scholarly journals 6 Presence and Impact of Possible Tardive Dyskinesia in Patients Prescribed Antipsychotics: Results from the RE-KINECT Study

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 176-177
Author(s):  
Andrew J. Cutler ◽  
Stanley N. Caroff ◽  
Caroline M. Tanner ◽  
Huda Shalhoub ◽  
William R. Lenderking ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Tardive Dyskinesia ◽  
Antipsychotic Treatment ◽  
Health State ◽  
Involuntary Movements ◽  
Body Regions ◽  
Abnormal Movements ◽  
Lifetime Exposure ◽  
The Impact

AbstractObjectiveTardive dyskinesia (TD) is a hyperkinetic movement disorder associated with antipsychotic treatment. RE KINECT (NCT03062033), a real-world study of outpatients prescribed antipsychotics, was designed to identify the presence of possible TD and characterize the impact of involuntary movements on functioning and quality of life. Data from RE-KINECT were used to compare the impact of possible TD in patients with schizophrenia/schizoaffective disorder [SZD] versus mood/other psychiatric disorders [Mood].MethodsAdults with ≥3months of lifetime exposure to antipsychotics and ≥1 psychiatric disorder were recruited. The presence of possible TD was based on clinicians’ observation of involuntary movements in 4 body regions (head, trunk, upper extremities, and lower extremities). Baseline outcomes included demographics, medication history, location/severity of abnormal movements, impact of abnormal movements on daily activities, the Sheehan Disability Scale (SDS), and the EuroQoL 5-Dimensional questionnaire (EQ-5D-5L).ResultsOf 204 patients with clinician-confirmed possible TD, 111 (54.4%) had a SZD diagnosis and 93 (45.6%) had a mood/other psychiatric diagnosis. Significant differences found between groups (Mood vs SZD) included: mean age (56.9 vs 52.7 years; P=0.0263); male sex (33.3% vs 62.2%; P<0.0001); African-American race (7.5% vs 26.1%; P=0.0005); mean lifetime exposure to antipsychotics (9.5 vs 19.5 years; P<0.0001); and percentage of patients currently taking ≥2 psychiatric medications (93.5% vs 79.3%; P=0.0093). Based on clinician observation, there were no significant differences between diagnosis groups in the number of body regions impacted by abnormal movements, maximum severity score across all 4 regions, or patient awareness of possible TD. Over 30% of patients in both groups reported that involuntary movements had “some” or “a lot” of impact on their ability to continue usual activities, be productive, and socialize. No significant differences between the diagnosis groups (Mood vs SZD) were found for mean SDS total score (12.8 vs 10.8), SDS domain scores (work/school [4.1 vs 4.2], social life [4.3 vs 3.7], family life [4.1 vs 3.5]), EQ-5D-5L utility score (0.68 vs 0.74), or EQ-5D-5L health state VAS (64.8 vs 68.5).ConclusionsIn this cohort of outpatients with possible TD, those with Mood disorders were more likely to be older, female, and white than patients with SZD. The ability to function and quality of life were equally impaired in both groups. Further studies on the impact of TD are needed.Funding Acknowledgements: Neurocrine Biosciences, Inc.

scholarly journals THE IMPACT OF MEDICATION ADHERENCE ON HEALTH-RELATED QUALITY OF LIFE OF DIABETIC PATIENTS IN THE KINGDOM OF SAUDI ARABIA: FINDINGS FROM A CROSS-SECTIONAL STUDY

2020 ◽  
Vol 17 (34) ◽  
pp. 867-873
Author(s):  
Dhfer ALSHAYBAN ◽  
Royes JOSEPH
Keyword(s):  
Quality Of Life ◽  
Medication Adherence ◽  
Cross Sectional Study ◽  
P Value ◽  
Diabetic Patients ◽  
Health State ◽  
Cross Sectional ◽  
Related Quality ◽  
The Impact

Diabetes is a common chronic disease that is considered as one of the fastest-growing health problems in the world. Adherence to medications could be an important factor in reducing these complications and improving the quality of life. The purpose of this research was to assess the impact of treatment adherence on health-related quality of life in patients with type 2 diabetes. A multicenter cross-sectional study was carried out among 368 diabetes patients. General Medication Adherence Scale was used to assess the adherence level and EuroQol-5D to assess the quality of life. The results show that 19%, 21%, and 23% of patients had maintained low medication adherence due to patient’s intentional or unintentional behavior due to additional diseases or pills burden and due to financial constraints, respectively. Overall, 43% (n=162) participants had maintained high medication adherence, and 37% (n=138) had maintained low medication adherence to antidiabetic drugs. Nearly one-third (31%) of patients with high overall adherence had perfect health state in comparison with 4% among patients with low adherence. Further, the lower proportion (21%) of patients with high overall adherence had perfect health state in comparison with that among patients with low adherence (34%). In addition to the overall adherence, the association was statistically significant for the domains related to non-adherence due to the patient’s intentional or unintentional behavior (p-value 0.001) and non-adherence due to additional diseases or pills burden (p-value 0.001) after taking into account of socio-demographic and clinical characteristics. In conclusion, the findings suggest that the policymakers should establish an intervention to improve adherence to diabetic treatment, and thus improve the quality of life for the type 2 diabetic patients.

scholarly journals What is the Responsiveness and Quality of Life “Utility” for PROMIS Outcomes in Foot and Ankle Patients Following Physical Therapy?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0036
Author(s):  
Christopher G. Neville ◽  
Judith F. Baumhauer ◽  
Jeff Houck
Keyword(s):  
Quality Of Life ◽  
Physical Therapy ◽  
Physical Function ◽  
Health State ◽  
Foot And Ankle ◽  
T Score ◽  
The Impact ◽  
Utility Scores

Category: Other Introduction/Purpose: Patients with foot and ankle conditions have been shown to demonstrate improvement in their generic outcomes using the Patient Reported Outcome Measurement Information System (PROMIS). However, the responsiveness to change and the impact change may have on quality of life has not been explored following non-operative care with physical therapy. The effect size (ES) is an assessment of the magnitude of change while the impact of change in physical function can be assed with quality of life utility scores. Therefore, the purpose of this analysis was to investigate the responsiveness of the PROMIS physical function (PF) scale on changes in quality of life. Methods: The PROMIS PF scale was available at the start and end of physical therapy treatment for 352 patients with foot and ankle ICD10 codes. PF was chosen as a good outcome measure to assess overall outcome from physical therapy care. Changes from baseline to post-care were examine using Cohen’s d to remove dependence on sample size and was interpreted as d=0.20 as a small effect, d=0.05 as a medium effect, and d=0.80 as a large effect. Using available isotonic regression with linear interpolation functions, health state utility scores were calculated from the PROMIS PF scores. These scores represent a health state between 0, representing ‘being dead’, and 1 being the utility of ‘full health’. This methodology has been shown to be reliable and valid for assessing overall health quality of life from changes in physical function. Repeated measures ANOVA models were used to compare outcomes across time. Results: A significant improvement (p<0.01) in PF scores was seen across the sample following physical therapy (PF t-score; baseline 38.6+-8.8; follow-up 45+-9.1). This change was associated with a moderate to large ES of 0.75. The average ES for those subjects with a starting t-score less than 45 (n=294) was 0.86 (large effect) while for those with a starting t-score of greater than 45 (n=58) was 0.27 (small effect). There was also a significant (p<0.01) improvement in utility scores following physical therapy (utility score; baseline 0.58+-0.2; follow-up 0.72+-0.2). Conclusion: There is a general improvement in reported physical function following physical therapy but the magnitude of this effect depends on baseline function. Lower function is associated with greater changes. Improvement in physical function was associated with an overall improvement in quality of life. The non-linear nature of utility scores suggests some patients may have large increases in quality of life with small changes in physical function.

scholarly journals MORBIDITY BY TUBERCULOSIS IN THE JIU VALLEY: RELATION WITH DIAGNOSTIC PRACTICE AND THE IMPACT ON THERAPEUTIC RESULTS

2017 ◽  
Vol 90 (1) ◽  
pp. 49-53
Author(s):  
Nicolae Petre ◽  
Daniela Homorodean ◽  
Carmen Monica Pop
Keyword(s):  
Quality Of Life ◽  
Life Style ◽  
Strong Relationship ◽  
Epidemiological Data ◽  
Health State ◽  
Tuberculous Disease ◽  
Poor Area ◽  
The Impact

Background and aim. In the last two and a half decades the dynamics of tuberculosis has been modelled by social and economic conditions, with consequences on the life style, and effects on the onset and evolution of the disease. The Jiu Valley is an area with social problems: mining, mines closing down and ceasing activity, poverty. We looked for a relationship between changes of life style in the Jiu Valley and the dynamics of tuberculosis.Methods. We studied 528 patients who asked for medical services in different hospitals in the Jiu Valley between 2010-2013. We structurally characterized this group, we identified the characteristics of life style, and we assessed the health state, in particular the relation with tuberculosis.Results. We found out that the quality of life was influenced by the health state, especially by tuberculous disease. Quality of life was influenced by the life style, professional factors and their long term consequences. The study evidenced a strong relationship between apparently very different factors such as life style, professional factors on one side and those characterizing tuberculosis.Conclusions. We report the first detailed epidemiological data on tuberculosis in an economically poor area, the Jiu Valley.

scholarly journals Recognition and Treatment of Tardive Dyskinesia in Individuals with Intellectual Disability

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Robert O. Morton ◽  
Lucas C. Morton ◽  
Rissa Fedora
Keyword(s):  
Quality Of Life ◽  
Intellectual Disability ◽  
Tardive Dyskinesia ◽  
Daily Functioning ◽  
Functional Impairments ◽  
Behavioral Disturbances ◽  
Abnormal Movements ◽  
History Of ◽  
The Individual

Individuals with intellectual disability (ID) commonly suffer from comorbid psychiatric and behavioral disorders that are frequently treated by antipsychotic medications. All individuals exposed to first- and second/third- generation antipsychotics are at risk for developing tardive dyskinesia (TD), characterized by abnormal, involuntary movements of the mouth/tongue/jaw, trunk, and extremities. TD can be highly disruptive for affected individuals and their caregivers, causing embarrassment, isolation, behavioral disturbances, and reduced functioning and quality of life. Information on TD incidence in individuals with ID is limited, but 2 small US studies reported TD prevalence rates of 42-45% in inpatients with ID. The safety and efficacy of vesicular monoamine transporter type 2 (VMAT2) inhibitors approved for treatment of TD in adults have been demonstrated in multiple clinical trials, but they excluded individuals with ID. Clinical characteristics and treatment outcomes of 5 adults (aged 28–63 years) with mild-to-severe ID and TD are presented, illustrating TD symptoms before/after treatment. All individuals had multiple comorbid psychiatric, behavioral, and other medical conditions, history of antipsychotic exposure, and abnormal movements affecting the tongue/mouth/jaw ( n = 5 ), upper extremities ( n = 5 ), lower extremities ( n = 3 ), and trunk ( n = 2 ), resulting in diminished ability to speak ( n = 2 ), ambulate ( n = 3 ), and perform activities of daily living ( n = 3 ). Treatment with valbenazine resulted in meaningful improvements in TD symptoms and improved daily functioning, demeanor, and social/caregiver interactions. Given the high likelihood of antipsychotic exposure in the ID population, it is appropriate to screen for TD at every clinical visit through careful monitoring for abnormal movements and questioning the individual/caregiver regarding abnormal movements or TD-related functional impairments (i.e., speaking, swallowing, eating, ambulating, and social functioning). In this study, 5 individuals with ID and TD received once-daily valbenazine and experienced marked improvement in TD symptoms and daily functioning, resulting in increased quality of life for affected individuals and caregivers.

P1474IMPACT OF MALNUTRITION ON HEALTH-RELATED QUALITY OF LIFE IN DIALYSIS PATIENTS: A PROSPECTIVE STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Daniela Viramontes Horner ◽  
Fiona Willingham ◽  
Zoe Pittman ◽  
Nicholas Selby ◽  
Maarten Taal
Keyword(s):  
Quality Of Life ◽  
Nutritional Status ◽  
Health State ◽  
Dialysis Patients ◽  
Nutritional Interventions ◽  
Related Quality ◽  
Health Related ◽  
The Impact ◽  
State Score

Abstract Background and Aims Health-related quality of life (HRQoL) is severely impaired in dialysis patients compared to the general population. Previous studies have shown that malnutrition, a frequent complication and independent risk factor for mortality in the dialysis population, is associated with poor HRQoL. However, there is no published evidence regarding the impact of malnutrition on change in HRQoL over time. We sought to determine the most important predictors of poor HRQoL as well as the determinants of change in HRQoL over time in dialysis patients, with a particular focus on malnutrition. Method We enrolled 119 haemodialysis and 31 peritoneal dialysis patients in a 1-year single-centre prospective observational study. HRQoL was assessed using the physical and mental component scores (PCS and MCS, respectively) from the 36-Item Short Form Health Survey and the health state and visual analogue scores from the European Quality of Life 5-Dimensions (EQ5D) questionnaire. The 7-point scale Subjective Global Assessment (SGA) was performed to evaluate nutritional status. Energy, protein and fat intake, biochemical variables, anthropometric measurements and handgrip strength (HGS) were also measured. All study assessments were performed at baseline, 6 and 12 months. Results Mean age was 64±14 years. Malnutrition was present in 37% of the population (as determined by 7-point SGA). Patients with malnutrition and diabetes had significantly lower MCS, PCS and EQ5D scores compared to well-nourished and non-diabetic patients, respectively. At baseline, chronological age, serum albumin, energy and protein intake, and HGS correlated positively with PCS and EQ5D health state score. Multivariable analysis at baseline identified malnutrition as the strongest independent predictor of decreased HRQoL, after adjusting for confounders (Table 1). Patients who stayed or became malnourished during one year showed a significant decrease in MCS, PCS and EQ5D health state score at 12 months compared to baseline. This same group of patients had significantly lower MCS, PCS and EQ5D scores at baseline and 12 months compared to those who stayed or became well-nourished during one year. Prevalent/development of malnutrition was independently and significantly associated with the 1-year decrease in MCS and EQ5D health state score. In addition, a decrease in serum total protein and dietary protein intake (markers of malnutrition) were identified as independent determinants of 1-year decrease in MCS, PCS and EQ5D health state score. Conclusion We observed in this prospective observational study that presence of malnutrition was the most important and strongest independent predictor of decreased HRQoL in this dialysis population. Furthermore, prevalence/development of malnutrition and a decrease in markers of nutritional status were independently associated with a decrease in some HRQoL scores over 1 year. These findings strengthen the importance of undertaking screening to identify malnutrition, and providing specialised, individualised nutritional advice to all dialysis patients in order to prevent and/or improve nutritional status. Future studies with larger sample sizes, longer follow-up, and which include evaluation of barriers to effective nutritional interventions are needed to evaluate the impact of nutritional interventions on HRQoL and other long-term outcomes.

scholarly journals LIVES WORSE THAN DEATH: ADULT CHILDREN ARE POOR AT ESTIMATING PARENTS’ QUALITY-OF-LIFE VALUATIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S636-S636
Author(s):  
Matthew Pichiello ◽  
Meghan McDarby ◽  
Elissa K Kozlov ◽  
Brian Carpenter
Keyword(s):  
Quality Of Life ◽  
Adult Children ◽  
Adult Child ◽  
Feeding Tube ◽  
Health State ◽  
Worth Living ◽  
Health States ◽  
Older Parents ◽  
The Impact

Abstract Adult children often help older parents make medical decisions when their health is compromised. To do so in a way that respects parent values requires children to know how their parent views health states and consequent quality of life. The current study compared older parent and adult child valuations of quality of life in different health contexts. Families consisted of older parents (n = 37) and their adult children (n = 66). Parents rated perceived quality of life in 14 compromised health states on a scale from 1 (difficult but acceptable) to 5 (not worth living). Children estimated how their parent responded to each health state, yielding an index of their knowledge of parent perceptions. Overall, parents described all compromised health states as less acceptable than adult children thought they would, t(99) = 2.19, p &lt; .05. Notably, parents believed situations that caused financial or emotional burden to their family were much less acceptable than their children estimated. Children were more knowledgeable about parent valuations for more extreme circumstances, such as living with a feeding tube. Within families, children demonstrated only slight knowledge about parent quality of life valuations (kappa = .081). Across the entire sample of families, there was a broad range of knowledge (kappas = -.181 – .351), but at best, knowledge was still only fair. Results from this study suggest that adult children may underestimate the impact of compromised health states on parent estimations of quality of life, which could affect collaborations on healthcare decisions.

The impact of comorbidities on health-related quality of life of people with osteoarthritis over ten years

Rheumatology ◽  
2021 ◽  
Author(s):  
Ting Zhao ◽  
Tania Winzenberg ◽  
Dawn Aitken ◽  
Barbara de Graaff ◽  
Hasnat Ahmad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Independent Living ◽  
Health State ◽  
Health Related Quality ◽  
Psychological Wellness ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Abstract Objective To investigate the impact of total number and patterns of comorbidities on health-related quality of life (HRQoL) and identify the most prevalent and influential comorbidity patterns in people with osteoarthritis (OA) over ten years. Methods Participants from the Tasmanian Older Adult Cohort aged 50-80 years, with self-reported OA and data on comorbidities and HRQoL were included. Participants were interviewed at baseline (n = 398), 2.5-years (n = 304), 5-years (n = 269) and 10-years (n = 191). Data on the self-reported presence of 10 chronic comorbidities were collected at baseline. HRQoL was assessed using the Assessment of Quality of Life-4-Dimensions. The long-term impacts of the number and of the nine most prevalent combinations of cardiovascular (CVD), non-OA musculoskeletal (Ms), metabolic, and respiratory comorbidities on HRQoL over ten years were analysed using linear mixed regressions. Results Compared with comorbidity-free OA participants, the health state utility (HSU) of those with 2 or ≥ 3 comorbidities was respectively -0.07 and -0.13 units lower over ten years, largely driven by reduced scores for independent living, social relationships and psychological wellness. Comorbidity patterns including ‘CVD+Ms’ were most influential, and associated with up to 0.13 units lower HSU, mostly through negative impacts on independent living (up to -0.12), psychological wellness (up to -0.08) and social relationship (up to -0.06). Conclusion Having more comorbidities negatively impacted OA patients’ long-term HRQoL. OA patients with CVD and non-OA musculoskeletal conditions had the largest HSU impairment, therefore optimal management and prevention of these conditions may yield improvements in OA patients’ HRQoL.

scholarly journals The Impact of Preoperative Depression and Health State on Quality-of-Life Outcomes after Anterior Cervical Diskectomy and Fusion

2015 ◽  
Vol 6 (4) ◽  
pp. 306-313 ◽  
Author(s):  
Matthew D. Alvin ◽  
Jacob A. Miller ◽  
Daniel Lubelski ◽  
Amy S. Nowacki ◽  
Judith Scheman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health State ◽  
Life Outcomes ◽  
Quality Of Life Outcomes ◽  
The Impact

scholarly journals Health state utility values in people living with HTLV-1 and in patients with HAM/TSP: The impact of a neglected disease on the quality of life

2020 ◽  
Vol 14 (10) ◽  
pp. e0008761
Author(s):  
Carolina Rosadas ◽  
Tatiane Assone ◽  
Marina Yamashita ◽  
Adine Adonis ◽  
Marzia Puccioni-Sohler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health State Utility ◽  
Health State ◽  
Neglected Disease ◽  
Utility Values ◽  
Health State Utility Values ◽  
The Impact

Health-related Quality of Life in Depressed Patients: 6-month Results from the French Cohort of Finder Study

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
N. Dantchev ◽  
S. Tcherny-Lessenot ◽  
C. Goldberger ◽  
J. Hautin
Keyword(s):  
Quality Of Life ◽  
Severe Pain ◽  
Health State ◽  
Experienced Pain ◽  
Related Quality ◽  
Health Related ◽  
State Index ◽  
The Impact

Objectives:to describe the impact of pain on quality of life (QoL) in patients with depressionMethods:FINDER was a 6-month, european observational study to assess outcomes of QoL (SF36, EQ-5D), depression and anxiety (HADS), somatic (SSI) and pain (VAS) in a clinically diagnosed population initiating antidepressants.Results:606 patients enrolled in France by 57 psychiatrists and 46 general practitioners were 45.6±13.0 years old, 69% female and 39% have had a previous episode in the last 2 years. According to the patient rated HADS score greater than 11, 75% of patients were classified as cases for depression and 84% as cases for anxiety. 51% of patients rated their overall pain severity (based on VAS cut-off of 30) as moderate/severe, with 65% of them reporting no medical explanation for their pain.During the 6-month follow-up, French patients improved on SF36 physical score (46.8±10.4 to 50.2±8.3) and mental score (20.2±8.6 to 40.5±12.3), EQ-5D Health State Index (0.38±0.28 to 0.75±0.27) and EQ-5D VAS (39.9±20.0 to 71.4±20.3). Patients with moderate/severe pain at baseline and patients defined as cases for depression or anxiety at baseline had poorer QoL scores on SF36 physical score, EQ-5D Health State Index, EQ-5D VAS and HADS both at baseline and over the 6 months of since treatment started.Conclusions:Over half of French patients of this study experienced pain associated with depression. We observed that patients experiencing a moderate/severe pain at baseline had worse outcomes on QoL and depression response than those with mild or not pain at baseline.

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