scholarly journals The effect of transportation modality to dialysis facilities on health-related quality of life among hemodialysis patients: results from the Japanese Dialysis Outcomes and Practice Pattern Study

2019 ◽  
Vol 13 (4) ◽  
pp. 640-646 ◽  
Author(s):  
Masahiko Yazawa ◽  
Kenji Omae ◽  
Yugo Shibagaki ◽  
Masaaki Inaba ◽  
Kazuhiko Tsuruya ◽  
...  

Abstract Background For hemodialysis (HD) patients, travel to the dialysis facility is an issue that can affect their quality of life (QOL), both physically and mentally. However, evidence on this association of transportation modality with health-related QOL (HRQOL) is scarce. Methods We conducted a cohort study among maintenance HD patients participating in the Japanese Dialysis Outcomes and Practice Pattern Study Phase 5. The study included patients who were functionally independent and able to walk. The primary exposure was the means of transportation to the dialysis facility, categorized into three groups, namely transportation by other drivers (Group 1), transportation via self-driving (Group 2) and transportation by bicycle or walking with or without public transportation (Group 3). The primary outcomes were physical and mental health composite scores (PCS and MCS) in the 12-item Short Form at 1 year after study initiation. Results Among 1225 eligible patients (Group 1, 34.4%; Group 2, 45.0%; Group 3, 20.7%), 835 were analyzed for the primary outcomes. Linear regression analyses revealed that patients in Groups 2 and 3 had significantly higher PCS and MCS at 1 year than those in Group 1 {adjusted mean differences of PCS 1.42 [95% confidence interval (CI) 0.17–2.68] and 1.94 [95% CI 0.65–3.23], respectively, and adjusted mean differences of MCS 2.53 [95% CI 0.92–4.14] and 2.20 [95% CI 0.45–3.95], respectively}. Conclusions Transportation modality was a significant prognostic factor for both PCS and MCS after 1 year in maintenance HD patients.

Pituitary ◽  
2021 ◽  
Author(s):  
Muhammad Fahad Arshad ◽  
Oluwafunto Ogunleye ◽  
Richard Ross ◽  
Miguel Debono

Abstract Purpose There is no consensus on quality of life (QOL) in patients with acromegaly requiring medical treatment after surgery compared with those achieving remission by surgery alone. Methods QuaLAT is a cross-sectional study comparing QOL in surgery-only treated acromegaly patients versus those requiring medical treatment post-surgery. Patients attending clinics were identified and divided into—Group 1: patients who had surgery only and were in biochemical remission, Group 2: all patients on medical treatment post-surgery, Group 3: patients from Group 2 with biochemical control. Participants were asked to fill three questionnaires; Acromegaly Quality of Life Questionnaire (ACROQOL), 36-Item Short Form Survey (SF36), and Fatigue Severity Scale (FSS). Results There were 32 patients in Group 1 and 25 in Group 2. There was no difference in QOL scores between groups 1 and 2, as measured by ACROQOL (mean difference [MD] = − 2.5, 95% CI − 16.6 to 11.6; p = 0.72), SF36v2 [Physical component score (PCS) MD = − 4.9, 95% CI − 10.9 to 1.2; p = 0.12; mental component score MD = − 3.0, 95% CI − 10.5 to 4.4; p = 0.44], or FSS (MD = − 0.004, 95% CI − 1.14 to 1.33; p = 0.1). Comparison between groups 1 and 3 however showed that PCS (and 3 subdomains) was significantly better in group 3 (MD = − 8.3, 95% CI − 14.8 to -1.8; p = 0.01). All three QOL scores were lower when compared with healthy controls. Conclusions Medical treatment not only achieves a QOL comparable to surgery, it may also be associated with better QOL in physical subdomains. When compared with healthy controls, QOL remains worse in treated acromegaly patients compared to controls.


2016 ◽  
Vol 15 (1) ◽  
pp. 84-89 ◽  
Author(s):  
Ishtpreet Mann ◽  
Manisha Khubber ◽  
Ashwani K Gupta ◽  
Prithpal Singh Matreja ◽  
Harbir K Rao

Background: Diabetes mellitus and hypertension are chronic disorders, inadequate management of these two disorders leads to several complications and end organ damage that can impair health related quality of life (HRQoL) in these individuals. Several studies in hypertensive patients concluded that hypertension reduced HRQoL and participants with diabetes also reported comparably decreased HRQoL. The data on HRQoL in patients suffering from both hypertension and diabetes is limited hence we designed this study to assess health related quality of life in patients suffering from hypertension and diabetes mellitus.Methodology: This single centre, cross-sectional study was conducted for 2 months between April and August 2013 in patients with hypertension and diabetes mellitus. Patients suffering from hypertension were recruited in study and were divided into two groups, Group 1 consisted of patient suffering from hypertension and diabetes mellitus whereas Group 2 consisted of patients suffering from hypertension. Patients were assessed on Short form health Survey (SF-36) and the WHOQOL – Bref scores. Results: A total of 85 patients were screened out of which 41 patients were enrolled in the study, 21 patients in Group 1 and 20 patients in group 2. The SF-36 Scores showed significantly (p<0.05) worse pain scores in patients in Group 2. Patients in Group 1 had a better quality of life as compared to other group as evident by higher scores in most of the parameters of SF-36 and WHO-QOL Bref Score, though it was not statistically significant. Conclusion: Both groups had compromised quality of life; patients with hypertension and diabetes had a better quality of life.Bangladesh Journal of Medical Science Vol.15(1) 2016 p.84-89


2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 48-48
Author(s):  
Victor Tsu-Shih Chang ◽  
Charles B. Scott ◽  
Melanie L. Gonzalez ◽  
Jan Einhorn ◽  
Houling Yan ◽  
...  

48 Background: A Recursive Partitioning Analysis (RPA) prognostic algorithm based on quality of life and symptoms predicted 4 groups with distinct median survivals in patients with metastatic solid tumors receiving chemotherapy (ASCO 2013, Abst 9567). We update our findings. Methods: The RPA algorithm is based upon Karnofsky performance status (KPS), Functional Assessment of Cancer Therapy (FACT) physical well-being (PWB) subscale, and Memorial Symptom Assessment Scale Short Form (MSAS-SF) physical symptom distress (PHYS) subscale. Starting in 2007, a convenience sample of Veterans who were prescribed systemic treatment for their cancer was enrolled in an IRB approved protocol, and completed quality of life (FACT- G) and symptom (MSAS SF) questionnaires at the first cycle of treatment. We analyzed records of patients with stage IV metastatic solid tumors enrolled through June 2013, and determined survival as of June 15, 2014. Analyses were performed with STATA 11.0. Results: There were 97 patients(pts). The median age was 64 yrs, range 27-88. Males comprised 95 (98%) pts. First line chemotherapy was given to 78 (80%) pts. The most common primary sites were lung cancer 33 (35%), prostate 17 (17%) and colon 11 (11%) pts. Median KPS was 90% range 40-100%, PWB median 23 (range 6-28), and MSAS SF median PHYS 0.76 (range 0-3.2). Overall median survival was 285 days (range 6-2,358) and 80 pts (82%) had died. There was 1 pt in group 1, 58 in group 2, 12 in group 3, and 23 in group 4. The patient in group 1 had uterine sarcoma. Median survival (days) by RPA group was 155 for group 1, 177 for group 2, 292 for group 3, and 674 for group 4 (p=.011). Conclusions: These preliminary findings suggest that this algorithm is capable of dividing patients with metastatic solid tumor who are starting systemic therapy into prognostic groups. Further development is indicated.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 681-681
Author(s):  
Andrew Gardner ◽  
Polly Montgomery ◽  
Ming Wang ◽  
Biyi Shen ◽  
Shangming Zhang ◽  
...  

Abstract We determined if meeting the 2018 physical activity guidelines was associated with better ambulatory function, health-related quality of life, and inflammation than failing to meet the guidelines in patients with peripheral artery disease and claudication. Secondly, we determined the optimal number of total daily steps that are needed to meet the physical activity guidelines. Five hundred seventy-two patients were assessed on their daily ambulatory activity for one week with a step activity monitor, and were grouped according to whether they achieved less than 150 minutes of moderate intensity physical activity per week (Group 1=Do Not Meet Guidelines; n=397), or whether they were above this threshold (Group 2=Meet Guidelines; n=175). Treadmill peak walking time (mean±SD) was significantly higher (p&lt;0.001) in Group 2 (709±359 sec) than in Group 1 (427±281 sec). The health-related quality of life score for physical function was significantly higher (p&lt;0.001) in Group 2 (61±22%) than in Group 1 (44±21%). High sensitivity C-reactive protein was significantly lower (p&lt;0.001) in Group 2 (3.6±4.5 mg/L) than in Group 1 (5.9±6.1 mg/L). Finally, 7,675 daily steps was the optimal threshold associated with meeting the physical activity guidelines, with a sensitivity of 82.9% and a specificity of 88.4%. In conclusion, patients with claudication who meet the 2018 physical activity guidelines for US adults had better ambulation, HRQoL, and inflammation outcomes than those who failed to meet the guidelines. From a practical standpoint, patients with claudication best achieved the physical activity guidelines by taking a total of 7,675 daily steps.


2020 ◽  
Vol 78 (5) ◽  
pp. 255-261 ◽  
Author(s):  
Prabhat VARSHNEY ◽  
Rizwana PARVEEN ◽  
Mohd Ashif KHAN ◽  
Sunil KOHLI ◽  
Nidhi B. AGARWAL

ABSTRACT Background: Co-morbid diabetes and depression are prevalent chronic conditions negatively affecting quality of life (QoL). Inflammation has been considered as an integral mechanism in patients with both diabetes and depression. Objective: The aim of the present study was to investigate depression and its association with interleukins (IL)-1β and IL-9 in type 2 diabetic patients (T2DM) and controls. The QoL in diabetic patient was also assessed. Methods: Eighty subjects were included, distributed among three groups: Group 1 - Healthy controls; Group 2 - T2DM patients without depression; Group 3 - T2DM patients with depression. Depression and QoL were assessed using Patient Health Questionnaire (PHQ-9) and The Audit of Diabetes-Dependent QoL (ADDQoL), respectively. IL-1β and IL-9 were measured in serum samples of all the patients using ELISA kit. Results: The PHQ score in the Group 3 was significantly higher as compared to Group 1. The ADDQoL scores in the Group 3 were significantly higher as compared to Group 2. Levels of IL-9 and IL-1β were elevated in Group 3, as compared to the other groups. Conclusion: This study showed positive association between depression and IL-1β, IL-9 in T2DM patients. Additionally, the diabetic patients have poorer quality of life, which is further worsened by the presence of depression. Thus, routine assessment for the presence of depression is suggested in T2DM patients.


Author(s):  
N. L. Perelman

Aim. To compare the nature and degree of influence of different types of airway hyperresponsiveness (AHR) on the general and specific quality of life (QoL) of patients with asthma and control over the disease.Materials and methods. 234 patients with mild-to-moderate asthma, aged from 18 to 60 years old, were interviewed and examined. Depending on the presence of one or another type of AHR, 4 groups were formed: group 1 included 60 patients with cold AHR, group 2 – 75 patients with hypoosmotic AHR, group 3 – 35 patients with hyperosmotic AHR, group 4 – 64 patients with exercise-induced bronchoconstriction (EIB). QoL and the state of the emotional sphere were assessed using the SF-36, AQLQ, HADS questionnaires. The level of asthma control was determined using the ACT questionnaire. Lung function was assessed by spirometry.Results. When comparing QoL between groups, statistical differences were obtained for most of the SF-36 scales, with the exception of the domains “Role Physical” (RP) and “Bodily Pain” (BP), and their presence and significance varied depending on the types of AHR being compared. The lowest QoL indices were found in group 1 of patients with cold AHR according to the domains “Physical Activity” (PA), RP, BP, and “Role Emotional” (RE). The lowest indices for the domains “General Health” (GH), “Vitality” (V) and “Mental health” (MH) were found in the respondents of the 2nd group. Most of the highest QoL indicators in the compared groups were found in patients of group 4 with EIB in the domains PA, RP, V, RE, and MH. When carrying out a comparative analysis, the maximum number of significant differences was found between the groups with cold AHR and EIB. A comparative study of QoL using a special AQLQ questionnaire showed the lowest indices for the “Activity” and “Symptoms” domains in groups 1 and 2 of asthma patients. In addition, in group 1, the minimum QoL values were recorded for the “General QoL” domain (3.6±0.2 points), and in group 2, for the “Environment” domain (2.9±0.3 compared with 3.9±0.2 points in group 3, p<0.01).Conclusion. This study has demonstrated the multifaceted effect of AHR on health-related QoL, dependent on sensitivity to a particular physical stimulus and the season of maximum trigger action. The subjective assessment of psychosocial functioning is most differentiated according to the GH domain of the SF-36 questionnaire. The greatest negative impact on the QoL indices is exerted by the cold and hypoosmotic AHR, the least – by the EIB. The assessment of QoL allows to get a full picture of the perception of the patient's health level at the moment and in the given conditions.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16071-e16071
Author(s):  
Benjamin Guix ◽  
Teresa Maria Lacorte ◽  
Jose Maria Bartrina ◽  
Jose Ignacio Tello ◽  
Ines Guix ◽  
...  

e16071 Background: To report long term Health Related Quality of Life (HRQoL) in a prospective series of 629 patients with intermediate or high-risk clinically localized prostate cancer treated with either IMRT or IMRT + HDR. Methods: Between December 1999 and December 2010, 629 patients (pts) with PSA›10, Gleason score›6 and/or T2b-T3 N0 M0 prostate cancer entered the study. Pts were prospectively assigned to one of the two treatment groups: 76 Gy HD-3D-IMRT to the prostate in 38 fractions (group 1; 315 patients) or 46 Gy LD-3D-CRT+ 16 Gy HDR-B given in 2 fractions of 8 Gy (group 2, 316 patients), limiting the maximum rectal dose to 85% of the prescribed dose. Both groups were well balanced taking into account patient’s as well as tumors’ characteristics. Toxicities were scored by the EORTC /RTOG morbidity grading scales. Special attention to local, regional or distant recurrence, survival, late effects, PSA and testosterone levels as well as HRQOL was done. Results: All pts completed treatment. None pts included in group 1 or 2 had grade 3 or more rectal toxicity. With a mean follow-up of 96 m, the 8-year free-from-failure survival was 90.7% and 98.3% (p<0.02) in group 1 and 2 respectively; free-from-metastases survival 96.9% and 97.9% (p<0,08)for group 1 and 2; and cause-specific survival 97.4% and 98.3% (p<0.09). HRQoL was evaluated before treatment, at 3 months interval during the first year follow up and in a yearly basis until 10-year. I-PSS and EORTC’s QLQ-C30 with PR-25 were used. I-PSS scores at 1, 3 and 6 months and at 1, 2, 3, 5 and 8 years follow-up were 6.39, 5.00, 2.52, 2.21, 2.35, 3.65 and 1.43 for group 1 pts and 1.50, 1.10, 1.01, 1.05, 0.89, 0.66, 0.67 for group 2 pts. Global HRQoL scores at 1, 3 and 6 months and at 1, 2, 3 and 5 years follow up were 5.56, 5.75, 5.33, 6.00, 5.40, 5.58 and 5.11 for group 1 pts and 5.60, 6.40, 5.78, 5.89, 5.83, 6.37, 6.00 for group 2 pts, being found to be statistically significant at 3 and 5 years follow up (p<0,001 and p<0,024). Conclusions: High-dose 3D-IMRT + HDR brachytherapy was found to be a method of escalating the dose to the prostate that not only increased the chances of cure for patients if not increased their long-term Health Related Quality of Life.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Andrew W Gardner ◽  
Polly Montgomery ◽  
Ming Wang ◽  
Biyi Shen

Introduction: The aims were to determine (a) whether patients with peripheral artery disease (PAD) who walked at least 7,000 and 10,000 steps/day had better ambulatory function and health-related quality of life (HRQoL) than patients who walked less than 7,000 steps/day, and (b) whether these group differences persisted after adjusting for covariates. Hypothesis: Patients who walk at least 7,000 steps/day have significantly better ambulatory function, as measured by greater 6-minute walk distance (6MWD), and better HRQoL, as measured by a higher distance score on the Walking Impairment Questionnaire (WIQ), than patients who walked less than 7,000 steps/day, and that patients who walked more than 10,000 steps/day would have the best values. Furthermore, group differences in the primary outcomes would persist after adjustment for covariates. Methods: Two hundred forty-eight patients were assessed on their daily activity for one week with a step activity monitor, and were grouped according to daily step counts as follows: Group 1 (<7,000 steps/day; n=153), Group 2 (7,000-9,999 steps/day; n=57), Group 3 (>10,000 steps/day; n=38). Primary outcomes were 6MWD and WIQ distance score, which is a disease-specific measurement of HRQoL. Results: Groups were different (p<0.05) on ankle/brachial index, and on prevalence of hypertension, diabetes, abdominal obesity, arthritis, and chronic obstructive pulmonary disease. Thus, these variables served as covariates in adjusted analyses, along with age, weight, and sex. 6MWD (mean±SD) was significantly different among the groups in unadjusted (p<0.01) and adjusted (p<0.01) analyses (Group 1=313±90 m, Group 2=378±84 m, Group 3=414±77 m), with Groups 2 and 3 having higher 6MWD than Group 1 (p<0.01). Similar results were found for the WIQ distance score (Group 1=30±30%, Group 2=45±35%, Group 3=47±34%; p<0.01). Conclusions: PAD patients who walked more than 7,000 and 10,000 steps/day had greater ambulatory function and HRQoL than patients who walked fewer than 7,000 steps/day, and this finding persisted after adjusting for covariates. The clinical significance is that PAD patients should be encouraged to walk more than 7,000 steps/day because this target is associated with greater ambulatory function and HRQoL


2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Iriah Festus Uwa-Agbonikhena

Motor dysfunction makes the greatest contribution to the patient’s functional independence and has a significant impact on the quality of life (QOL) of post-stroke patients. The objective of the research was to evaluate the impact of different physical therapy approaches and choline alphoscerate on the functional independence and quality of life in patients in 1 year after ischemic stroke. Materials and methods. There were 104 patients examined in 1-year period after first anterior circulation ischemic stroke. Neurological status, functional independence and QOL were assessed according to the National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Functional Independence Measurement (FIM) and Stroke Specific Quality of Life Scale (SS-QOL). Patients in Group 1 received secondary stroke prevention therapy and performed the exercises complex for general muscle function improvement for 2 months; patients in Group 2 also performed the exercise complex for hand motility improvement for 2 months; patients in Group 3 received choline alphoscerate 400 mg twice a day for 2 months in addition to the abovementioned physical therapy. Results. 2 months of physical therapy in Group 1 resulted in increase of “Transfer” and subtotal motor scores. A significant increase in the “Self-care”, “Transfer” and therefore subtotal motor and total scores was observed in the patients in Group 2 and Group 3; the motor subtotal and total scores in Group 3 were 11.4% and 11.6 % higher than the same indices in Group 1, respectively. The most significant improvement of QOL parameters was observed in patients in Group 3, whose total score increased by 36.8% from the baseline (p<0.05), and exceeded the same index of Group 1 by 17.1% (p<0.05). Conclusions. Adding of hand exercise into the physical therapy complex for post-stroke patients contributes to better upper extremity motor performance and therefore functional independence. Stimulation of cholinergic neurotransmission with the choline alphoscerate may also increase the efficacy of physical therapy and contribute to patients’ general mobility, upper extremity function and QOL.


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