Health related quality of life in older patients with solid tumors and prognostic factors for decline

Abstract Background Older people are particularly vulnerable to severe COVID-19. Little is known about long-term consequences of COVID-19 on health-related quality of life and functional status in older people, and the impact of age in this context. We aimed to study age-related change in health-related quality of life (HR-QoL), functional decline and mortality among older patients six months following hospitalisation due to COVID-19. Methods This was a cohort study including patients aged 60 years and older admitted to four general hospitals in South-Eastern Norway due to COVID-19, from March 1 up until July 1, 2020. Patients who were still alive were invited to attend a six-month follow-up. Change in HR-QoL and functional status compared to before the COVID-19 hospitalisation were assessed using the EuroQol 5-dimensional-5 levels questionnaire (EQ 5D-5L). A change in visual analogue scale (VAS) score of 7 or more was considered clinically relevant. Results Out of 216 patients aged 60 years and older that were admitted to hospital due to COVID-19 during the study period, 171 were still alive 180 days after hospital admission, and 106 patients (62%) attended the six-month follow-up. Mean age was 74.3 years, 27 patients (26%) had experienced severe COVID-19. 57 participants (54%) reported a decrease in the EQ5D-5L VAS score after six months, with no significant difference between persons aged 75 years and older compared to younger. 70 participants (66%) reported a negative change in any of the dimensions of the EQ-5D-5L, with impaired ability to perform activities of daily life (35%), reduced mobility (33%) and having more pain or discomfort (33%) being the most commonly reported changes. 46 participants (43%) reported a negative change in cognitive function compared to before the COVID-19 hospitalisation. Six-month mortality was 21%, and increased with increasing age. Conclusions More than half of the patients reported a negative change in HR-QoL six months following hospitalisation due to COVID-19, and one out of three experienced a persistently impaired mobility and ability to carry out activities of daily living. The results suggest awareness of long-term functional decline in older COVID-19 patients.

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Effects of Chronic Comorbidities on the Health-Related Quality of Life among Older Patients after Falls in Vietnamese Hospitals

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16193623 ◽

2019 ◽

Vol 16 (19) ◽

pp. 3623 ◽

Cited By ~ 8

Author(s):

Hai Minh Vu ◽

Long Hoang Nguyen ◽

Tung Hoang Tran ◽

Kiet Tuan Huy Pham ◽

Hai Thanh Phan ◽

...

Keyword(s):

Quality Of Life ◽

Older Patients ◽

Health Related Quality ◽

Tobit Regression ◽

Cross Sectional ◽

Fall Injuries ◽

Spine Diseases ◽

Related Quality ◽

Health Related

Although comorbidities are prevalent in older people experiencing falls, there is a lack of studies examining their influence on health-related quality of life (HRQOL) in this population. This study examines the prevalence of comorbidities and associations between comorbidities and HRQOL in older patients after falls in Vietnamese hospitals. A cross-sectional design was employed among 405 older patients admitted to seven hospitals due to fall injuries in Thai Binh province, Vietnam. The EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) was used to measure HRQOL. Socio-demographic characteristics were collected using a structured questionnaire, while comorbidities and other clinical characteristics were examined by physicians and extracted from medical records. Multivariate Tobit regression was used to determine the associations between comorbidities and HRQOL. Among 405 patients, 75.6% had comorbidities, of which hypertension and osteoarthritis were the most common. Lumbar spine/cervical spine diseases (Coefficient (Coef.) = −0.10; 95%CI = −0.18; 0.03) and stroke (Coef. = −0.36; 95%CI = −0.61; −0.10) were found to be associated with a significantly decreased EQ-5D index. Participants with three comorbidities had EQ-5D indexes 0.20 points lower (Coef. = −0.20; 95%CI = −0.31; −0.09) in comparison with those without comorbidities. This study underlined a significantly high proportion of comorbidities in older patients hospitalized due to fall injuries in Vietnam. In addition, the existence of comorbidities was associated with deteriorating HRQOL. Frequent monitoring and screening comorbidities are critical to determining which individuals are most in need of HRQOL enhancement.

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A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy

Journal of Clinical Epidemiology ◽

10.1016/j.jclinepi.2020.10.006 ◽

2021 ◽

Vol 130 ◽

pp. 1-12

Author(s):

Ana I. González-González ◽

Andreas D. Meid ◽

Truc S. Dinh ◽

Jeanet W. Blom ◽

Marjan van den Akker ◽

...

Keyword(s):

Quality Of Life ◽

Older Patients ◽

Prognostic Model ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Associations between safety, tolerability, and toxicity and the reporting of health‐related quality of life in phase III randomized trials in common solid tumors

Cancer Medicine ◽

10.1002/cam4.3390 ◽

2020 ◽

Vol 9 (21) ◽

pp. 7888-7895

Author(s):

Ramy R. Saleh ◽

Nicholas Meti ◽

Domen Ribnikar ◽

Hadar Goldvaser ◽

Alberto Ocana ◽

...

Keyword(s):

Quality Of Life ◽

Solid Tumors ◽

Randomized Trials ◽

Phase Iii ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Fear of Falling among Older Patients Admitted to Hospital after Falls in Vietnam: Prevalence, Associated Factors and Correlation with Impaired Health-Related Quality of Life

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17072493 ◽

2020 ◽

Vol 17 (7) ◽

pp. 2493 ◽

Cited By ~ 2

Author(s):

Long Hoang Nguyen ◽

Giang Thu Vu ◽

Giang Hai Ha ◽

Cuong Tat Nguyen ◽

Hai Minh Vu ◽

...

Keyword(s):

Quality Of Life ◽

Older Patients ◽

Associated Factors ◽

Fear Of Falling ◽

Negative Relationship ◽

Health Related Quality ◽

Fall Injuries ◽

Related Quality ◽

Health Related

Fear of falling (FOF) diminishes older people’s independence in daily activities, as well as causes serious health and economic consequences. This study examined the prevalence of FOF in older patients hospitalized due to fall-injuries, its effect on health-related quality of life (HRQOL), and its associated factors. We conducted a cross-sectional study in seven hospitals in Thai Binh, Vietnam. FOF was assessed using a single close-ended question. HRQOL was evaluated by the EQ-5D-5L instrument. Multilevel logistic regression and Tobit regression models were utilized. The prevalence of FOF in 405 older patients admitted to hospitals after fall injuries was 88.2%, with a mean EQ-5D index and EQ-VAS of 0.34 (SD = 0.38) and 61.6 (SD = 15.2), respectively. Factors associated with FOF included living alone (OR = 0.13, 95%CI = 0.04; 0.50.,), history of eye diseases (OR = 4.12; 95%CI = 1.91; 8.89), and experiencing psychological distress (OR= 3.56, 95% CI = 1.05; 12.00). After adjusting for confounders, the EQ-5D index in the FOF group reduced by 0.15 points (Coef. = −0.15; 95%CI= −0.24; −0.05) compared to that of non-FOF group. Our study shows that FOF had an independent negative relationship with HRQOL of patients. Improving knowledge about fall prevention in patients and caregivers could reduce the burden of falls in older people.

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Social support and its association with health-related quality of life among older patients with chronic heart failure

European Journal of Cardiovascular Nursing ◽

10.1177/1474515111432997 ◽

2012 ◽

Vol 12 (1) ◽

pp. 69-77 ◽

Cited By ~ 42

Author(s):

Kristofer Årestedt ◽

Britt-Inger Saveman ◽

Peter Johansson ◽

Kerstin Blomqvist

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Social Support ◽

Chronic Heart Failure ◽

Older Patients ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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CLO19-050: Risk of Health- Related Quality of Life (HRQOL) Events in Patients With Advanced Solid Tumors Treated With Cabozantinib: A Combined Analysis of Four Phase 3 Randomized Controlled Trials

Journal of the National Comprehensive Cancer Network ◽

10.6004/jnccn.2018.7150 ◽

2019 ◽

Vol 17 (3.5) ◽

pp. CLO19-050

Author(s):

Sriman Swarup ◽

Anita Sultan ◽

Nusrat Jahan ◽

Upama Sharma ◽

Nimesh Adhikari ◽

...

Keyword(s):

Quality Of Life ◽

Side Effects ◽

Solid Tumors ◽

Meta Analysis ◽

Health Related Quality ◽

Phase 3 ◽

Randomized Controlled ◽

Related Quality ◽

Health Related

Background: VEGFR, KIT, RET, and MET pathways are implicated in several solid tumors. Cabozantinib is an oral inhibitor of these kinase pathways, and hence has found its use in treatment of multiple malignancies. However, it has several side effects that can limit tolerance amongst patients. We performed a systematic review and meta-analysis of randomized controlled trials (RCT) to determine the risk of health-related quality of life (HRQOL) events in patients with advanced solid tumors treated with cabozantinib. Methods: We systematically conducted a comprehensive literature search using MEDLINE, EMBASE databases, and meeting abstracts through September 30, 2018. Phase 3 trials that mention HRQOL events like pain, arthralgia, fatigue, and reduced appetite as adverse effects were incorporated in the analysis. Mantel-Haenszel method was used to calculate the estimated pooled risk ratio (RR) with 95% CI. Random effects model was applied. Results: 4 phase 3 RCTs with a total of 2,703 patients with medullary thyroid cancer, prostate cancer, renal cell carcinoma, and hepatocellular carcinoma were eligible. Studies comparing cabozantinib (C) vs everolimus, C vs placebo, C vs prednisone were included in the analysis. The relative risks of all-grade side effects were as follows: fatigue, 1.378 (95% CI: 1.236–1.536; P<.0001); asthenia, 1.704 (95% CI: 1.190–2.441; P=.004); reduced appetite, 2.088 (95% CI: 1.471–2.964; P<.0001); back pain, 1.047 (95% CI: 0.871–1.259; P=.626); pain in limbs, 1.444 (95% CI: 1.128–1.847; P=.004); arthralgia, 0.982 (95% CI: 0.707–1.363; P=.912). The RR of high-grade side effects were as follows: fatigue, 1.937 (95% CI: 1.483–2.528; P<.0001); asthenia, 2.211 (95% CI: 1.536–3.184; P<.0001); reduced appetite, 4.329 (95% CI: 2.372–7.900; P<.0001); back pain, 1.227 (95% CI: 0.738–2.040; P=.431); pain in limbs, 2.933 (95% CI: 1.127–7.635; P=.028); arthralgia, 0.820 (95% CI: 0.394–1.709; P=.597). Conclusion: Our meta-analysis showed that cabozantinib contributed to significant toxicity of all grades of fatigue, asthenia, pain in limbs, and reduced appetite. Identifying and addressing these toxicities will be important in improving quality of life for these patients.

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Comprehensive and subacute care interventions improve health-related quality of life for older patients after surgery for hip fracture: A randomised controlled trial

International Journal of Nursing Studies ◽

10.1016/j.ijnurstu.2012.11.020 ◽

2013 ◽

Vol 50 (8) ◽

pp. 1013-1024 ◽

Cited By ~ 18

Author(s):

Yea-Ing L. Shyu ◽

Jersey Liang ◽

Ming-Yueh Tseng ◽

Hsiao-Juan Li ◽

Chi-Chuan Wu ◽

...

Keyword(s):

Quality Of Life ◽

Older Patients ◽

Controlled Trial ◽

Health Related Quality ◽

Subacute Care ◽

Related Quality ◽

Health Related ◽

Randomised Controlled ◽

Improve Health

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Changes in health-related quality of life among patients with coronary artery disease: a 2-year follow-up

Medicina ◽

10.3390/medicina46120118 ◽

2010 ◽

Vol 46 (12) ◽

pp. 843 ◽

Cited By ~ 9

Author(s):

Margarita Staniūtė ◽

Julija Brožaitienė

Keyword(s):

Quality Of Life ◽

Older Patients ◽

Treatment Method ◽

Effect Sizes ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Over Time

The aim of this study was to evaluate the changes in health-related quality of life in patients with coronary heart disease according to age, gender, and treatment method. Material and methods. The study enrolled 167 patients after acute myocardial infarction (MI), percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass grafting (CABG). The mean age was 59.3 years; there were 71.9% of males. General health-related quality of life was measured using the SF-36 questionnaire. Patients were examined at the beginning of rehabilitation and after 6-, 12-, 18-, and 24-month follow-up. Effect sizes were computed to assess the changes in health-related quality of life over time. Results. Health-related quality of life significantly improved at 6 months, but improvements did not continue over time. The largest effect size was seen in the pain domain. Effect sizes were greater in the physical health domains among male patients and among female patients in the mental health domain. With regard to age, effect sizes were greater in the physical functioning domain among older patients. With regard to treatment method, at baseline, the CABG patients had the poorest healthrelated quality of life; however, the largest effect sizes were seen in this group. Conclusions. Health-related quality of life improved over 2 years; the greatest improvement was seen at 6 months. Males better improved on the physical component summary domain; there was no significant improvement in the mental component summary domain in males and females. Older patients improved better on the physical activity and physical component summary domains. Changes in health-related quality of life were related to treatment method.

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