scholarly journals Impact of socio-demographic and clinical characteristics on functional disability and health-related quality of life in patients with rheumatoid arthritis: a cross-sectional study from Palestine

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Samah W. Al-Jabi ◽  
Diaa I. Seleit ◽  
Adnan Badran ◽  
Amer Koni ◽  
Sa’ed H. Zyoud

Abstract Background Rheumatoid arthritis (RA) is a chronic autoimmune disorder, which has a significant impact on patients' health-related quality of life (HRQoL), and limits physical function as well as increases pain and fatigue. Therefore, this study aimed to evaluate the HRQoL and functional disability profile of patients with RA in Palestine to determine the socio-demographic and clinical features associated with low HRQoL and functional disability in patients with RA and to investigate the impact of drugs used on functional disability and HRQoL. Methodology A cross-sectional, observational study conducted at rheumatology clinics in Northern West-Bank, Palestine (Alwatani Hospital—Nablus, Khalil Suleiman Hospital—Jenin, Thabet Thatbet Hospital-Tulkarem, and Darweesh Nazzal Hospital—Qalqilia). EuroQoL-5 Dimension scale (EQ-5D-5L) was used to evaluate HRQoL, Health Assessment Questionnaire, Disability Index (HAQ-DI) to evaluate the functional disability, and the Health Assessment Questionnaire pain visual analog scale (HAQ-VAS) to evaluate pain. Results 300 patients were included in the study, 229(76.3%) were females, the mean ± standard deviation age was 49 ± 13.10 years, and the median RA duration (lower–upper quartiles) was 6 (4–12) years. The median EQ-5D-5L index value and Euro QOL visual analogue scale (EQ-VAS) scores were 0.56 and 60, respectively. There was a significant strong positive correlation (R = 0.773; p < 0.001) between the EQ-5D-5L index values and the reported EQ-VAS scores. The median HAQ-DI and HAQ-VAS were 0.94 and 40, respectively. The results of multiple linear regression showed that treatment with biological DMARD (Etanercept), having work, higher income, absence of night pain, and absence of comorbid diseases were significantly associated with higher EQ-5D-5L index score (better HRQoL) and lower HAQ-DI scores (less disability). On the other hand, older age and the presence of morning stiffness were significantly associated with higher HAQ-DI scores (more disability). Conclusions This study revealed the impact of treatment, clinical variables, and socio-demographic factors on disability and HRQoL in RA patients. Healthcare providers should be aware of the association between treatment with biological DMARD and improved HRQoL and functional status to make early interventions that reduce disability and improve HRQoL in susceptible patients.

2021 ◽  
Vol 48 (1) ◽  
Author(s):  
Enas A. Abdelaleem ◽  
Dina A. Ezzat ◽  
Gehad R. Mostafa

Abstract Background Juvenile idiopathic arthritis (JIA) is a common childhood disease which causes significant impairment in quality of life. The aim of the study is to assess the health-related quality of life and its relation to functional disability in JIA patients. Child health assessment questionnaire (CHAQ) and pediatrics quality of life 4 generic core questionnaire (PedsQL) were used to evaluate functional disability and health-related quality of life. Results CHAQ (VAS) of JIA patients ranged from 0 to 9 with a mean of 3.64 ± 2.9 (SD), and of controls ranged from 0 to 4 with a mean of 1.32 ± 1.3 (SD) with a statistically significant difference and a p value of 0.001. CHAQ-disability index (DI) of the cases ranged from 0 to 3 with a mean of 1.06 ± 0.9 (SD) and of controls was consistent = 0. Pediatric quality of life (PedsQL) among cases ranged from 26.08 to 91.3 with a mean of 67.95 ± 19.2 (SD) and among controls ranged from 78.27 to 100 with a mean of 90.73 ± 7.7 (SD) showing statistically significant difference with a p value < 0.001. Childhood health assessment questionnaire (CHAQ) scores were significantly higher among studied females with JIA as compared with males. The mean CHAQ-DI scores were 4.56 ± 2.7 vs. 1.29 ± 2.6 in females and males respectively with a significant p value of 0.002. The mean CHAQ-(VAS) scores were 1.38 ± 0.8 vs. 0.23 ± 0.3 in females and males respectively with a significant p value of 0.016. Pediatric quality of life (PedsQL) scores were significantly higher among studied males with JIA as compared with studied females. The childhood health assessment questionnaire (CHAQ) was negatively correlated with all (physical, emotional, social, and school) items of the pediatric quality of life (PedsQL) (p < 0.001). Conclusion We found a significant impairment in the functional ability and health-related quality of life in patients with JIA compared to healthy children, with more impairment in females than males. CHAQ was negatively correlated with all items of PedsQL.


Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3826
Author(s):  
Oumar Billa ◽  
Franck Bonnetain ◽  
Jérôme Chamois ◽  
Angeline Ligey ◽  
Valérie Ganansia ◽  
...  

The impact of routine assessment of health-related quality of life (HRQoL) on satisfaction with care and the HRQoL of patients with head and neck cancer (HNC) treated with radiotherapy was assessed. Patients with HNC were randomly assigned to two arms, with stratification on sex, cancer localization, and stage of the disease. In the intervention arm, the patients completed the EORTC QLQ-C30 and EORTC QLQ-H&N35 questionnaires first before randomization, then before each medical appointment during radiotherapy (7 weeks), and then every 3 months until 1 year and at 2 years thereafter. In the control arm, the EORTC QLQ-C30 and EORTC QLQ-H&N35 questionnaires were completed before randomization and at 1 year and 2 years thereafter. The primary endpoint was mean change in HRQoL at score at 2 years from baseline assessed by EQ VAS from the EuroQol questionnaire. The secondary endpoint was mean change in satisfaction with care at 2 years from baseline assessed by QLQ-SAT32. Two hundred patients with head and neck cancers were involved in this study (mean age, 58.83 years (range, 36.56–87.89)), of whom 100 were assigned to the intervention arm and 100 to the control arm. Patients in the intervention arm were reported to have a statistically significant increase in EQ VAS at 2 years (p < 0.0001) and exceeded the minimal clinically important difference (mean change at 2 years from baseline = 10.46). In the two arms, mean differences between arms were not statistically significant, but minimal clinically important differences in favor of the intervention arm were found for EQ VAS (mean change difference (MD) = 5.84), satisfaction with care, in particular waiting times (MD = 10.85) and satisfaction with accessibility (MD = 6.52). Routine assessment of HRQoL improves HRQoL and satisfaction with care for patients with HNC treated with radiotherapy.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Lourdes Carhuapoma ◽  
Radhika Avadhani ◽  
Noeleen Ostapkovich ◽  
Karen Lane ◽  
Nichol McBee ◽  
...  

Introduction: Recovery in intracerebral hemorrhage (ICH) is prolonged and unpredictable, resulting in challenges in estimating health-related quality of life (HRQoL). We describe HRQoL and patient disposition for ICH survivors with similar clinical characteristics to ICH patients who had withdrawal of life-sustaining treatment (WoLST). Methods: Using MISTIE III trial data (N = 499), we performed a matched cohort analysis using a published modified severity index (mSI) to compare ICH survivors (N = 379) with WoLST patients (N = 61). We used multivariable logistic regression adjusting for age, Glasgow Coma Score, deep ICH location, stability ICH and intraventricular hemorrhage volume and ≥ 3 comorbidities to create the mSI. After matching survivors with equal mSI to WoLST patients, we compared EuroQoL (EQ) visual analog scale (VAS) scores (US norm 69-76; range 0-100) by mSI quartile and patient disposition. Results: We matched 224 survivors to WoLST patients by mSI (range 0-6.5), with data at all timepoints. Given the large mSI range, EQ VAS scores and patient disposition were evaluated by mSI quartile groups. The median (interquartile range [IQR]) EQ VAS score increase for all mSI groups from day 30 (D30) to 180 (D180) was 20 (0-35.5, p < 0.0001), and 23.5 (5-40, p < 0.0001) for D30 to 365 (D365). The highest percentage of survivors for all mSI groups were home by D365 (G1 55%, G2 88%, G3 84.5%, G4 90%). Median (IQR) EQ VAS scores by mSI quartile, patient disposition and timepoint are reported below. Conclusion: ICH survivors, matching WoLST individuals, in all mSI groups demonstrated improvement in HRQoL over time, and the majority were home by D365. This study challenges current practice of identifying poor outcomes in concert with decision making employing WoLST in ICH. If goals of care are to include return to home and HRQoL, these results strongly suggest that prognostication can be improved. Prospective studies of ICH prognostication and decision making are needed.


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


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shinichi Noto ◽  
Masashi Miyazaki ◽  
Hidemi Takeuchi ◽  
Shinya Saito

Abstract Background Hemodialysis is a medical technology implemented for various renal diseases and has a significant budget impact in Japan. Hemodialysis also affects health-related quality of life, as it interferes with daily life, but the effect of diagnosis and duration of hemodialysis is not clear. The purpose of this study was to examine the impact of hemodialysis on health-related quality of life, with a focus on diagnosis and duration of hemodialysis. Methods We conducted EQ-5D-5L surveys among hemodialysis patients at a single hemodialysis hospital between November 2015 and September 2017 and used a scoring algorithm that was developed in Japan to calculate the scores. Results A total of 274 subjects without missing data were included in the data analysis. The mean score of the entire group was 0.772 ± 0.215. Compared with other domains, pain/discomfort had the highest percentage of problems (59.1%). There were no differences in the distributions with respect to diagnostic names in any domain. Multiple regression analysis showed that hemodialysis duration was the only explanatory variable that had a mild significant effect on EQ-5D-5L scores, but it was not large. Conclusions QOL measured using the EQ-5D-5L survey score was not affected by age, gender, or diagnosis but was affected by hemodialysis duration. Future studies are needed to investigate the impact of prolonged hemodialysis on health-related quality of life.


2018 ◽  
Vol 7 (1) ◽  
pp. 45-49
Author(s):  
Manish Pradhan ◽  
Chandra Bhal Jha ◽  
Dipa Rai

Background: Acne is a very common distressing skin condition that affects multiple aspects of quality of life of an individual. It has been illustrated that acne have tremendous effect on an individual’s self-image and impacts his or her quality of life. The extent of burden of the disease experienced by the patients seems to be underestimated by the whole medical fraternity. The aim of the study is to determine the health related quality of life impairment in acne patients using CADI and to identify various variables that increase the patients’ susceptibility for quality of life impairment. Subjects and Methods: This is a hospital based, cross sectional study conducted in the Department of Dermatology, Nobel Medical College Teaching Hospital from Jan 2017 to December 2017.A total of 202 acne patients were evaluated with CADI. Clinical characteristics were recorded after history and clinical examination. Results: Out of total 202 patients enrolled, 56.4% of patient scored a CADI score of (5-9) indicating moderate quality of life impairment and 15.3% of patient scored a CADI score of 10 or more indicating severe quality of life impairment. The mean CADI score was 6.82 ± 2.75. There was positive correlation between the CADI score and impact on quality of life with grade of acne, which was statistically significant (p<0.001). Conclusion: Acne is a common skin disease with tremendous adverse effect on the patient’s health related quality of life. Patients are affected both physically and mentally with this condition. Journal of Nobel Medical College Volume 7, Number 1, Issue 12, January-June 2018, Page: 45-49 


2019 ◽  
Vol 47 (1) ◽  
pp. 132-139 ◽  
Author(s):  
Claudia Alvarado-de la Barrera ◽  
Carlos Omar López-López ◽  
Everardo Álvarez-Hernández ◽  
Ingris Peláez-Ballestas ◽  
Citlallyc Gómez-Ruiz ◽  
...  

Objective.Determine the proportion of patients achieving target serum urate (SU), defined as < 6 mg/dl for patients with non-severe gout and < 5 mg/dl for patients with severe gout, as well as the proportion of patients achieving remission after 5 years of followup.Methods.Patients from the Gout Study Group (GRESGO) cohort were evaluated at 6-month intervals. Demographic and clinical data were obtained at baseline. Visits included assessments of serum urate, flares, tophus burden, health-related quality of life using the EQ-5D, activity limitations using the Health Assessment Questionnaire adapted for gout, and pain level and patient’s global assessment using visual analog scales. Treatment for gout and associated diseases was prescribed according to guidelines and available drugs.Results.Of 500 patients studied, 221 had severe gout (44%) and 279 had non-severe gout (56%) at baseline. No significant differences were observed across the study in percentages of severe gout versus non-severe gout patients achieving SU 6 mg/dl or 5 mg/dl. The highest proportion of patients achieving target SU (50–70%) and remission (39%) were found after 3–4 years of followup. In the fifth year, these proportions decreased and 28% of the patients were in remission, but only 40 patients remained in the study. None of the patients with severe gout achieved remission.Conclusion.In patients with severe gout, target SU was hard to achieve and remission was not possible. The main obstacles for target SU and gout remission include poor medication adherence, persistent tophi, and loss to followup.


Author(s):  
Gemma Biviá-Roig ◽  
Valentina Lucia La Rosa ◽  
María Gómez-Tébar ◽  
Lola Serrano-Raya ◽  
Juan José Amer-Cuenca ◽  
...  

(1) Background: This study aimed to analyze the impact of the confinement due to the COVID-19 pandemics on the eating, exercise, and quality-of-life habits of pregnant women. (2) Methods: This was an internet-based cross-sectional survey which collected information about adherence to the Mediterranean diet, physical exercise, health-related quality of life (HRQoL), and perceived obstacles (in terms of exercise, preparation for delivery, and medical appointments) of pregnant women before and after the confinement. The survey was conducted in 18–31 May 2020. (3) Results: A total of 90 pregnant women participated in this study. There was a significant decrease in the levels of physical activity (p < 0.01) as well as in HRQoL (p < 0.005). The number of hours spent sitting increased by 50% (p < 0.001), 52.2% were unable to attend delivery preparation sessions because these had been cancelled. However, there were no significant differences in the eating pattern of these women (p = 0.672). Conclusions: These results suggest the need to implement specific online programs to promote exercise and reduce stress, thus improving the HRQoL in this population, should similar confinements need to occur again for any reason in the future.


Cephalalgia ◽  
1997 ◽  
Vol 17 (8) ◽  
pp. 867-872 ◽  
Author(s):  
NC Santanello ◽  
AB Polis ◽  
SL Hartmaier ◽  
MS Kramer ◽  
GA Block ◽  
...  

A validated migraine-specific questionnaire (24-h Migraine Quality of Life Questionnaire1: 24-h MQoLQ) was used to assess the impact of migraine and migraine therapy on health related quality of life during an acute migraine attack. Male and female migraineurs aged 18-55 years were randomized to placebo ( n = 41), rizatriptan 2.5 mg ( n = 47), 5 mg ( n = 74), or 10 mg ( n = 85) in a triple-blind, placebo-controlled clinical trial. Rizatriptan 5 mg and 10 mg were significantly more efficacious than placebo on pain relief and functional disability. After accounting, for multiple comparisons to placebo, rizatriptan 10 mg showed significantly better responses compared to placebo on three of five domains of 24-h MQoLQ (social functioning, migraine symptoms, and feelings/concerns). The O'Brien's Rank Sum Test statistic showed a statistically significant overall difference on the 24-h MQoLQ between the 10 mg rizatriptan and placebo groups ( p = 0.005) and for the overall close trend ( p 0.001).


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