scholarly journals Clinically Meaningful Change in Quality of Life and Associated Factors Among Older Patients With Atrial Fibrillation

2020 ◽  
Vol 9 (18) ◽  
Author(s):  
Hawa O. Abu ◽  
Jane S. Saczynski ◽  
Jordy Mehawej ◽  
Mayra Tisminetzky ◽  
Catarina I. Kiefe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Older Patients ◽  
Logistic Models ◽  
Life Questionnaire ◽  
Meaningful Change ◽  
Patient Centered ◽  
Factors Associated ◽  
Fair Poor

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.

Quality of life and patient-centered outcomes following atrial fibrillation ablation: short- and long-term perspectives to improving care

2012 ◽  
Vol 10 (7) ◽  
pp. 889-900 ◽  
Author(s):  
Sanghamitra Mohanty ◽  
Luigi Di Biase ◽  
Rong Bai ◽  
Pasquale Santangeli ◽  
Agnes Pump ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Atrial Fibrillation Ablation ◽  
Patient Centered ◽  
Short And Long Term

Quality of Life Among Breast and Colon Cancer Patients Before and After First-Cycle Chemotherapy

2020 ◽  
pp. 089801012095885
Author(s):  
Osama N. Zamel ◽  
Ergie P. Inocian ◽  
Abdualrahman S. Alshehry ◽  
Regie B. Tumala ◽  
Joel G. Patalagsa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colon Cancer ◽  
Treatment Protocol ◽  
Care Plan ◽  
Life Questionnaire ◽  
Patient Centered ◽  
European Organization ◽  
Before And After ◽  
Questionnaire Version

Purpose: This study aimed to compare the functioning, symptoms, and quality of life (QoL) of patients with breast or colon cancer before and after their first-cycle (FC) chemotherapy. Design: One-group pretest/posttest design. Method: The study utilized the standardized Arabic-translated Quality of Life Questionnaire Version 3 from the European Organization for Research and Treatment of Cancer in measuring the functioning, symptoms, and QoL of 120 Saudi patients diagnosed with breast or colon cancer. Dependent t test was used in analyzing the presence of significant differences in mean scores before and after chemotherapy with periods ranging from 14 days to 21 days following the treatment protocol. Results: The findings revealed significant differences in the functioning, symptoms, and QoL among patients with breast or colon cancer before and after FC chemotherapy ( p < .001). Baseline scores showed higher physical, role, emotional, cognitive, and social functioning; lesser symptoms; lower financial difficulties; and better overall global health status compared to post-FC chemotherapy. Conclusion: Assessing the QoL of patients with breast or colon cancer undergoing FC chemotherapy is essential to establish a holistic care plan in supporting and alleviating the unfavorable effects of chemotherapy and implement patient-centered interventions that aid in the enhancement of their overall QoL.

scholarly journals Factors Associated With Large Improvements in Health-Related Quality of Life in Patients With Atrial Fibrillation

2020 ◽  
Vol 13 (5) ◽  
Author(s):  
Benjamin A. Steinberg ◽  
DaJuanicia N. Holmes ◽  
Karen Pieper ◽  
Larry A. Allen ◽  
Paul S. Chan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Health Related Quality ◽  
Factors Associated ◽  
Related Quality ◽  
Health Related

The association of resilience with health-related quality of life (HRQoL) in adolescent students

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Mina Maheri ◽  
Mansoureh Alipour ◽  
Alireza Rohban ◽  
Gholamreza Garmaroudi
Keyword(s):  
Quality Of Life ◽  
High School Students ◽  
Life Questionnaire ◽  
Health Related Quality ◽  
School Students ◽  
Factors Associated ◽  
Adolescent Students ◽  
Related Quality ◽  
Health Related

Abstract Objectives Identifying the factors associated with HRQoL in adolescents is a prerequisite of interventions aimed at improving the overall quality of life and health status among them. Studies have identified many factors associated with HRQoL in different populations; however, very little is known about the role of resilience on HRQoL in adolescent students. Subjects This cross-sectional study was conducted on 1500 high school students (750 boys and 750 girls) in Tehran. The subjects were selected through the cluster and multistage sampling methods. Methods The data collection tool included three questionnaires; a demographic information questionnaire, the Health-Related Quality of Life Questionnaire (KIDSCREEN-27), and the Children and Youth Resilience Measurement (CYRM-28). Data were analyzed with SPSS 23 software. Regression analysis was performed to determine the association of resilience with HRQoL. Results The mean score of overall health-related quality of life and overall resilience were 57.51 ± 15.03 and 98.35 ± 16.48, respectively. Individual sub-scale (β = 0.402, p < 0.001), caregiver sub-scale (β = 0.279, p < 0.001) and context sub-scale (β = 0.122, p < 0.001) of resilience were, respectively, the positive and significant predictors of HRQoL in students. The resilience sub-scales explained 49% of the total variance of HRQoL, and the individual sub-scale was the strongest predictive factor for HRQoL in students. Conclusion It is recommended to incorporate resilience training programs into the regular school education in order to improve the quality of life and health of students in all high schools and educational centers of the country.

scholarly journals Multimorbidity, physical frailty, and self-rated health in older patients with atrial fibrillation

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hawa O. Abu ◽  
Jane Saczynski ◽  
Jordy Mehawej ◽  
Tenes Paul ◽  
Hamza Awad ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Health Status ◽  
Older Patients ◽  
Logistic Models ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Self Rated Health ◽  
Patient Reported ◽  
Fair Poor

Abstract Background Holistic care models emphasize management of comorbid conditions to improve patient-reported outcomes in treatment of atrial fibrillation (AF). We investigated relations between multimorbidity, physical frailty, and self-rated health (SRH) among older adults with AF. Methods Patients (n = 1235) with AF aged 65 years and older were recruited from five medical centers in Massachusetts and Georgia between 2015 and 2018. Ten previously diagnosed cardiometabolic and 8 non-cardiometabolic conditions were assessed from medical records. Physical Frailty was assessed with the Cardiovascular Health Study frailty scale. SRH was categorized as either “excellent/very good”, “good”, and “fair/poor”. Separate multivariable ordinal logistic models were used to examine the associations between multimorbidity and SRH, physical frailty and SRH, and multimorbidity and physical frailty. Results Overall, 16% of participants rated their health as fair/poor and 14% were frail. Hypertension (90%), dyslipidemia (80%), and heart failure (37%) were the most prevalent cardiometabolic conditions. Arthritis (51%), anemia (31%), and cancer (30%), the most common non-cardiometabolic diseases. After multivariable adjustment, patients with higher multimorbidity were more likely to report poorer health status (Odds Ratio (OR): 2.15 [95% CI: 1.53–3.03], ≥ 8 vs 1–4; OR: 1.37 [95% CI: 1.02–1.83], 5–7 vs 1–4), as did those with more prevalent cardiometabolic and non-cardiometabolic conditions. Patients who were pre-frail (OR: 1.73 [95% CI: 1.30–2.30]) or frail (OR: 6.81 [95% CI: 4.34–10.68]) reported poorer health status. Higher multimorbidity was associated with worse frailty status. Conclusions Multimorbidity and physical frailty were common and related to SRH. Our findings suggest that holistic management approaches may influence SRH among older patients with AF.

scholarly journals A Review on Deprescribing in Elderly

2021 ◽  
Vol 11 (4) ◽  
pp. 136-137
Author(s):  
Christy Babu ◽  
Lincy George ◽  
K. Krishnakumar
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
High Risk ◽  
Older Patients ◽  
Adverse Drug Events ◽  
Patient Centered ◽  
Inappropriate Medications ◽  
Related Harm ◽  
Improve Health

Deprescribing can be defined as the process of stopping a medication or reducing its dose to reduce adverse effects and improve health outcomes. Elderly people with co morbidities usually have a risk of adverse drug events and these events can only be treated by medicines. Despite the benefits offered by these medicines, older patients are at a high risk of harm caused by these medications. The use of multiple medications for treating the comorbidities may also leads to severe health problems. Deprescribing help to reduce the risk related to inappropriate medicines. Deprescribing is usually a patient centered process which helps to withdraw drugs which are harmful to be prescribed to older patients. Several explicit and implicit tools have been developed internationally to identify these inappropriate medications. Deprescribing of inappropriate medicines would help to reduces drug-related harm and improves the quality of life of older adults. Keywords: Deprescribing, polypharmacy, older adults

P1035Factors associated with quality-of-life improvement after catheter ablation of atrial fibrillation: insights from the Kansai Plus Atrial Fibrillation (KPAF) registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Kanda ◽  
M Masuda ◽  
S Shizuta ◽  
A Kobori ◽  
K Inoue ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Heart Rate ◽  
Multivariate Analysis ◽  
Catheter Ablation ◽  
Left Atrial ◽  
Left Atrial Diameter ◽  
Factors Associated ◽  
Af Recurrence

Abstract Background Improving the quality of life (QoL) is one of the main purposes of catheter ablation (CA) of persistent atrial fibrillation (AF). Factors associated with QoL improvement after CA of AF patients have not been clarified. The Kansai Plus Atrial Fibrillation (KPAF) Registry is a multi-center registry enrolling more than 5,000 consecutive patients undergoing the first radiofrequency catheter ablation of AF. Purpose The aim of this study was to investigate the QoL change after AF ablation and its associated factors. Methods A total of 2030 patients in whom the QoL score was assessed before and one year after the ablation were enrolled from the KPAF registry (age 64±10 years, 75% male, paroxysmal 66%, CHADS2 score 1.1±1.1). The QoL was evaluated using the AF specific QoL evaluation method (AFQLQ), which scores the patient QoL within a range of 0–98 points. Results Overall, catheter ablation showed a significant increase in the AFQLQ score (68±19 vs. 86±13 points, P<0.01). AF recurrence was observed in 372 cases (18%) during a 1-year follow-up period. A multivariate analysis showed that AF recurrence, symptomatic AF, long AF duration, high preprocedural heart rate (>110 bpm) and small left atrial diameter were independent predictors of a QoL improvement defined as a >10% score increase. Multivariate analysis Conclusions CA of AF significantly improved the QoL. AF recurrence was one of the strong factors associated with QoL improvement. Symptomatic AF, long AF duration, high preprocedural heart rate and small left atrial diameter were independent predictors of QoL improvement.

Development and validation of a patient-centered, meningioma-specific quality-of-life questionnaire

2021 ◽  
pp. 1-10
Author(s):  
Ami Baba ◽  
Ashirbani Saha ◽  
Melissa D. McCradden ◽  
Kanwar Boparai ◽  
Shudong Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Concurrent Validity ◽  
Life Questionnaire ◽  
Patient Centered ◽  
Item Generation ◽  
Item Reduction ◽  
Quality Of Life Questionnaire ◽  
Extreme Groups ◽  
Disease Specific

OBJECTIVE Meningiomas can have significant impact on health-related quality of life (HRQOL). Patient-centered, disease-specific instruments for assessing HRQOL in these patients are lacking. To this end, the authors sought to develop and validate a meningioma-specific HRQOL questionnaire through a standardized, patient-centered questionnaire development methodology. METHODS The development of the questionnaire involved three main phases: item generation, item reduction, and validation. Item generation consisted of semistructured interviews with patients (n = 30), informal caregivers (n = 12), and healthcare providers (n = 8) to create a preliminary list of items. Item reduction with 60 patients was guided by the clinical impact method, multiple correspondence analysis, and hierarchical cluster analysis. The validation phase involved 162 patients and collected evidence on extreme-groups validity; concurrent validity with the SF-36, FACT-Br, and EQ-5D; and test-retest reliability. The questionnaire takes on average 11 minutes to complete. RESULTS The meningioma-specific quality-of-life questionnaire (MQOL) consists of 70 items representing 9 domains. Cronbach’s alpha for each domain ranged from 0.61 to 0.91. Concurrent validity testing demonstrated construct validity, while extreme-groups testing (p = 1.45E-11) confirmed the MQOL’s ability to distinguish between different groups of patients. CONCLUSIONS The MQOL is a validated, reliable, and feasible questionnaire designed specifically for evaluating QOL in meningioma patients. This disease-specific questionnaire will be fundamentally helpful in better understanding and capturing HRQOL in the meningioma patient population and can be used in both clinical and research settings.

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

AIDS Care ◽  
2016 ◽  
Vol 28 (sup1) ◽  
pp. 92-98 ◽  
Author(s):  
Fabiana Monteiro ◽  
Maria Cristina Canavarro ◽  
Marco Pereira
Keyword(s):  
Quality Of Life ◽  
Older Patients ◽  
Middle Aged ◽  
Factors Associated ◽  
Living With Hiv

scholarly journals Evaluation of meaningful change in bowel movement frequency for patients with carcinoid syndrome

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Stacie Hudgens ◽  
John Ramage ◽  
Matthew Kulke ◽  
Emily Bergsland ◽  
Lowell Anthony ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Effect Size ◽  
Carcinoid Syndrome ◽  
Bowel Movement ◽  
Life Questionnaire ◽  
Meaningful Change ◽  
Movement Frequency ◽  
Bowel Movements ◽  
Bowel Movement Frequency

Abstract Background Carcinoid syndrome is associated with a reduced quality of life that can be attributed to symptoms such as diarrhea and fatigue as well as social and financial issues. This study was conducted to psychometrically assess meaningful change in bowel movement frequency among carcinoid syndrome patients using data from the TELESTAR clinical study. Methods An anchor-based approach for deriving meaningful change thresholds consisted of mapping change from baseline bowel movement frequency to other patient-reported assessments of change. These included the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core Questionnaire (QLQ-C30) Diarrhea Symptom responders, the EORTC Gastrointestinal NET questionnaire (GI.NET21) GI Symptom responders, and reported adequate relief at Week 12 (≥ 10-point score decrease from Day 1 to Week 12). Parameters included within-group mean change from baseline to Week 12, t-tests of the change (Wilcoxon rank sum for adequate relief), and effect size. Results There were 135 carcinoid syndrome patients with a mean baseline frequency of 5.7 bowel movements a day. A distribution-based method yielded meaningful change estimates of 0.62 bowel movements a day for overall frequency and 0.83 bowel movements a day at Week 12. Anchor-based analysis indicated a large effect size among patients who reported adequate relief at Week 12 (− 1.58; n = 18; P = 0.014), the QLQ-C30 Diarrhea domain responders (− 1.24; n = 40; P < 0.001), and the GI.NET21 GI Symptoms Domain responders (− 1.49; n = 25; P = 0.005). Exit interview data for meaningful change yielded effect size estimates of − 1.57 for overall change during the Double-blind Treatment Period and − 1.97 for change between Baseline and Week 12. Conclusions Meaningful change derivation is critical to interpret patient outcomes for evaluating treatment efficacy. In this study, carcinoid syndrome patients experienced clinically meaningful reductions in bowel movement frequency of ≥30% over 12 weeks with telotristat ethyl treatment. Trial registration NCT01677910.

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