Factors associated with quality of life in middle-aged and older patients living with HIV

Background Among older patients with atrial fibrillation, there are limited data examining clinically meaningful changes in quality of life (QoL). We examined the extent of, and factors associated with, clinically meaningful change in QoL over 1‐year among older adults with atrial fibrillation. Methods and Results Patients from cardiology, electrophysiology, and primary care clinics in Massachusetts and Georgia were enrolled in a cohort study (2015–2018). The Atrial Fibrillation Effect on Quality‐of‐Life questionnaire was used to assess overall QoL and across 3 subscales: symptoms, daily activities, and treatment concern. Clinically meaningful change in QoL (ie, difference between 1‐year and baseline QoL score) was categorized as either a decline (≤−5.0 points), no clinically meaningful change (−5.0 to +5.0 points), or an increase (≥+5.0 points). Ordinal logistic models were used to examine factors associated with QoL changes. Participants (n=1097) were on average 75 years old, 48% were women, and 87% White. Approximately 40% experienced a clinically meaningful increase in QoL and 1 in every 5 patients experienced a decline in QoL. After multivariable adjustment, women, non‐Whites, those who reported depressive and anxiety symptoms, fair/poor self‐rated health, low social support, heart failure, or diabetes mellitus experienced clinically meaningful declines in QoL. Conclusions These findings provide insights to the magnitude of, and factors associated with, clinically meaningful change in QoL among older patients with atrial fibrillation. Assessment of comorbidities and psychosocial factors may help identify patients at high risk for declining QoL and those who require additional surveillance to maximize important clinical and patient‐centered outcomes.

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Perspectives, Preferences, Care Practices, and Outcomes Among Older and Middle-Aged Patients With Late-Stage Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2004.06.050 ◽

2004 ◽

Vol 22 (24) ◽

pp. 4907-4917 ◽

Cited By ~ 98

Author(s):

Julia Hannum Rose ◽

Elizabeth E. O'Toole ◽

Neal V. Dawson ◽

Renee Lawrence ◽

Diana Gurley ◽

...

Keyword(s):

Quality Of Life ◽

Older Patients ◽

Perceived Quality ◽

Therapeutic Interventions ◽

Middle Aged ◽

Aged Patients ◽

Perceived Quality Of Life ◽

Care Practices ◽

Aggressive Care

PurposeTo evaluate relationships among physician and cancer patient survival estimates, patients' perceived quality of life, care preferences, and outcomes, and how they vary across middle-aged and older patient groups.Patients and MethodsSubjects were from the Study to Understand Prognoses and Preferences for Risks of Treatments (SUPPORT) prospective cohort studied in five US teaching hospitals (from 1989 to 1994), and included 720 middle-aged (45 to 64 years) and 696 older (≥ 65 years) patients receiving care for advanced cancer. Perspectives were assessed in physician and patient/surrogate interviews; care practices and outcomes were determined from hospital records and the National Death Index. General linear models were used within age groups to obtain adjusted estimates.ResultsAlthough most patients had treatment goals to relieve pain, treatment preferences and care practices were linked only in the older group. For older patients, preference for life-extending treatment was associated with more therapeutic interventions and more documented discussions; cardiopulmonary resuscitation (CPR) preference was linked to more therapeutic interventions and longer survival. For middle-aged patients, better perceived quality of life was associated with preferring CPR. In both groups, patients' higher survival estimates were associated with preferences for life-prolonging treatment and CPR; physicians' higher survival estimates were associated with patients' preferences for CPR, fewer documented treatment limitation discussions about care, and actual 6-month survival. More discussions were associated with readmissions and earlier death. More aggressive care was not related to outcomes.ConclusionFewer older patients preferred CPR or life-prolonging treatments. Although older patients’ goals for aggressive treatment were related to care, this was not so for middle-aged patients. Aggressive care was not related to prolonged life in either group.

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Factors Associated with HIV Status Disclosure and Its Effect on Treatment Adherence and Quality of Life among Children 6–17 Years on Antiretroviral Therapy in Southern Highlands Zone, Tanzania: Unmatched Case Control Study

International Journal of Pediatrics ◽

10.1155/2018/8058291 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Regina Edward Bulali ◽

Stephen Matthew Kibusi ◽

Bonaventura C. T. Mpondo

Keyword(s):

Quality Of Life ◽

Treatment Adherence ◽

Case Control Study ◽

Hiv Status ◽

Factors Associated ◽

Hiv Status Disclosure ◽

Living With Hiv ◽

Status Disclosure ◽

Control Study

Background. The World Health Organization (WHO) recommends that children should be informed of their HIV status at ages 6 to 12 years and full disclosure of HIV and AIDS be offered in a caring and supportive manner at about 8 to 10 years. The objective of this study was to determine factors associated with HIV status disclosure and its effect on treatment adherence and health-related quality of life among children between 6 and 17 years of age living with HIV/AIDS in the Southern Highlands Zone, Tanzania, 2017. Methods. A hospital based unmatched case control study was conducted between April and September 2017. A total of 309 children between 6 and 17 years on ART for at least six months were enrolled in this study. Simple random sampling was employed in selecting the children from existing treatment registers. Data were collected using a structured questionnaire which included the WHO Quality of Life standard tool (WHOQOL-BREF 2012 tool) and treatment adherence manual. Multiple logistic regression was used to test for the independent effect of HIV status disclosure on treatment adherence and quality of life at p value less than 0.05. Results. Out of 309 children, only 102 (33%) had their HIV status disclosed to them. The mean age at HIV status disclosure was 12.39 (SD=3.015). HIV status disclosure was high among girls (51%), children aged 10-13 years (48.3%), and those living with their biological parents (59.8%). After adjusting for confounders, being aged between 10-13 and 14-17 years was associated with HIV status disclosure (AOR 19.178, p<0.05 and AOR=65.755, p<0.001, respectively). HIV status disclosure was associated with ART adherence (AOR=8.173, p<0.05) and increased the odds of having good quality of life (AOR=3.283, p<0.001). Conclusions. HIV status disclosure significantly improved adherence to treatment and quality of life among children living with HIV/AIDS.

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Suicidality in middle aged and older patients with schizophrenia and depressive symptoms: relationship to functioning and Quality of Life

International Journal of Geriatric Psychiatry ◽

10.1002/gps.1817 ◽

2007 ◽

Vol 22 (12) ◽

pp. 1223-1228 ◽

Cited By ~ 21

Author(s):

J. Kasckow ◽

L. Montross ◽

S. Golshan ◽

S. Mohamed ◽

T. Patterson ◽

...

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Older Patients ◽

Middle Aged

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Health-related quality of life of people living with HIV/AIDS: the role of social inequalities and disease-related factors

10.21203/rs.3.rs-22152/v1 ◽

2020 ◽

Author(s):

Fikadu Tadesse Nigusso ◽

Azwihangwisi Helen Mavhandu-Mudzusi

Keyword(s):

Quality Of Life ◽

Social Inequalities ◽

People Living With Hiv ◽

Health Related Quality ◽

Factors Associated ◽

Related Quality ◽

Health Related ◽

Study Population ◽

Living With Hiv

Abstract Background: Health-related quality of life (HRQoL) serves as a direct measure of individuals’ health, life expectancy and the impact that the utilisation of health care has on quality of life. The purpose of this study is to assess the HRQoL of people living with HIV and AIDS, and to ascertain its association with the social inequalities and clinical determinants among people living with HIV in Benishangul Gumuz Regional State, Ethiopia.Methods: A cross-sectional study was conducted between December 2016 and February 2017; 390 people at two referral hospitals and three health centres participated in the study. The Patient-Reported Outcomes Measurement Information System Global Health Scale (PROMIS Global 10) was used to measure key HRQoL domains. Physical Health Summary (PHS) and Mental Health Summary (MHS) scores were employed. PHS and MHS scores below 50 (the standardised mean score) were determined to be poor and above 50 to be good. Bivariate and multivariate logistic regression analyses were used to identify factors associated with PHS and MHS scores.Results: This study included 259 (66.4%) females and 131 (33.6%) males. The PHS scores ranged from 16.2 to 67.7 with a mean of 48.8 (SD = 8.9). Almost 44.6% of the study population has a PHS score of below 50; the MHS scores ranged from 28.4 to 67.6 with a mean of 50.8 (SD = 8.1). About 41.8% of the study population has an MHS score of below 50. Unemployment, household food insecurity and comorbidities with HIV were associated with both poor PHS and poor MHS scores. The demographic factors associated with poor PHS scores were being a member of the Oromo ethnic group and having non-Christian religious affiliations; while age of below 25 years were inversely associated with poor PHS. The least wealth index score was also associated with a poor MHS score.Conclusion: Overall, socioeconomic inequalities and HIV-related clinical factors play an important role in improving the HRQoL of PLWHA. Many of these determinants are alterable risk factors. Appropriate strategies can improve the holistic management of chronic HIV care and maximise PLWHAs’ HRQoL. Such strategies require the adoption of comprehensive interventions, including policies and programmes that would improve the health, wellbeing and livelihood of PLWHAs.

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Health-related quality of life and associated factors among people living with human immunodeficiency virus on highly active antiretroviral therapy in North East Ethiopia: Cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0247777 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0247777

Author(s):

Solomon Ahmed Mohammed ◽

Minilu Girma Yitafr ◽

Birhanu Demeke Workneh ◽

Abel Demerew Hailu

Keyword(s):

Quality Of Life ◽

Cross Sectional Study ◽

Health Related Quality ◽

Cross Sectional ◽

Factors Associated ◽

North East ◽

Related Quality ◽

Health Related ◽

Living With Hiv

Introduction HIV/AIDS remains a public health concern affecting millions of people across the world. Although the health-related quality of life (HRQoL) of patients living with HIV has significantly improved after treatment, its chronicity makes the HRQoL uncertain. This study assessed factors associated with the health-related quality of life among people living with HIV/AIDS on HAART in North-East Ethiopia. Methods An institutional-based cross-sectional study was conducted from March to April 2018, and systematic random sampling was used to select 235 participants who were on HAART. HRQoL was assessed using the Medical Outcomes Study HIV Health Survey. Descriptive and multiple linear regression analysis were computed using the statistical package for social sciences version 20. Results The study revealed one-factor structure and had good overall internal consistency (78.5). Over one-third (42.6%; 95% CI; 36.2%, 48.9%) of participants had good HRQoL. The least HRQoL mean score was found for cognitive functioning 32.21(±19.78), followed by social functioning 40.58(±29.8). Factors associated with the overall HRQoL were 25–45 years of age (β = − 3.55, 95% CI;-6.54, -0.55), working in private sector (β = -5.66, 95% CI;-9.43, -1.88), government (β = -4.29, 95% CI;-7.83, -0.75) and self-employment (β = -8.86, 95% CI;-13.50, -4.21), 100–200 (β = − 4.84, 95% CI;-9.04, -0.63) and 201–350 CD4 at the time of diagnosis (β = − 7.45, 95% CI;-11.73, -3.16), 351–500 current CD4 level (β = 8.34, 95% CI;5.55, 11.41), 6–10 years of disease duration (β = -8.28, 95% CI;-12.51, -4.04), WHO stage II (β = -4.78, 95% CI;-8.52, -1.04) and III (β = 3.42, 95% CI;0.06, 6.79) during treatment initiation and not taking of Cotrimoxazole prophylaxis (β = -5.79, 95% CI;-8.34, -3.25). Conclusions High proportion of participants had a poor HRQoL. Routine assessment and appropriate interventions at each visit is recommended to improve HRQoL.

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