scholarly journals Comorbidities and their link with individual health status: A cross-sectional analysis of 23,892 people with knee and hip osteoarthritis from primary care

2020 ◽  
Vol 10 ◽  
pp. 2235042X2092045 ◽  
Author(s):  
Paul Edward Muckelt ◽  
EM Roos ◽  
M Stokes ◽  
S McDonough ◽  
DT Grønne ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Health Status ◽  
Pain Intensity ◽  
Walking Speed ◽  
Individual Health ◽  
Pain Site ◽  
Individual Health Status ◽  
The Impact

Objectives: Robust data on the impact of comorbidities on health in people with osteoarthritis (OA) are lacking, despite its potential importance for patient management. Objectives were to determine coexisting conditions in people with OA in primary care and whether more comorbidities were linked with individual health status. Methods: A retrospective analysis of 23,892 patients with knee and hip OA was conducted to determine comorbidities present (number/clusters) and how these linked with pain intensity (0–100), widespread pain (site numbers), medication usage (paracetamol, nonsteroidal anti-inflammatory drugs, opioids), quality of life EuroQol five dimension scale (EQ-5D), and physical function (walking speed) using independent t-tests or χ 2 test. Results: Sixty-two percent of people with OA treated in primary care had at least one comorbidity; hypertension (37%), heart disease (8%), and diabetes (7%) being most common. Outcome measures worsened with more comorbidities (0–4+ comorbidities); pain intensity [mean (SD)] 46(22)–57(21); number of painful sites 3.7(3.0)–6.3(5.4); quality of life 0.73(0.10)–0.63(0.15); walking speed 1.57 m/s (0.33)–1.24 m/s (0.31), while the proportion of people using pain medication increased from 0 to 2 comorbidities (58–69%; p < 0.001), with an increase in opioid use from 4.6% to 19.5% with more comorbidities (0–4+ comorbidities). Conclusion: Most people with knee or hip OA in primary care have at least one other long-term condition. A greater number of comorbidities is linked with worsening health, highlighting the importance of screening for comorbidities when treating patients with OA. It is important for clinicians to consider how OA treatments will interact and affect other common comorbidities.

scholarly journals Implementing spirometry and fractional exhaled nitric oxide testing in childhood asthma management in UK primary care: an observational study to examine training and implementation cost and impact on patient’s health use and outcome

2021 ◽  
pp. archdischild-2020-319310
Author(s):  
Yaling Yang ◽  
David KH Lo ◽  
Caroline Beardsmore ◽  
Damian Roland ◽  
Matthew Richardson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nitric Oxide ◽  
Primary Care ◽  
Health Status ◽  
Observational Study ◽  
Healthcare Utilisation ◽  
Exhaled Nitric Oxide ◽  
Related Quality ◽  
The Impact

ObjectivesImplementation of guidelines into clinical practice is challenging and complex. This study aims to (1) identify the training needs and capacity requirements, and (2) explore the impact on healthcare utilisation and asthma-related quality of life of implementing both spirometry and fraction of exhaled nitric oxide in diagnosis of asthma among children in the UK primary care.MethodsTen UK general practitioner practices and a total of 612 children (5–16 years) with diagnosed or suspected asthma were invited to participate in this prospective observational study. The total times that the trainer and trainee clinical staff spent on developing the training package, providing and receiving, and performing and interpreting the two tests as part of routine child asthma review were collected, and costs were calculated. We compared healthcare utilisation and asthma-related and general health-related quality of life data between the 6 months before and after the asthma review guided by objective tests.ResultsThe average training cost for the 27 primary care clinical members was £1395. The average cost to implement and deliver the test-guided asthma review among the 612 included children was £22. In the 6 months following the tests-guided asthma review, both unplanned primary care attendance, and hospital admissions were reduced, and the asthma-related health status increased significantly.ConclusionThis study provides robust cost estimates of the resources needed to implement the National Institute for Health and Care Excellence asthma guideline. It also demonstrates the potential to save healthcare costs and improve health status among asthmatic children by implementing this guideline.

scholarly journals Characteristics and health status of patients with and without confirmed HFpEF

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Deaton ◽  
F Forsyth ◽  
J Mant ◽  
D Edwards ◽  
R Hobbs ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Cohort Study ◽  
Health Status ◽  
Functional Impairment ◽  
Funding Source ◽  
Walk Distance ◽  
Minute Walk Distance ◽  
Minute Walk

Abstract Aims Patients with heart failure with preserved ejection fraction (HFpEF) are usually older and multi-morbid and diagnosis can be challenging. The aims of this cohort study were to confirm diagnosis of HFpEF in patients with possible HFpEF recruited from primary care, to compare characteristics and health status between those with and without HFpEF, and to determine factors associated with health status in patients with HFpEF. Methods Patients with presumed HFpEF were recruited from primary care practices and underwent clinical assessment and diagnostic evaluation as part of a longitudinal cohort study. Health status was measured by Montreal Cognitive Assessment (MOCA), 6-minute walk test, symptoms, and the Kansas City Cardiomyopathy Questionnaire (KCCQ), and quality of life (QoL) by EQ-5D-5L visual analogue scale (VAS). Results 151 patients (mean age 78.5±8.6 years, 40% women, mean EF 56% + 9.4) were recruited and 93 (61.6%) were confirmed HFpEF (those without HFpEF had other HF and cardiac diagnoses). Patients with and without HFpEF did not differ by age, MOCA, blood pressure, heart rate, NYHA class, proportion with atrial fibrillation, Charlson Comorbidity Index, or NT-ProBNP levels. Patients with HFpEF were more likely to be women, overweight or obese, frail, and to be more functionally impaired by 6 minute walk distance and gait speed than those without. Although not statistically significant, patients with HFpEF had clinically significant differences (&gt;5 points) on the physical limitations, symptom burden and clinical summary subscales of the KCCQ, but did not differ by other subscales or by EQ-5D-5L VAS (70±17 vs 73±19, p=0.385). More patients with HFpEF reported daytime dyspnoea (63% vs 46%, p=0.035) and fatigue (81% vs 61%, p=0.008), but not other symptoms compared to those without HFpEF. For both groups BMI was moderately negatively correlated with KCCQ subscale scores, and 6 minute walk distance was positively correlated with KCCQ subscales. Conclusions Nearly 40% were not confirmed as HFpEF indicating the challenges of diagnosis. Patients with confirmed HFpEF differed by sex, overweight/obesity, frailty, functional impairment, and symptoms but not by age or comorbidities from those without HFpEF. These differences were reflected in some subscale scores of the KCCQ, but not how patients reported their quality of life on the KCCQ QoL subscale and EQ-5D-5L VAS. Older patients with HFpEF reported relatively high QoL despite poor health status by functional impairment, frailty and symptoms. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institute of Health Research School of Primary Care Research

scholarly journals Meeting Psychosocial Needs to Improve Health: A Prospective Cohort Study

2019 ◽  
Author(s):  
Austyn Snowden ◽  
Jenny Young ◽  
Jan Savinc
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Health Status ◽  
Cancer Type ◽  
Cancer Stage ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Abstract Background Cancer impacts on patients and their families across a range of different domains. For that reason, optimal cancer care has moved away from a disease-centric focus to a more holistic approach in order to proactively support people with their individual needs and concerns. While international policy clearly advocates this agenda, implementation into routine care is limited. Therefore, relevant interventions that measurably improve patient outcomes are essential to understand if this ideal is to become routine multidisciplinary practice. The aim of this study was to analyse the impact of a proactive, holistic, community-based intervention on health-related quality of life in a cohort of people diagnosed with cancer. Secondary aim was to explore the relationship between changes in health status and: cancer type, cancer stage, number of concerns expressed and change in severity of concerns pre and post intervention. Method Prospective observational cohort study. A convenience sample of 437 individuals were referred to the service ‘Improving the Cancer Journey (ICJ) in the UK. Each completed the Euroqol EQ-5D-3L and visual analogue scale (VAS) and a Holistic Needs Assessment (HNA) during initial visit to the service and again at follow-up review, approximately 4 months later. Change between scores was tested with paired t-tests and relationships between variables with multiple regression models. Results Participants were White British with median age between 50-64 years. Cancer type and stage were varied. There was a statistically significant improvement in EQ-5D scores over time (t(330)=7.48, p<.001). The strongest predictor of change was a decrease in severity of concerns. Cancer stage ‘palliative care’ contributed to a reduction in health status. Conclusion This study is the first to show that a holistic community intervention dedicated to supporting the individual concerns of participants has a statistically and meaningful impact on participants’ health-related quality of life. The mean change in EQ-5D scores was more than the ‘minimally important clinical difference’ described in the literature. This is important because while quality of life has multiple determinants this study has reported that it is possible to capture a meaningful improvement as a function of reducing someone’s personally identified concerns.

scholarly journals Pengaruh Faktor Demografi dan Sosial Ekonomi terhadap Status Kesehatan Individu di Indonesia

2021 ◽  
Vol 5 (2) ◽  
pp. 146-157
Author(s):  
Liani Surya Rakasiwi
Keyword(s):  
Socioeconomic Status ◽  
Health Status ◽  
Low Income ◽  
The Other ◽  
Individual Health ◽  
Indonesia Family Life Survey ◽  
Individual Health Status ◽  
The Individual ◽  
Logit Regression Model ◽  
The Impact

This study analyzed the impact of demography and socioeconomic status on individual health status in Indonesia. The data used Indonesia Family Life Survey 5 (IFLS 5). The study use logit regression model for analysis with health status variable as dependent variable. The other variable such as demography and socioeconomic status as independent variables. Socioeconomic status seen from two measures, namely education and income. The result of this study concludes the demography influence significantly on individual health status in Indonesia. Individual who lives in urban area has higher probability of being health by 1,02 percent compared to individual who lives in rural area. The other variable like socioeconomic status also influences significantly on the individual health status in Indonesia. Individual with longer years of education has higher probability of being health by 3,07 percent compared to individual with less years of education. Individual with high income has higher probability of being health compared to individual with low income.

Impact of musculoskeletal disorders on quality of life of patients visiting tertiary care hospital.

2021 ◽  
pp. 1-11
Author(s):  
Shah Khalid ◽  
Sayed Zulfiqar Ali Shah ◽  
Abid Ali Khalil ◽  
Ihsan Ullah
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Musculoskeletal Disorders ◽  
Teaching Hospital ◽  
Adhesive Capsulitis ◽  
Care Hospital ◽  
Cross Sectional ◽  
Quality Of Life Scale ◽  
The Impact

Abstract Objective: To determine the impact of musculoskeletal disorders on quality of life of patients visiting Khyber Teaching Hospital, Peshawar. Method and Material: A cross sectional survey conducted in Khyber Teaching Hospital, Peshawar from September 2018 to March 2019 using a validated EQ-5D quality of life scale. The survey questionnaire was attended by 377 respondents having variety of musculoskeletal disorders (MSDs). EQ-5D can be effectively used for assessing the quality of life and health status using the VAS pain scale. Results: There were total 377 respondents. Mean age of the participants was 35.9 ± 12.5 years. Out of 377 participants, 204 (54.1%) were male, while 173 (45.9%) were female. Muscular weakness was the most commonly encountered problem (40.6%), followed by muscle stiffness (13.0%) and adhesive capsulitis (10.3%). The remaining respondents were having different kinds of MSDs. Patients with MSDs were having significantly moderately low score on EQ-5D. Conclusion: The finding of this study suggests that MSDs have negative impact on quality of life and health status of the sufferers. Individuals having any sort of MSDs should seek proper care in order to improve their quality of life, health status and work performance. Key words: Musculoskeletal Diseases, Health, Quality of Life, visual analog scales, Cross Sectional Studies. Continuou....

scholarly journals Health-Related Quality of Life in Patients With Progressive Midgut Neuroendocrine Tumors Treated With 177Lu-Dotatate in the Phase III NETTER-1 Trial

2018 ◽  
Vol 36 (25) ◽  
pp. 2578-2584 ◽  
Author(s):  
Jonathan Strosberg ◽  
Edward Wolin ◽  
Beth Chasen ◽  
Matthew Kulke ◽  
David Bushnell ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Global Health ◽  
Phase Iii ◽  
High Dose ◽  
Health Related Qol ◽  
Health Related ◽  
Phase Iii Study ◽  
The Impact

Purpose Neuroendocrine tumor (NET) progression is associated with deterioration in quality of life (QoL). We assessed the impact of 177Lu-Dotatate treatment on time to deterioration in health-related QoL. Methods The NETTER-1 trial is an international phase III study in patients with midgut NETs. Patients were randomly assigned to treatment with 177Lu-Dotatate versus high-dose octreotide. European Organisation for Research and Treatment of Cancer quality-of-life questionnaires QLQ C-30 and G.I.NET-21 were assessed during the trial to determine the impact of treatment on health-related QoL. Patients completed the questionnaires at baseline and every 12 weeks until tumor progression. QoL scores were converted to a 100-point scale according to European Organisation for Research and Treatment of Cancer instructions, and individual changes from baseline scores were assessed. Time to QoL deterioration (TTD) was defined as the time from random assignment to the first QoL deterioration ≥ 10 points for each patient in the corresponding domain scale. All analyses were conducted on the intention-to-treat population. Patients with no deterioration were censored at the last QoL assessment date. Results TTD was significantly longer in the 177Lu-Dotatate arm (n = 117) versus the control arm (n = 114) for the following domains: global health status (hazard ratio [HR], 0.406), physical functioning (HR, 0.518), role functioning (HR, 0.580), fatigue (HR, 0.621), pain (HR, 0.566), diarrhea (HR, 0.473), disease-related worries (HR, 0.572), and body image (HR, 0.425). Differences in median TTD were clinically significant in several domains: 28.8 months versus 6.1 months for global health status, and 25.2 months versus 11.5 months for physical functioning. Conclusion This analysis from the NETTER-1 phase III study demonstrates that, in addition to improving progression-free survival, 177Lu-Dotatate provides a significant QoL benefit for patients with progressive midgut NETs compared with high-dose octreotide.

scholarly journals The Impact of a Primary Care, Pharmacist-Driven Intervention in Patients with Chronic Non-Cancer Pain—A Pilot Study

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 113
Author(s):  
Mo Chen ◽  
Tejal Patel ◽  
Feng Chang
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Pain ◽  
Cancer Pain ◽  
Family Health ◽  
Primary Care Settings ◽  
Pain Intervention ◽  
Family Health Team ◽  
The Impact

Background: Chronic pain is a prevalent condition, experienced by 15.3% to 55% of Canadians, that is difficult to manage. With their broad accessibility and expertise on drugs, primary care pharmacists can help patients optimize their pain management. Methods: The objective of this study is to examine the effectiveness of a primary care, pharmacist-driven chronic pain intervention on pain and quality of life in patients with chronic non-cancer pain. A three-month naturalistic prospective study was conducted in primary care settings (five community pharmacies and one Family Health Team) across Ontario, Canada with a total of six pharmacists and 19 study participants. The primary care, pharmacist-driven chronic pain intervention consisted of patient assessments, medication reviews, care plan recommendations, and patient education. In order to evaluate the effectiveness of the intervention, pain intensity, pain interference, and quality of life were evaluated at baseline and at follow up (week 2 and month 3). Results: Trends towards improvement in pain and quality of life were found, however, these improvements were not statistically significant at follow up (month 3). Conclusions: This study provides the foundational research required to better understand the impact of Ontario pharmacists’ extended role in pain management in non-cancer patients within multiple primary care settings (e.g., Family Health Team, etc.) and has illustrated the importance of modifying and customizing care plans in patients with chronic pain. A larger sample size with tailored outcome measures may be necessary to better highlight significant improvements in pain and quality of life in patients with chronic non-cancer pain using a primary care, pharmacist-driven intervention.

Predictors of Quality of Life in Young Adults Diagnosed With Cancer

2020 ◽  
Vol 29 (8) ◽  
pp. 587-597
Author(s):  
Charmaine A. McKie ◽  
Adeyinka O. Laiyemo
Keyword(s):  
Quality Of Life ◽  
Young Adults ◽  
Health Status ◽  
Cancer Survivors ◽  
Functional Status ◽  
Cancer Type ◽  
Health Related ◽  
Perception Of Health ◽  
The Impact

A cross-section correlational study was conducted to evaluate the overall quality of life in young adults (AYAs) diagnosed with cancer, and the impact of health-related and non-health-related factors on their quality of life. Fifty-six AYA cancer survivors were recruited to elicit the impact of biological function (cancer type and comorbidity), symptoms, functional status, general perception of health status, gender, and characteristics of the environment on quality of life. Participants experienced higher than average quality of life. Symptoms, functional status, and general perception of health status were significant predictors of quality of life in this group of AYAs diagnosed with cancer. In delivering quality cancer care, nurses must be able to thoroughly assess symptom status, AYA cancer survivors’ perception of their health status, and functioning in order to implement supportive measures to help improve their quality of life.

Physical activity diminishes aging-related decline of physical and cognitive performance

2014 ◽  
Vol 155 (21) ◽  
pp. 817-821 ◽  
Author(s):  
Péter Apor ◽  
László Babai
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Life Expectancy ◽  
Aging Process ◽  
Muscle Force ◽  
Walking Speed ◽  
Prognostic Impact ◽  
Elderly Persons ◽  
The Impact

Aging-related decline of muscle force, walking speed, locomotor coordination, aerobic capacity and endurance exert prognostic impact on life expectancy. Proper use of training may diminish the aging process and it may improve the quality of life of elderly persons. This paper provides a brief summary on the impact of training on aging-related decline of physical and cognitive functions. Orv. Hetil., 2014, 155(21), 817–821.

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