scholarly journals “The trouble with QALYs…”

2007 ◽  
Vol 16 (4) ◽  
pp. 289-293 ◽  
Author(s):  
Martin Knapp ◽  
Roshni Mangalore
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Mental Health Disorder ◽  
Comprehensive Model ◽  
Health States ◽  
Hyperactivity Disorder ◽  
Related Quality ◽  
Health Related ◽  
Health Field

AbstractThis paper summarises the use of QALYs in evaluating changes in mental health states, highlighting the benefits and challenges of their use in this field. The general principles underlying the QALY measure and the most common methods of measuring QALYs are discussed briefly. Evidence of the usefulness and problems of using this generic measure of health-related quality of life are provided from a sample of recent studies relating to depression, schizophrenia, attention deficit hyperactivity disorder and dementia. In each case, attempts were made to use QALYs to measure changes in health states. While in principle, the QALY is enormously attractive, its suitability for measuring changes in many mental health conditions remains open to doubt as existing tools for generating QALY scores such as the EQ-5D have tended not to perform sufficiently well in reflecting changes in many mental health states. New developmental work is needed to construct better QALY-measuring tools for use in the mental health field. Both the conceptualisation and measurement of QALYs need to be built on a valid, comprehensive model of quality of life specific to a mental health disorder, to ensure that the resultant tool is sensitive enough to pick up changes that would be expected and seen as relevant in the course of the illness.

scholarly journals Oral Health Interventions in Patients with a Mental Health Disorder: A Scoping Review with Critical Appraisal of the Literature

2021 ◽  
Vol 18 (15) ◽  
pp. 8113
Author(s):  
Sonja Kuipers ◽  
Nynke Boonstra ◽  
Linda Kronenberg ◽  
Annette Keuning-Plantinga ◽  
Stynke Castelein
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Oral Health ◽  
Scoping Review ◽  
Health Knowledge ◽  
Mental Health Disorder ◽  
Health Interventions ◽  
Related Quality ◽  
Health Related

Poor oral health affects quality of life and daily functioning in the general population and especially in patients with mental health disorders. Due to the high burden of oral health-related quality of life in patients with a mental health disorder, it is important for nurses to know how they can intervene in an early phase. The aim of this systematic scoping review was to identify and appraise oral health interventions in patients with a mental health disorder. A systematic scoping review with a critical appraisal of the literature was conducted using the Joanna Briggs Institute (JBI) methodology for scoping reviews and their checklists. MEDLINE, CINAHL, PsycINFO and reference lists were searched from their inception until December 2020. Results: Eleven quantitative studies were included in the review: four randomized controlled trials, six quasi-experimental studies and one cohort study. Studies focused on interventions for patients (n = 8) or focused on patients together with their professionals (n = 3). Four types of oral health interventions in mental health were found: (I) educational interventions; (II) physical interventions; (III) interventions combining behavioural and educational elements and (IV) interventions combining educational and physical elements. All studies (n = 11) had an evaluation period ≤12 months. Nine studies showed an effect on the short term (≤12 months) with regard to oral health knowledge, oral health behaviour, or physical oral health outcomes (e.g., plaque index). Two studies showed no effects on any outcome. Overall, the methodological insufficient to good. Conclusion: Four types of interventions with positive effects (≤12 months) on oral health knowledge, oral health behaviour, and physical oral health outcomes in different diagnostic patient groups were found. Due to the heterogeneity in both interventions, diagnostic groups and outcomes, one golden standard oral health intervention cannot be advised yet, although the methodological quality of studies seems sufficient. Developing an integrated oral health toolkit might be of great importance in mental health considering its potential effect on oral health-related quality of life.

Mental Health Status and Health-Related Quality of Life among Systemic Lupus Erythematosus (SLE) Patients in Thailand: A Multi-Site Study

2020 ◽  
Vol 103 (11) ◽  
pp. 1185-1193
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Status ◽  
Lupus Erythematosus ◽  
Self Esteem ◽  
Mental Health Status ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Background: The systemic lupus erythematosus (SLE) patients oftentimes suffer from both physical and psychosocial challenges that may lead to low health-related quality of life (HRQoL). However, limited research has been done in this area. Objective: To examined mental health status and HRQoL among SLE patients in Thailand. Materials and Methods: The present study was a cross-sectional study conducted at the rheumatology clinic of four major hospitals in Thailand. The paper-based questionnaire consisted of demographic, health history such as depression, anxiety, stress Scale (DASS-21), and the Rosenberg self-esteem scale (RSE), and the disease-specific Lupus Quality of Life scale (LupusQoL). Depending on the variable’s level of measurement such as categorical or continuous, Spearman’s Rho or Pearson’s product moment correlation coefficients were used to explore the relationships among the variables. Hierarchical multiple regression was used to identify the predictors of LupusQoL. Results: Among the 387 participants, many might have experienced depression, anxiety, and stress (30%, 51%, and 29%, respectively). Self-esteem among the participants was good (31.8 out of 40). All eight domains of LupusQoL were affected with intimate relationship domain being impacted the most. The overall LupusQoL was significantly associated with the number of prescribed medications (r=–0.23), depression (r=–0.70), anxiety (r=–0.58), stress (r=–0.67), and self-esteem (r=0.59), p<0.001. Significant predictors of the overall LupusQoL were mental health status (depression, anxiety, and stress) and self-esteem, F (3, 81)=43.10, p<0.001, adjusted R²=0.60. Conclusion: SLE patients should be holistically assessed in both physical and psychological aspects. In addition to proper medical treatments, healthcare providers should use a multidisciplinary team approach to resolve the patients’ psychosocial issues, which in turn, may increase the patients’ quality of life. Self-care education may be necessary to help the patients manage the condition and decrease the number of medications. Keywords: Mental health, Quality of life, SLE, Thailand

scholarly journals Is Helping Really Helping? Health-Related Quality of Life after TBI Predicting Caregiver Depression Symptom Trajectories in Latin America

2021 ◽  
Vol 18 (3) ◽  
pp. 1247
Author(s):  
Chimdindu Ohayagha ◽  
Paul B. Perrin ◽  
Annahir N. Cariello ◽  
Juan Carlos Arango-Lasprilla
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Latin America ◽  
Depression Symptom ◽  
Caregiver Depression ◽  
Symptom Trajectories ◽  
Related Quality ◽  
Health Related ◽  
Caregiver Mental Health

Previous research connecting health-related quality of life (HRQoL) in people with traumatic brain injury (TBI) and caregiver mental health has primarily been conducted cross-sectionally in the U.S. and Western Europe. This study, therefore, examined how HRQoL in individuals immediately after their TBI predicts longitudinal caregiver depression symptom trajectories in Latin America. A sample of 109 patients with an acute TBI and 109 caregivers (total n = 218) was recruited from three hospitals in Mexico City, Mexico, and in Cali and Neiva, Colombia. TBI patients reported their HRQoL while they were still in hospital, and caregivers reported their depression symptoms at the same time and at 2 and 4 months later. Hierarchal linear models (HLM) found that caregiver depression symptom scores decreased over time, and lower patient mental health and pain-related quality of life at baseline (higher pain) predicted higher overall caregiver depression symptom trajectories across the three time points. These findings suggest that in Latin America, there is an identifiable relationship between psychological and pain-related symptoms after TBI and caregiver depression symptom outcomes. The results highlight the importance of early detection of caregiver mental health needs based in part upon patient HRQoL and a culturally informed approach to rehabilitation services for Latin American TBI caregivers.

scholarly journals Psychosomatic interactions in kidney transplantation: role of personality dimensions in mental health-related quality of life

2021 ◽  
Vol 12 ◽  
pp. 204062232110243
Author(s):  
Federica Guerra ◽  
Jessica Ranieri ◽  
Domenico Passafiume ◽  
Diana Lupi ◽  
Daniela Maccarone ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Kidney Transplantation ◽  
Health Related Quality ◽  
Personality Dimensions ◽  
Related Quality ◽  
Health Related ◽  
Body Self ◽  
High Level

Background and aims: The increase in innovative and personalized medicine solutions in kidney surgery can improve patients’ chances of survival; however, during the transplantation process, patients are exposed to many psychological challenges. This study aimed to evaluate the role and impact of personality dimensions on the behaviour of waiting-list patients towards the post-surgery adaptation process. Method: The participants were 113 out-patients aged 18–70 years (mean age 54.7 years, SD ± 9.9) who had received a kidney transplant at least 3 years prior to the study. Results: The results of the study revealed that personality dimensions can predict mental health-related quality of life after kidney transplantation; in particular, the dimensions play an important role in patients’ behavioural ability to manage their quality of life both during end-stage renal disease and after kidney transplantation. Psychological distress and anxiety were associated with a low level of the conscientiousness dimension, while a high level of the openness dimension was associated with a high level of psychological distress and stress. In addition, body self-perception was associated with personality dimensions. Conclusion: Personality dimensions were found to predict behavioural reactions when emotional traits and body self-perception for each patient were combined; clinical psychologists could apply personalized intervention by modeling the treatments step by step and mitigating the negative effects of the whole kidney transplantation disease, thus helping the individual to adapt to a new life.

scholarly journals Prevalence and 11-year incidence of common eye diseases and their relation to health-related quality of life, mental health, and visual impairment

2021 ◽  
Author(s):  
Petri K. M. Purola ◽  
Janika E. Nättinen ◽  
Matti U. I. Ojamo ◽  
Seppo V. P. Koskinen ◽  
Harri A. Rissanen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Visual Impairment ◽  
Eye Diseases ◽  
Health Related Quality ◽  
Time Points ◽  
Related Quality ◽  
Health Related

Abstract Purpose To study the prevalence and incidence of the most common eye diseases and their relation to health-related quality of life (HRQoL), depression, psychological distress, and visual impairment in the aging population of Finland. Methods Our study was based on two nationwide health surveys conducted in 2000 and 2011. Eye disease status data were obtained from 7379 and 5710 individuals aged 30 + years, of whom 4620 partook in both time points. Both surveys included identical indicators of HRQoL (EuroQol-5 Dimension [EQ-5D], 15D), depression (Beck Depression Inventory [BDI]), psychological distress (General Health Questionnaire-12 [GHQ-12]), visual acuity, and self-reported eye diseases. We assessed the impact of known eye diseases on these factors, adjusted for age, gender, and co-morbidities. Results Prevalence of self-reported eye diseases was 3.1/2.7% for glaucoma, 8.1/11.4% for cataract, and 3.4/3.8% for retinal degeneration in 2000 and 2011, and the average incidence between 2000 and 2011 was 22, 109, and 35 /year/10,000 individuals, respectively. These eye diseases were associated with a significant decrease in EQ-5D and 15D index scores in both time points. BDI and GHQ-12 scores were also worsened, with some variation between different eye diseases. Impaired vision was, however, the strongest determinant of declined HRQoL. During the 11-year follow-up the effect of eye diseases on HRQoL and mental health diminished. Conclusion Declined HRQoL associated with eye diseases is more related to impaired vision than the awareness of the disease itself, and this declining effect diminished during the follow-up. Therefore, information directed to the public on the risks and prevention of blindness can and should be strengthened to prevent the deleterious effects of visual impairment.

scholarly journals Valuing health-related quality of life among the Indian population: a protocol for the Development of an EQ-5D Value set for India using an Extended design (DEVINE) Study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039517
Author(s):  
Gaurav Jyani ◽  
Shankar Prinja ◽  
Sitanshu Sekhar Kar ◽  
Mayur Trivedi ◽  
Binod Patro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Added Value ◽  
Computer Assisted ◽  
Health Related Quality ◽  
Health States ◽  
Value Set ◽  
Related Quality ◽  
Health Related ◽  
The Government

IntroductionQuality-adjusted life year (QALY) has been recommended by the government as preferred outcome measure for Health Technology Assessment (HTA) in India. As country-specific health-related quality of life tariff values are essential for accurate measurement of QALYs, the government of India has commissioned the present study. The aim of this paper is to describe the methods for the Development of an EQ-5D Value set for India using an Extended design (DEVINE) Study. Additionally, this study aspires to establish if the design of 10-time trade-off (TTO) blocks is enough to generate valid value sets.Methods and analysisA cross-sectional survey using the EuroQol Group’s Valuation Technology (EQ-VT) will be undertaken in a sample of 2700 respondents selected from six different states of India using a multistage stratified random sampling technique. The participants will be interviewed using computer-assisted personal interviewing technique. The TTO valuation will be done using 10 composite TTO (c-TTO) tasks and 7 discrete choice experiment (DCE) tasks. Hybrid modelling approach using both c-TTO and DCE data to estimate the potential value set will be applied. Values of all 3125 health states will be predicted using both the conventional EQ-VT design of 10 blocks of 10 TTO tasks, and an extended design of 18 blocks of 10 TTO tasks. The potential added value of the eight additional blocks in overall validity will be tested. The study will deliver value set for India and assess the adequacy of existing 10-blocks design to be able to correctly predict the values of all 3125 health states.Ethics and disseminationThe ethical approval has been obtained from Institutional Ethics Committee of PGIMER, Chandigarh, India. The anonymised EQ-5D-5L value set will be available for general use and in the HTAs commissioned by India’s central HTA Agency.

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