scholarly journals Health-related quality of life in adult patients with brain metastases after stereotactic radiosurgery: a systematic, narrative review

2019 ◽  
Vol 28 (2) ◽  
pp. 473-484 ◽  
Author(s):  
Eline Verhaak ◽  
Karin Gehring ◽  
Patrick E. J. Hanssens ◽  
Neil K. Aaronson ◽  
Margriet M. Sitskoorn

Abstract Purpose A growing number of patients with brain metastases (BM) are being treated with stereotactic radiosurgery (SRS), and the importance of evaluating the impact of SRS on the health-related quality of life (HRQoL) in these patients has been increasingly acknowledged. This systematic review summarizes the current knowledge about the HRQoL of patients with BM after SRS. Methods We searched EMBASE, Medline Ovid, Web-of-Science, the Cochrane Database, PsycINFO Ovid, and Google Scholar up to November 15, 2018. Studies in patients with BM in which HRQoL was assessed before and after SRS and analyzed over time were included. Studies including populations of several types of brain cancer and/or several types of treatments were included if the results for patients with BM and treatment with SRS alone were described separately. Results Out of 3638 published articles, 9 studies met the eligibility criteria and were included. In 4 out of 7 studies on group results, overall HRQoL of patients with BM remained stable after SRS. In small study samples of longer-term survivors, overall HRQoL remained stable up to 12 months post-SRS. Contradictory results were reported for physical and general/global HRQoL, which might be explained by the different questionnaires that were used. Conclusions In general, SRS does not have significant negative effects on patients’ overall HRQoL over time. Future research is needed to analyze different aspects of HRQoL, differences in individual changes in HRQoL after SRS, and factors that influence these changes. These studies should take into account several methodological issues as discussed in this review.

2021 ◽  
pp. 1-24
Author(s):  
Daniela Viramontes-Hörner ◽  
Zoe Pittman ◽  
Nicholas M Selby ◽  
Maarten W Taal

Abstract Health-related quality of life (HRQoL) is severely impaired in persons receiving dialysis. Malnutrition has been associated with some measures of poor HRQoL in cross-sectional analyses in dialysis populations, but no studies have assessed the impact of malnutrition and dietary intake on change in multiple measures of HRQoL over time. We investigated the most important determinants of poor HRQoL and the predictors of change in HRQoL over time using several measures of HRQoL. We enrolled 119 haemodialysis and 31 peritoneal dialysis patients in this prospective study. Nutritional assessments (Subjective Global Assessment [SGA], anthropometry and 24-hour dietary recalls) and HRQoL questionnaires (Short Form-36 [SF-36] mental [MCS] and physical component scores [PCS] and European QoL-5 Dimensions [EQ5D] health state [HSS] and visual analogue scores [VAS]) were performed at baseline, 6 and 12 months. Mean age was 64(14) years. Malnutrition was present in 37% of the population. At baseline, malnutrition assessed by SGA was the only factor independently (and negatively) associated with all four measures of HRQoL. No single factor was independently associated with decrease in all measures of HRQoL over 1 year. However, prevalence/development of malnutrition over one year was an independent predictor of 1-year decrease in EQ5D HSS and 1-year decrease in fat intake independently predicted the 1-year decline in SF-36 MCS and PCS, and EQ5D VAS. These findings strengthen the importance of monitoring for malnutrition and providing nutritional advice to all persons on dialysis. Future studies are needed to evaluate the impact of nutritional interventions on HRQoL and other long-term outcomes.


2018 ◽  
Vol 6 (4) ◽  
pp. 274-282 ◽  
Author(s):  
Nadia N Laack ◽  
Stephanie L Pugh ◽  
Paul D Brown ◽  
Sherry Fox ◽  
Jeffrey S Wefel ◽  
...  

Abstract Background This study evaluated the association between health-related quality of life (HRQOL) and cognition in patients receiving memantine for prevention of cognitive dysfunction during whole-brain radiotherapy (WBRT). Methods Adult patients with brain metastases received WBRT and were randomized to receive placebo or memantine, 20 mg per day, within 3 days of initiating radiotherapy, for 24 weeks. The Functional Assessment of Cancer Therapy-Brain module (FACT-Br) and Medical Outcomes Scale-Cognitive Functioning Scale (MOS-C) were completed in coordination with serial standardized tests of cognitive function. Results Of the 508 eligible patients, 442 (87%) consented to participate in the HRQOL portion and contributed to baseline analyses. Evaluable patients at 24 weeks (n = 246) included surviving patients completing FACT-Br, MOS-C, and objective cognitive assessments (n = 146, 59%) and patients alive at time of missed assessment (n = 100, 41%). Baseline cognitive function correlated significantly with FACT-Br and MOS-C self-reports. All domains of objective cognitive function showed declines over time. Neither FACT-Br nor MOS-C differed between the treatment arms. Emotional and functional well-being subscales of the FACT improved over time while the remainder of the FACT-Br domains remained stable. MOS-C scores declined over time. Conclusion Baseline cognitive function correlated significantly with FACT-Br and MOS-C scores. No by-arm differences in HRQOL were observed despite differences in objective cognitive function. Patient attrition and poor testing compliance remain significant problems in studies of cognitive function of brain metastases patients and further effort is needed to improve compliance with testing and sensitivity of patient-reported measures.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A143-A144
Author(s):  
Kelly Showen ◽  
Kathleen O’Hora ◽  
Beatriz Hernandez ◽  
Laura Lazzeroni ◽  
Jamie Zeitzer ◽  
...  

Abstract Introduction Insomnia affects 30–48% of older adults and impairs health-related quality of life (HRQoL). Numerous studies report Cognitive Behavioral Therapy (CBT-I) as an effective non-pharmacological treatment for insomnia symptoms, with few examining the impact of CBT-I on mental and physical aspects of HRQoL. While limited research suggests that CBT-I leads to improvements in HRQoL, the impact of the cognitive versus behavioral components of CBT-I on HRQoL is unknown. Methods 128 older adults with insomnia (mean age=69, 66% female, 19% minority) were randomized to receive cognitive therapy (CT), behavior therapy (BT), or CBT-I. The Short Form (36) Health Survey (SF-36) was collected at baseline, post-treatment and six-month follow-up. Split-plot linear mixed models with age and sex as covariates to assess within and between subject changes were used to test intervention, time, and interaction effects on the mental health and physical well-being domains of HRQoL. Significance for all effects was defined as p < 0.05. The effect size (d) was calculated by dividing the difference between means by the root-mean-squared error of the mixed effects model. Results The mental health-related QoL improved over time independent of treatment (Main effect of time: F(2, 202) = 6.51, p < 0.002). The interaction failed to reach significance (Interaction: F(4, 202) = 1.19, p = .31). Simple effects revealed significant improvements among CBT-I participants at six months (p = .02, d = .53) and CT participants at post-treatment (p = .00, d = .79) and six months (p = .03, d = .66), but not among BT participants for either time point (p = .32, d = .24; p = .16, d = .35). Treatment did not improve physical health-related QoL over time (F(2, 202) = 1.01, p = .37) nor was there a significant interaction (F(4, 202) = .46, p = .76). Conclusion These findings suggest that CBT-I, particularly the CT component, may be effective in improving mental health-related QoL outcomes for older adults with insomnia. In contrast, neither CBT-I nor its component treatments were effective in improving physical health-related QoL. Support (if any) NIMHR01MH101468-01; Mental Illness Research, Education, and Clinical Center (MIRECC) at the VAPAHCS


2020 ◽  
Vol 8 (1) ◽  
pp. e000842
Author(s):  
Edward Zimbudzi ◽  
Clement Lo ◽  
Sanjeeva Ranasinha ◽  
Helena Teede ◽  
Tim Usherwood ◽  
...  

ObjectiveTo evaluate the impact of an integrated diabetes and kidney disease model of care on health-related quality of life (HRQOL) of patients with comorbid diabetes and chronic kidney disease (CKD).Research design and methodsA longitudinal study of adult patients (over 18 years) with comorbid diabetes and CKD (stage 3a or worse) who attended a new diabetes kidney disease service was conducted at a tertiary hospital. A questionnaire consisting of demographics, clinical data, and the Kidney Disease Quality of Life (KDQOL-36) was administered at baseline and after 12 months. Paired t-tests were used to compare baseline and 12-month scores. A subgroup analysis examined the effects by patient gender. Multiple regression analysis examined the factors associated with changes in scores.Results179 patients, 36% of whom were female, with baseline mean±SD age of 65.9±11.3 years, were studied. Across all subscales, HRQOL did not significantly change over time (p value for all mean differences >0.05). However, on subgroup analysis, symptom problem list and physical composite summary scores increased among women (MD=9.0, 95% CI 1.25 to 16.67; p=0.02 and MD=4.5, 95% CI 0.57 to 8.42; p=0.03 respectively) and physical composite scores decreased among men (MD=−3.35, 95% CI −6.26 to −0.44; p=0.03).ConclusionThe HRQOL of patients with comorbid diabetes and CKD attending a new codesigned, integrated diabetes and kidney disease model of care was maintained over 12 months. Given that HRQOL is known to deteriorate over time in this high-risk population, the impact of these findings on clinical outcomes warrants further investigation.


2019 ◽  
Vol 143 (3) ◽  
pp. 537-546 ◽  
Author(s):  
Eline Verhaak ◽  
Karin Gehring ◽  
Patrick E. J. Hanssens ◽  
Margriet M. Sitskoorn

2017 ◽  
Vol 74 (11) ◽  
pp. 1025-1029
Author(s):  
Milos Bjelovic ◽  
Nemanja Zaric ◽  
Tamara Babic ◽  
Igor Dragicevic ◽  
Aleksandar Corac ◽  
...  

Background/Aim. Recent population based studies have proved that patients with functional dyspepsia (FD) have a significantly impaired health-related quality of life HRQoL as compared to general population. The aim of the study was to evaluate the impact of FD on (HRQoL) in patients treated in primary healthcare settings in Serbia. Methods. The study involved 1,448 patients with FD. The diagnosis was made by a general practice physician or gastroenterologist using the Rome III diagnostic criteria. The Serbian version of the questionnaire for the assessment of HRQoL of the U.S. Department of Health and Human Services? Centers for Disease Control and Prevention (HRQoL-4 item CDC) was used for data collection, while descriptive statistical measurements were applied to calculate standard deviation, frequency as well as multiple logistic regression model. Results. Out of the total number of patients, 41.8% assessed their health condition as seriously disordered or poor. The mean values of health disorder duration over the last 30 days was 11.8 days, disordered physical health 7.2 days, mental disorder 6.3 days, and activity limitation 5.1 days. Also, 29.7%, 15.2%, 12.8% and 10.7% of the patients reported ? 14 unhealthy days, ? 14 physically unhealthy days, ? 14 mentally unhealthy days and ? 14 activity limitation days, respectively. Conclusion. From patients? perspective, FD has a significant impact on HRQoL. In this study, 41.8% of the patients described their health status as fair or poor, and FD significantly affects all aspects of life, both mental and physical. The recognition of that impact is probably the most important step towards appropriate treatment and decreasing HRQoL impairment in patients with FD.


2004 ◽  
Vol 171 (4S) ◽  
pp. 42-42 ◽  
Author(s):  
Kevin P. Weinfurt ◽  
Liana D. Castel ◽  
Yun Li ◽  
Fred Saad ◽  
Justin W. Timbie ◽  
...  

Author(s):  
Phillippa Carnemolla ◽  
Catherine Bridge

The multi-dimensional relationship between housing and population health is now well recognised internationally, across both developing and developed nations. This paper examines a dimension within the housing and health relationship – accessibility – that to date has been considered difficult to measure. This paper reports on the mixed method results of larger mixed-method, exploratory study designed to measure the impact of home modifications on Health-Related Quality of Life, supported by qualitative data of recipients’ experiences of home modifications. Data was gathered from 157 Australian HACC clients, who had received home modifications. Measurements were taken for both before and after home modifications and reveal that home modifications were associated with an average 40% increase in Health-Related Quality of Life levels. The qualitative results revealed that participants positively associated home modifications across six effect themes: increased safety and confidence, improved mobility at home, increased independence, supported care-giving role, increased social participation, and ability to return home from hospital. This exploratory research gives an insight into the potential for accessible architecture to impact improvements in community health and wellbeing.


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