性住院起12个月内与健康相关的生活质量(HRQoL)的纵向变化(IMMENSE研究)及相关因素,以调查药物优化干预对这一变化的影响:在一项随机对照试验中,出院时、出院后 1 个月、6 个月和 12 个月使用了 EQ-5D-3L 测定,共有 285 人参加。采用多层次逻辑回归(EQ-5D-3L维度)和混合模型回归(EQ-5D-3L指数得分、EQ-VAS)来探讨干预与否的纵向变化,以及与药物、合并症和社会经济变量的关联。对非长期住院患者和长期住院患者进行了分组分析:12 个月后,EQ-5D-3L 指数得分明显下降(β -0.06 [95% 置信区间(CI:)-0.10--0.02],p = 0.003)。非长期住院患者在出院 1 个月后有明显改善(β 0.05 [0.00-0.09],p = 0.040)。药物数量和接受家庭护理服务是导致 HRQoL 降低的主要因素。在家居住是与 HRQoL 高相关的主要因素。干预组非长期住院者的 EQ-VAS 值明显高于对照组(β 4.02 [0.11-7.93],p = 0.044):我们观察到,在住院后的 12 个月内,两个 IMMENSE 研究组的 HRQoL 纵向变化无明显差异。然而,非长期住院患者亚组分析表明,干预措施可能对部分干预患者的 HRQoL 产生了长期影响。在规划未来的患者护理和医疗服务时,应考虑到用药数量以及生活和自理能力:该试验已于2016年6月28日在clinicaltrials.gov注册,注册时间为注册开始前(NCT02816086)。
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Health-related quality of life among older adults following acute hospitalization: longitudinal analysis of a randomized controlled trial.

Purpose: To describe the longitudinal change of health-related quality of life (HRQoL) over 12 months from acute hospitalization in older adults ≥ 70 years (IMMENSE study), and associated factors, to investigate how a medication optimization intervention influenced this change.

Methods: The EQ-5D-3L was used at discharge and 1, 6 and 12 months after discharge during a randomized controlled trial including 285 participants. Multilevel logistic (EQ-5D-3L dimensions) and mixed model regression (EQ-5D-3L index scores, EQ-VAS) were used to explore the longitudinal change with/without the intervention, and associations with medications, comorbidities, and socioeconomic variables. Subgroup analyses were performed for non-long and long stayers with hospitalizations < or ≥ 14 days.

Results: EQ-5D-3L index scores significantly declined after 12 months (β -0.06 [95% confidence interval (CI:) -0.10--0.02], p = 0.003). Non-long stayers showed significant improvement 1 month from discharge (β 0.05 [0.00-0.09], p = 0.040). The number of medications and receiving home-care services were the main factors associated with reduced HRQoL. Being home-dwelling was the main factor associated with higher HRQoL. Non-long stayers of the intervention group reported significantly higher EQ-VAS than the control group (β 4.02 [0.11-7.93], p = 0.044).

Conclusion: We observed no significant difference in the longitudinal change in HRQoL between the two IMMENSE study groups over 12 months after hospitalization. However, the non-long stayer subgroup analysis indicates that the intervention may have had a long-term effect on HRQoL in some of intervention patients. The number of medications and the ability to live and care for oneself should be taken into consideration when planning future patient care and health-care services.

Trial registration: The trial was registered in clinicaltrials.gov on 28/06/2016 before enrolment started (NCT02816086).

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来源期刊
Quality of Life Research
Quality of Life Research 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.50
自引率
8.60%
发文量
224
审稿时长
3-8 weeks
期刊介绍: Quality of Life Research is an international, multidisciplinary journal devoted to the rapid communication of original research, theoretical articles and methodological reports related to the field of quality of life, in all the health sciences. The journal also offers editorials, literature, book and software reviews, correspondence and abstracts of conferences. Quality of life has become a prominent issue in biometry, philosophy, social science, clinical medicine, health services and outcomes research. The journal''s scope reflects the wide application of quality of life assessment and research in the biological and social sciences. All original work is subject to peer review for originality, scientific quality and relevance to a broad readership. This is an official journal of the International Society of Quality of Life Research.
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