scholarly journals 008 Associations between comorbidities and adverse events of antiepileptic drugs and quality of life: a survey of epilepsy patients in australia

2019 ◽  
Vol 90 (e7) ◽  
pp. A3.2-A3
Author(s):  
Jeremy M Welton ◽  
Christine Walker ◽  
Kate Riney ◽  
Alvin Ng ◽  
Lisa M Todd ◽  
...  

IntroductionThis study explored the impact of specific types of comorbidities and adverse events (AEs) from antiepileptic drugs (AEDs) on quality of life (QoL) among adult patients with epilepsy (PwE) in Australia.MethodsCross-sectional surveys were completed by PwE, or caregiver proxies, recruited via the online pharmacy application MedAdvisor and Australian PwE Facebook groups from May–August 2018 Data were collected on demographics, epilepsy severity and management, AEs, comorbidities, and QoL (using QOLIE-10-P total score).1 Multiple linear regression models were constructed to explore associations between AEs or comorbidities and QOLIE-10-P, with possible confounders determined using stepwise selection.Results978 responses were included (mean age 44.5 years, 64% female, 52% employed). 97% reported recent AED use, 47% on AED monotherapy, 35% exposed to ≤2 lifetime AEDs, and 55% seizure-free for >1 year. After stepwise selection, control variables included in both models were: time since diagnosis, employment status, seizure frequency, number of currently prescribed AEDs, and number of general practitioner visits per year. In the model for comorbidities, ‘psychiatric disorders’ was associated with the largest QOLIE-10-P decrease (-23.30, p<0.001). In the model for AEs, which additionally controlled for depression and anxiety disorder, ‘memory problems’ was associated with the largest decrease in QOLIE-10-P (-14.27, p<0.001).ConclusionsIn this survey of Australian PwE, of which many had relatively well-controlled epilepsy, psychiatric and memory problems were common and associated with the greatest detrimental impact on QoL. Further research is needed to understand causality, relationships between possibly interrelated or overlapping symptoms, and management strategies. UCB Pharma-sponsored.ReferenceCramer JA, Perrine K, Devinsky O, Meador K. A brief questionnaire to screen for quality of life in epilepsy: The QOLIE-10. Epilepsia 1996;37:577–582.

2018 ◽  
Vol 103 (9) ◽  
pp. 1314-1319 ◽  
Author(s):  
Eva K Fenwick ◽  
Ryan E K Man ◽  
Alfred Tau Liang Gan ◽  
Neelam Kumari ◽  
Charlene Wong ◽  
...  

Background/aimsTo assess the independent impact of diabetic retinopathy (DR) on three domains of vision-related quality of life (VRQoL) in a Chinese Singapore population.MethodsThe Singapore Chinese Eye Study (n=3353; 2009–2011) was a population-based, prospective, cross-sectional study conducted at the Singapore Eye Research Institute. The study population included 292 adults with diabetes, with and without DR. DR (better eye) was categorised as presence and absence of any DR; severity of DR (no vision-threatening DR (VTDR); severe non-proliferative DR (NPDR); PDR and/or clinically significant macular oedema and VTDR). Our main outcome was VRQoL which was measured using Rasch-calibrated scores from the ‘Reading’, ‘Mobility’ and ‘Emotional’ domains of the Impact of Vision Impairment questionnaire. The relationship between DR and VRQoL was assessed using multiple linear regression models.ResultsOf the 292 individuals (mean age 61.35 ± 9.66 years; 55.8% male), 201 (68.8%), 49 (16.8%), 20 (6.8%), 22 (7.5%) and 27 (9.2%) had no DR, minimal-mild NPDR, moderate-severe NPDR, PDR and VTDR, respectively. Any DR and VTDR were independently associated with 6% and 12% worse Reading scores and 7% and 18% poorer Emotional well-being, respectively, compared with those without DR. These associations persisted after separate adjustment for visual impairment and presenting visual acuity. No significant difference was found in the Mobility domain between persons with and without DR.ConclusionsWe documented that DR, particularly VTDR, was independently associated with restrictions in Reading and Emotional well-being. Understanding factors underlying the detrimental DR-VRQoL relationship may optimise rehabilitation outcomes for individuals with DR.


2019 ◽  
Vol 90 (e7) ◽  
pp. A31.2-A32
Author(s):  
Jeremy M Welton ◽  
Christine Walker ◽  
Kate Riney ◽  
Alvin Ng ◽  
Lisa M Todd ◽  
...  

IntroductionThis analysis explored relationships between memory/cognitive issues, quality of life (QoL), and employment among patients with epilepsy (PwE) in Australia.MethodsCross-sectional surveys were completed by PwE, or caregiver proxies, recruited via the online pharmacy application MedAdvisor and Australian PwE Facebook groups from May–August 2018. Data were collected on adverse events from antiepileptic drugs (AEDs), comorbidities, epilepsy severity and management, QoL (using QOLIE-10-P total score)1 and demographics. Descriptive statistics were stratified by employment status: employed; not looking for work (NLW); looking for work (LW); or unable to work (UW), and differences in means or distributions were analysed using chi-squared, Mann-Whitney U or Kruskal-Wallis H tests. Regression models were constructed to explore associations between memory/cognition-related variables and QOLIE-10-P within each employment group.Results950 eligible responses reporting current AED use were included (71% via MedAdvisor, 29% via Facebook; 55% seizure-free for >1 year). Mean QOLIE-10-P score was significantly different across employment groups (p<0.001): 49.61 in employed PwE (n=493), 48.87 in NLW (n=227), 32.75 in LW (n=52), and 25.97 in UW (n=178). After controlling for possible confounders, presence of memory problems from AEDs was associated with a -7.50 decrease in QOLIE-10-P only among employed PwE (p=0.002). The extent that PwE felt bothered by memory difficulties, however, was significantly associated with QOLIE-10-P in all employment groups; generally, as level of concern about memory difficulties increased, estimated QOLIE-10-P decreased.ConclusionsSelf-reported memory problems are prevalent among PwE in Australia and may impact QoL differentially depending on employment status. UCB Pharma-sponsored.ReferencesCramer JA, Perrine K, Devinsky O, Meador K. A brief questionnaire to screen for quality of life in epilepsy: The QOLIE-10. Epilepsia 1996;37:577–582.


Cephalalgia ◽  
2016 ◽  
Vol 38 (2) ◽  
pp. 274-282 ◽  
Author(s):  
Michele Romoli ◽  
Cinzia Costa ◽  
Sabrina Siliquini ◽  
Ilenia Corbelli ◽  
Paolo Eusebi ◽  
...  

Background The impact of adverse events (AEs) of antiepileptic drugs (AEDs) have an impact on compliance and dropouts. We compared tolerability of AEs of AEDs among patients with migraine, epilepsy, or both. Methods Overall, 335 patients (epilepsy (n = 142), migraine (n = 131), and both (n = 62)), were evaluated with the Liverpool Adverse Events Profile (LAEP) to assess the magnitude, profile and occurrence rate of the AEs of valproate, topiramate, and lamotrigine. Results AEs were significantly more common with topiramate treatment (71.0%) and among migraineurs (69.5%), the latter being more prone to discontinue AEDs (46.6%). The profile of AEs with topiramate and valproate differed among groups. Moreover, treatment with both topiramate and valproate was associated, for all groups, with a worse tolerability profile compared to lamotrigine. Conclusion Our data suggest a specific drug and disease AE profile of AEDs. Specifically, migraineurs are the most affected by AEs, even though they receive very low dosages of AEDs. This finding might be considered a clinical implication of central sensitization mechanisms. Both the profile and tolerability of AEs, highly influencing quality of life, depended on the underlying conditions, and deeply impacted on treatment dropout. Therefore, before starting, switching or stopping AED treatment, all options need to be considered.


Heart ◽  
2001 ◽  
Vol 86 (1) ◽  
pp. 69-73
Author(s):  
Z Saliba ◽  
G Butera ◽  
D Bonnet ◽  
P Bonhoeffer ◽  
E Villain ◽  
...  

OBJECTIVETo evaluate the quality of life in patients with univentricular heart and to determine the impact of sociodemographic and clinical characteristics.DESIGN AND SETTINGRetrospective, cross sectional study conducted in a regional paediatric cardiology centre.PATIENTSThe health records of 89 survivors with univentricular heart (median age 21 years; range 17–49 years) were reviewed. Sixty seven answered the Duke questionnaire. Sociodemographic and clinical variables were similar in the responders and non-responders. The impact of sociodemographic and clinical variables on individual Duke's measures was assessed.RESULTSThe Duke scores of adults with univentricular heart were similar to the normal population. Cyanosis predicted a worse score for physical (p = 0.05) and perceived health measures (p = 0.02). A higher educational level predicted a better score for physical (p = 0.004), mental (p = 0.01), and general health measures (p = 0.02). Orthopaedic problems worsened the social score (p = 0.05). Psychosocial problems worsened the pain score (p = 0.04). In comparison with the other anatomical types, mitral atresia worsened the perceived health score (p = 0.02). Patients younger than 23 years scored better for almost all health and dysfunction measures.CONCLUSIONSDespite repeated interventions and other disease related everyday stresses, a selected group of adults with univentricular heart had a satisfying quality of life.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amy M. Yeh ◽  
Ashley Y. Song ◽  
Douglas L. Vanderbilt ◽  
Cynthia Gong ◽  
Philippe S. Friedlich ◽  
...  

Abstract Background Our objectives were (1) to describe Care Transitions Measure (CTM) scores among caregivers of preterm infants after discharge from the neonatal intensive care unit (NICU) and (2) to describe the association of CTM scores with readmissions, enrollment in public assistance programs, and caregiver quality of life scores. Methods The study design was a cross-sectional study. We estimated adjusted associations between CTM scores (validated measure of transition) with outcomes using unconditional logistic and linear regression models and completed an E-value analysis on readmissions to quantify the minimum amount of unmeasured confounding. Results One hundred sixty-nine parents answered the questionnaire (85% response rate). The majority of our sample was Hispanic (72.5%), non-English speaking (67.1%) and reported an annual income of <$20,000 (58%). Nearly 28% of the infants discharged from the NICU were readmitted within a year from discharge. After adjusting for confounders, we identified that a positive 10-point change of CTM score was associated with an odds ratio (95% CI) of 0.74 (0.58, 0.98) for readmission (p = 0.01), 1.02 (1, 1.05) for enrollment in early intervention, 1.03 (1, 1.05) for enrollment in food assistance programs, and a unit change (95% CI) 0.41 (0.27, 0.56) in the Multicultural Quality of Life Index score (p < 0.0001). The associated E-value for readmissions was 1.6 (CI 1.1) suggesting moderate confounding. Conclusion The CTM may be a useful screening tool to predict certain outcomes for infants and their families after NICU discharge. However, further work must be done to identify unobserved confounding factors such as parenting confidence, problem-solving and patient activation.


2013 ◽  
Vol 70 (10) ◽  
pp. 935-939 ◽  
Author(s):  
Jelena Peric ◽  
Natasa Maksimovic ◽  
Janko Jankovic ◽  
Biljana Mijovic ◽  
Vesna Reljic ◽  
...  

Background/Aim. Acne is a common problem in adolescent children with considerable emotional and psychological effects. The aim of this study was to determine the self-reported prevalence of acne and to assess its impact on the quality of life in high school pupils in Serbia. Methods. The cross-sectional study was conducted in May 2011 in two medical high schools in Serbia. Only pupils who gave a written informed consent to participate in the study (n = 440) were asked to fill in two questionnaires: short demographic questionnaire and Cardiff Acne Disability Index (CADI), a disease-specific questionnaire measuring disability induced by acne. Internal consistency (tested by Cronbach?s alpha) and item-total score correlations (Spearman's correlation analysis) were used for reliability analyses. Results. The study population consisted of 440 pupils, 281 from Belgrade and 159 from Uzice. Among them 371 (84.3%) were girls and 69 (15.7%) boys, with similar sex distribution in Belgrade and Uzice. The total mean age of pupils was 16.48 years (SD = 0.55). Out of 440 pupils 228 (51.8%) self-reported their acne. The acne prevalence was significantly higher in pupils from Uzice (73.6%) than in those from Belgrade (39.6%). The overall mean CADI score for the whole sample was 2.87 ? 2.74, with the similar quality of life impairment in adolescents from Belgrade and from Uzice. The mean Cronbach?s alpha was 0.82. Conclusion. This study shows that the quality of life impairment due to acne is mild for the majority of the affected pupils. The Serbian version of the CADI is a reliable, valid, and valuable tool for assessing the impact of acne on the quality of life.


ASAIO Journal ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Marc D. Samsky ◽  
Carmelo A. Milano ◽  
Salpy Pamboukian ◽  
Mark S. Slaughter ◽  
Emma Birks ◽  
...  

2021 ◽  
Vol 33 (3) ◽  
pp. 249-264
Author(s):  
Gert Scheerder ◽  
Sandra Van den Eynde ◽  
Patrick Reyntiens ◽  
Ria Koeck ◽  
Jessika Deblonde ◽  
...  

This cross-sectional survey explored the quality of life in 505 people living with HIV in Belgium. Several domains of quality of life were impaired: 26% had been diagnosed with depression and 43% had weak social support. HIV-related stigma is still widespread, with 49% believing most people with HIV are rejected and 65% having experienced discrimination due to HIV. The impact of HIV was limited on professional life, but 40% experienced a negative impact on life satisfaction and 41% a negative impact on sexual life. For several domains, people with a recent diagnosis of HIV and long-term survivors had significantly worse scores. This survey also uncovered strengths of people living with HIV, such as positive coping and HIV self-image. Expanding the scope of quality of life in people living with HIV may provide a more complete picture of relevant life domains that may be impacted by living with HIV, but this needs further validation.


2017 ◽  
Vol 6 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Shanti Chhetri ◽  
Muhammad Waseem Ullah Khan ◽  
Nazia Yazdanie

Background: Hypodontia is the developmental absence of one or more teeth from the dentition whereas acquired missing teeth are those lost due to carries, periodontal problem or dental trauma. Patients with congenitally missing teeth suffer aesthetic, functional and psychological morbidity to various degree through childhood, adolescence and adulthood. Greater understanding of the impact of hypodontia on patient’s quality of life is very important. Oral health related quality of life (OHRQoL) is considered as an outcome measure to evaluate the consequences of edentulism and the available treatment options.Material and Methods: A cross-sectional comparative survey was carried out in the department of Prosthodontics, de’Montmorency College of Dentistry/Punjab Dental Hospital Lahore from 02/03/2010 to 01/09/2010. Total 80 partially dentate patients were studied which included 40 hypodontia patients and 40 patients with acquired missing teeth. All patients were given OHIP-14 questionnaire and responses were recorded on 5-point Likert scale. The mean scores of the two groups were calculated and compared using chi square test.Results: The total OHIP scores in hypodontia patients was more compared to that in patients with acquired missing teeth and difference was significant in the patient group with 4-5 missing teeth.Conclusion: As the missing teeth number increased, it was found that the OHRQoL in hypodontia patients was more impaired compared to the OHRQoL in patients with acquired missing teeth. Journal of Nobel Medical CollegeVolume 6, Number 1, Issue 10 (January-June, 2017), Page: 77-82


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