MO822POLYPHARMACY NEGATIVELY AFFECTS HEALTH-RELATED QUALITY OF LIFE IN DIALYSIS PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Julia Colombijn ◽  
Anna Bonenkamp ◽  
Anita Van Eck van der Sluijs ◽  
Alferso C Abrahams ◽  
Joost Bijlsma ◽  
...  

Abstract Background and Aims Dialysis patients are often prescribed a large number of medications to improve metabolic control and manage co-existing comorbidities. However, several studies suggest that a large number of medications can also detrimentally affect their health-related quality of life (HRQoL). Therefore, this study aims to provide insight in the association between the number of medications and various aspects of HRQoL in dialysis patients. Method A multicentre study was conducted among dialysis patients from Dutch dialysis centres three months after initiation of dialysis as part of the ongoing prospective DOMESTICO study. The number of medications, defined as the number of concomitantly prescribed types of drugs, was obtained from electronic patient records. Primary outcome was HRQoL measured with the Physical Component Summary (PCS) score and Mental Component Summary (MCS) score (range 0-100) of the Short Form 12. Secondary outcomes were number of symptoms (range 0-30) measured with the Dialysis Symptoms Index and self-rated health (range 0-100) measured with the visual analogue scale of the EuroQol-5D-5L. Data were analysed using linear regression and adjusted for possible confounders, including age, sex, dialysis modality, and comorbidity. Analyses for MCS and number of symptoms were performed after categorising patients in tertiles according to their number of medications because assumptions of linearity were violated for these outcomes. Results A total of 162 patients were included. Mean age of patients was 58 ± 17 years, 35% were female, and 80% underwent haemodialysis. The mean number of medications was 12.2 ± 4.5. Mean PCS and MCS were 36.6 ± 10.2 and 46.8 ± 10.0, respectively. The mean number of symptoms was 12.3 ± 6.9 and mean self-rated health 60.1 ± 20.6. In adjusted analyses, PCS was 0.6 point lower for each additional medication (95%CI -0.9 – -0.2; p=0.002). MCS was 4.9 point lower (95%CI -8.8 – -1.0; p=0.01) and 1.0 point lower (95%CI -5.1 – 3.1; p=0.63) for the highest and middle tertiles of medications, respectively, compared to the lowest tertile. Patients in the highest tertile of medications reported 4.1 more symptoms compared to the lowest tertile (95%CI 1.5 – 6.6; p=0.002) but no significant difference in the number of symptoms was observed between the middle and lowest tertile. Self-rated health was 1.5 point lower for each medication (95%CI -2.2 – -0.7; p<0.001). Conclusion After adjustment for comorbidity and other confounders, a higher number of medications was associated with a lower PCS, MCS, and self-rated health in dialysis patients and with more symptoms. This suggests that it may be relevant to weigh expected therapeutic benefits of medication against their possible harmful effects on HRQoL. An unfavourable balance between expected benefits and impact on HRQoL might be ground to deviate from clinical guidelines, especially for patients with a limited life-expectancy and for whom a kidney transplant is unattainable.

2021 ◽  
pp. 1-10
Author(s):  
Julia M.T. Colombijn ◽  
Anna A. Bonenkamp ◽  
Anita van Eck van der Sluijs ◽  
Joost A. Bijlsma ◽  
Arnold H. Boonstra ◽  
...  

<b><i>Introduction:</i></b> Dialysis patients are often prescribed a large number of medications to improve metabolic control and manage coexisting comorbidities. However, some studies suggest that a large number of medications could also detrimentally affect patients’ health-related quality of life (HRQoL). Therefore, this study aims to provide insight in the association between the number of types of medications and HRQoL in dialysis patients. <b><i>Methods:</i></b> A multicentre cohort study was conducted among dialysis patients from Dutch dialysis centres 3 months after initiation of dialysis as part of the ongoing prospective DOMESTICO study. The number of types of medications, defined as the number of concomitantly prescribed types of drugs, was obtained from electronic patient records. Primary outcome was HRQoL measured with the Physical Component Summary (PCS) score and Mental Component Summary (MCS) score (range 0–100) of the Short Form 12. Secondary outcomes were number of symptoms (range 0–30) measured with the Dialysis Symptoms Index and self-rated health (range 0–100) measured with the EuroQol-5D-5L. Data were analysed using linear regression and adjusted for possible confounders, including comorbidity. Analyses for MCS and number of symptoms were performed after categorizing patients in tertiles according to their number of medications because assumptions of linearity were violated for these outcomes. <b><i>Results:</i></b> A total of 162 patients were included. Mean age of patients was 58 ± 17 years, 35% were female, and 80% underwent haemodialysis. The mean number of medications was 12.2 ± 4.5. Mean PCS and MCS were 36.6 ± 10.2 and 46.8 ± 10.0, respectively. The mean number of symptoms was 12.3 ± 6.9 and the mean self-rated health 60.1 ± 20.6. In adjusted analyses, PCS was 0.6 point lower for each additional medication (95% confidence interval [95% CI]: −0.9 to –0.2; <i>p</i> = 0.002). MCS was 4.9 point lower (95% CI: −8.8 to –1.0; <i>p</i> = 0.01) and 1.0 point lower (95% CI: −5.1–3.1; <i>p</i> = 0.63) for the highest and middle tertiles of medications, respectively, than for the lowest tertile. Patients in the highest tertile of medications reported 4.1 more symptoms than in the lowest tertile (95% CI: 1.5–6.6; <i>p</i> = 0.002), but no significant difference in the number of symptoms was observed between the middle and lowest tertiles. Self-rated health was 1.5 point lower for each medication (95% CI: −2.2 to –0.7; <i>p</i> &#x3c; 0.001). <b><i>Discussion/Conclusion:</i></b> After adjustment for comorbidity and other confounders, a higher number of medications were associated with a lower PCS, MCS, and self-rated health in dialysis patients and with more symptoms.


2021 ◽  
Author(s):  
Fatemh Saki ◽  
Hashem Mohamadian ◽  
Fataneh GhorbanyJavadpour ◽  
Maria Cheraghi

Abstract Backgrounds: Quality of life related to oral health impact profile-14 (OHIP-14) is one of the important dimensions of quality of life. Since using narcotics or stimulants increases the incidence of periodontal diseases, we aimed to determine impact of Oral health-related quality of life in narcotic or stimulant addicts who referred to maintenance methadone therapy (MMT) centers in Ahvaz City, Iran.Methods: It was descriptive-analytical cross-sectional study which has conducted on 187 narcotic and stimulant addicts who referred to MMT centers in Ahvaz city; 2020. The data collection tools included the demographic variables and the standard OHIP-14 questionnaires. Descriptive statistics, independent t-test, one-way analysis of variance, and LMS test were run at the significance level of less than 0.05. Results: The mean and standard deviation of the participants' age was 36.03 ± 8.98 years. The quality-of-life scores related to oral health were 34.89 ± 6.50 totally as well as 37.37 and 33.96 in narcotic and stimulant addicts, respectively. The total quality of life related to OHIP-14 did not have a significant relationship with variables of age, life companions, level of education, number of children, economic status, employment status, insurance status, underlying disease, toothbrush use status, last dentist visit, and number of missing teeth (P> 0.05). However, a significant difference was found between the quality of life related to oral health based on the type of substance used (narcotic or stimulant), so that the mean quality of life related to oral health was higher in narcotic addicts than stimulant users (P <0.05). Conclusion: The quality of life related to OHIP-14 was more unfavorable in stimulant users than narcotic users. So, policy makers and authorities are required to focus their interventions and research programs to improve health-related quality of life in addicts, especially stimulant users.


Author(s):  
Sevcihan Gunen Yilmaz ◽  
munevver kilic

Objective: Chemotherapy and radiotherapy, used to treat childhood hematological malignancies (HM), can negatively impact oral tissues and organs. This study aimed to evaluate oral health-related quality of life in children with HM. Material and Methods: A total of 59 children, including 29 undergoing HM (21 for acute lymphocytic leukemia, 2 for acute myelocytic leukemia, 4 for Hodgkin lymphoma, and 2 for non-Hodgkin lymphoma) and 30 healthy volunteers, were included in this cross-sectional study. The mean age of the entire study group was 78.63 ± 34.41 months. The mean age of the HM and control groups was 87.12 ± 35.04 and 70.95 ± 34.85 months, respectively. The Simplified Oral Hygiene Index (SOHI), Decayed, Missing, and Filled Teeth (DMFT) index, and Turkish version of the Early Childhood Oral Health Impact Scale (ECOHIS-T) were administered to all children. The data were analyzed using SPSS software (version 22.0). Results: The age and gender distributions of the two groups were similar. The SOHI was significantly higher in the HM group, whereas the DMFT score was similar between the groups. No significant difference in the total ECOHIS-T score was observed between the two groups, but there was a group difference in the responses to questions on pain and psychological processes. Conclusions: Oral health and self-care were negatively affected by childhood HM and the treatment thereof. Close clinical dental follow-up of such patients is required. Keywords: Hematological malignancies, DMFT, Oral health-related quality of life


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Deborah O. Aluh ◽  
Maxwell O. Adibe ◽  
Abubakar Abba ◽  
Chukwudi E. Sam-Eze ◽  
Abdulmuminu Isah

Purpose Depression and its symptoms negatively influence the health-related quality of life of patients. This paper aims to explore the occurrence of depressive symptoms and their relationship with health-related quality of life and sociodemographic characteristics. Design/methodology/approach It was a cross-sectional study conducted among patients attending the outpatient psychiatric clinics of two Nigerian hospitals. Data were collected using sociodemographic, PHQ-9 and 15 D questionnaires from a convenience sample of patients. Statistical Product and Services Solution Software (SPSS) version 21.0 was used to evaluate depressive symptoms, health-related quality of life, sociodemographic characteristics and the associations among them. Findings The mean depressive symptoms and health-related quality of life scores were found to be 12.118 ± 4.373 and 0.829 ± 0.141, respectively. The result showed a significant negative correlation (r = −0.318, p < 0.001) between respondents’ depressive symptoms and health-related quality of life. Patients with comorbid conditions reported a significantly higher level of depressive symptoms (p = 0.002) and lower health-related quality of life (p < 0.001). There was a significant difference in the mean health-related quality of life of the respondents across their level of education and marital status. Originality/value Depressive symptoms are a common occurrence in psychiatric conditions. This study provides an insight into the associations between depressive symptoms, socio-demographic factors and the health-related quality of life of psychiatric patients in a low-income country.


Author(s):  
munevver kilic ◽  
Sevcihan Gunen Yilmaz

Objective: Chemotherapy and radiotherapy, used to treat childhood hematological malignancies (HM), can negatively impact oral tissues and organs. This study aimed to evaluate oral health-related quality of life in children with HM. Material and Methods: A total of 99 children, including 49 undergoing HM (41 for acute lymphocytic leukemia, 8 for acute myelocytic leukemia,) and 50 healthy volunteers, were included in this cross-sectional study. The mean age of the entire study group was 78.63 ± 34.41 months. The mean age of the HM and control groups was 87.12 ± 35.04 and 70.95 ± 34.85 months, respectively. The Simplified Oral Hygiene Index (SOHI), Decayed, Missing, and Filled Teeth (DMFT/dmft) index, and Turkish version of the Early Childhood Oral Health Impact Scale (ECOHIS-T) were administered to all children. The data were analyzed using SPSS software (version 22.0). Results: The age and gender distributions of the two groups were similar. The SOHI was significantly higher in the HM group, whereas the DMFT/dmft score was similar between the groups. No significant difference in the total ECOHIS-T score was observed between the two groups, but there was a group difference in the responses to questions on pain and psychological processes. Conclusions: Oral health and self-care were negatively affected by childhood HM and the treatment thereof. Close clinical dental follow-up of such patients is required.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sait Ashina ◽  
Dawn C. Buse ◽  
Jakob B. Bjorner ◽  
Lars Bendtsen ◽  
Ann C. Lyngberg ◽  
...  

Abstract Objectives Tension-type headache (TTH) is the most prevalent primary headache disorder. We assessed the cross-sectional impact of TTH on health related quality of life (HRQoL) in a general population. We also examined the association of HRQoL scores with headache frequency, disability, medication overuse, poor self-rated health, psychiatric comorbidity, and pain sensitivity in individuals with TTH. Methods A sample of 547 subjects completed a headache diagnostic interview, the SF-12 to calculate physical (PCS) and mental (MCS) health component scores, depression (major depression inventory [MDI]) and neuroticism (Eysenck Personality Questionnaire) measures. We defined the following headache diagnosis categories: pure TTH, pure migraine, and coexistent headache (TTH + migraine). Cases were further classified into chronic (≥15) or episodic (<15 headache days/month). Results Using generalized linear models (GLM) adjusted for age, sex and education, both PCS-12 and MCS-12 scores varied in groups distinguished by migraine and TTH status; scores were lower for individuals with coexistent headache (TTH + migraine; n=83), followed by pure TTH (n=97) and pure migraine (n=43) compared to the no headache group (n=324) (p≤0.001). In analyses considering chronicity, PCS-12 scores were lower in chronic coexistent headache followed by pure chronic TTH (CTTH), episodic migraine +/− episodic TTH (ETTH) and pure ETTH than in the no headache group (p≤0.001). MCS-12 scores were lower in pure CTTH, followed by chronic coexistent headache, episodic migraine +/− ETTH and pure ETTH compared to the no headache group (p≤0.001). Multiple regression models showed that in TTH, lower PCS-12 scores were associated with age (p=0.04), female sex (p=0.02), and poor self-rated health (p≤0.001). Lower MCS-12 scores in TTH were associated with depression (p≤0.001). Conclusions In a population sample, TTH, and to higher degree CTTH, are associated with decreased HRQoL.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mina Pakkhesal ◽  
Elham Riyahi ◽  
AliAkbar Naghavi Alhosseini ◽  
Parisa Amdjadi ◽  
Nasser Behnampour

Abstract Background Childhood dental caries can affect the children’s and their parents’ oral health-related quality of life. The aim of the present study was to evaluate the impact of oral and dental health conditions on the oral health-related quality of life in preschool children and their parents. Methods In this descriptive-analytical cross-sectional study, samples were selected from children 3 to 6 years old enrolled in licensed kindergartens using "proportional allocation" sampling. Then, the parents of the children were asked to complete the Early Childhood Oral Health Impact Scale (ECOHIS). Results In this study, 350 children aged 3 to 6 years were evaluated with a mean age of 4.73 years. The mean dmft index (decayed, missed, and filled teeth) was 3.94 ± 4.17. The mean score of oral health-related quality of life was 11.88 ± 6.9, which 9.36 ± 5.02 belongs to the impact on children and 2.52 ± 3.20 to parents' impact. Conclusions The mean score of ECOHIS increased with the dmft index increase in children, indicating a significant relationship between the dmft and ECOHIS score. These outcomes can be used as proper resources to develop preventive policies and promote oral health in young children.


2019 ◽  
pp. 35-42
Author(s):  
Tri Vo Duc ◽  
Ngoc Nguyen Phuoc Bich

Background: The prevalence of diabetes mellitus (DM) has been increasing significantly in the world as well as in Viet Nam. DM is a serious and complex chronic disease that affects the physical health of the patients and lower health-related quality of life (HRQoL). Objectives: (1) To analyze the HRQoL in DM outpatients at Hue University of Medicine and Pharmacy Hospital. (2) To evaluate the associated factorsin outpatients with DM. Materials and method: A cross-sectional descriptive study was conducted on 253 outpatients at Hue University of Medicine and Pharmacy Hospital. EuroQoL-5 dimension-5 level (EQ-5D-5L) scale was used for the assessment of HRQoL. Results: The median of the EQ-5D index was 0.85(interquartile range (IQR) = 0.28). The mean of EQ-VAS score was 64.07 (SD=16.99). Aging was associated with lower HRQoL. Unemployed participants had the lowest HRQoL index compared to workers. Higher educational levels led to higher HRQoL. Patients withDM duration of over 10 years had lower HRQoL index than the other groups. Conclusion: The median of the EQ-5D index was 0.85 (IQR = 0.28). The mean of EQ-VAS score was 64.07 (SD=16.99). The HRQoL in diabetic patients was associated with age, occupation, level of education and DM duration. Key words: EQ-5D-5L, quality of life, diabetes mellitus.


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