scholarly journals The association between waiting time and multidisciplinary pain treatment outcomes in patients with rheumatic conditions

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Simon Deslauriers ◽  
Jean-Sébastien Roy ◽  
Sasha Bernatsky ◽  
Debbie E. Feldman ◽  
Anne Marie Pinard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Clinical Outcomes ◽  
Waiting Time ◽  
Pain Treatment ◽  
Pain Interference ◽  
Related Quality ◽  
Health Related ◽  
Rheumatic Conditions

Abstract Background Access to multidisciplinary pain treatment facilities (MPTF) is limited by extensive waiting time in many countries. However, there is a lack of knowledge about the impact of waiting time on clinical outcomes, particularly for patients with rheumatic conditions. This study examined the association between waiting time for MPTF and clinical outcomes in patients with rheumatic conditions. Methods Data were extracted from the Quebec Pain Registry, a large database of patients who received services in MPTF. The associations between waiting time (classified as < 2 months, 2–6 months and >  6 months) and change in pain interference, pain intensity and health-related quality of life, from the initial visit at the MPTF to the 6-month follow-up, were tested using generalized estimating equations. Results A total of 3230 patients with rheumatic conditions (mean age: 55.8 ± 14.0 years; 66% were women) were included in the analysis. Small significant differences in improvement between waiting time groups were revealed, with patients waiting less than 2 months having a larger improvement in all clinical outcomes compared to patients who waited 2–6 months or over 6 months before their initial visit (adjusted time X group effect p ≤ 0.001). Only patients waiting less than 2 months reached a clinically important improvement in pain interference (1.12/10), pain intensity (1.3/10) and physical and mental quality of life (3.9 and 3.7/100). Conclusions Longer delays experienced by patients before receiving services in MPTF were associated with statistically significant smaller improvements in pain interference, pain intensity and health-related quality of life; these differences were, however, not clinically significant. Based on these results, we advise that strategies are developed not only to reduce waiting times and mitigate their impacts on patients with rheumatic conditions, but also to improve treatment effectiveness in MPTF.

scholarly journals Effect of multimorbidity patterns on the decline in health-related quality of life: a nationwide prospective cohort study in Japan

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047812
Author(s):  
Takuya Aoki ◽  
Shunichi Fukuhara ◽  
Yasuki Fujinuma ◽  
Yosuke Yamamoto
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Clinical Outcomes ◽  
Prospective Cohort ◽  
Summary Score ◽  
Health Related Quality ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

ObjectivesLongitudinal studies, which consider multimorbidity patterns, are useful for better clarifying the effect of multimorbidity on health-related quality of life (HRQoL) and for identifying the target population with poorer clinical outcomes among patients with multimorbidity. This study aimed to examine the effects of different multimorbidity patterns on the decline in HRQoL.DesignNationwide prospective cohort study.SettingJapanese adult residents.ParticipantsResidents aged ≥50 years selected by the quota sampling method.Primary outcome measureClinically relevant decline in HRQoL was defined as a 0.50 SD (5-point) decrease in the 36-Item Short Form Health Survey (SF-36) component summary scores for 1 year.ResultsIn total, 1211 participants completed the follow-up survey. Among the multimorbidity patterns identified using confirmatory factor analysis, multivariable logistic regression analyses revealed that high cardiovascular/renal/metabolic and malignant/digestive/urologic pattern scores were significantly associated with the clinically relevant decline in SF-36 physical component summary score (adjusted OR (aOR)=1.25, 95% CI: 1.08 to 1.44 and aOR=1.28, 95% CI: 1.04 to 1.58, respectively). High cardiovascular/renal/metabolic pattern score was also significantly associated with the clinically relevant decline in SF-36 role/social component summary score (aOR=1.23, 95% CI: 1.06 to 1.42).ConclusionsOur study revealed that multimorbidity patterns have different effects on the clinically relevant decline in HRQoL for 1 year. These findings can be useful in identifying populations at high risk and with poor clinical outcomes among patients with chronic diseases and multimorbidity for efficient resource allocation.

scholarly journals Health-related quality of life of patients presenting to the emergency department with a musculoskeletal disorder

2020 ◽  
Author(s):  
Rose Gagnon ◽  
Kadija Perreault ◽  
Jason Robert-Guertin ◽  
Simon Berthelot ◽  
Bertrand Achou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Emergency Department ◽  
Musculoskeletal Disorder ◽  
Pain Interference ◽  
Quebec City ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Utility Scores

AbstractObjectivesThe purpose of this study was to assess utility scores of patients presenting to the emergency department (ED) with a musculoskeletal disorder and to explore the influence of diverse factors on health-related quality of life.DesignSecondary analysis of data obtained before randomization during a pragmatic randomized controlled trialSettingAcademic ED in Quebec City (Canada)ParticipantsParticipants aged 18-80 years old presenting with a minor MSKD.Main Outcome MeasuresHealth-related quality of life (five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and utility scores (0 – dead, 100 – perfect health), measured with the EQ-5D-5L, were compared between subgroups and with reference values using descriptive statistics (mean, median), rankFD ANOVAs, and χ2 tests.ResultsSixty-nine participants completed the EQ-5D-5L. Mean and median utility scores were respectively 0.536 (95% CI: 0.479-0.594) and 0.531 (IQR: 0.356-0.760). Participants with higher levels of pain (<4/10: 0.741; 4-7/10: 0.572; >7/10: 0.433) or pain interference on function (<4/10: 0.685; 4-7/10: 0.463; >7/10: 0.294) presented significantly lower utility scores. No significant differences were found for other socio-demographic characteristics. The mean overall VAS score was 58.1 (95% CI: 52.2-64.0).ConclusionsIn patients with MSKDs presenting to the ED, higher levels of pain and pain interference on function may influence perceived health-related QoL. These findings need to be confirmed on a larger scale.Trial RegistrationThis trial was registered at the US National Institutes of Health (ClinicalTrials.gov) #NCT04009369 on July 5, 2019

scholarly journals Association between ongoing pain intensity, health-related quality of life, disability and quality of sleep in elderly people with total knee arthroplasty

2014 ◽  
Vol 19 (6) ◽  
pp. 1881-1888 ◽  
Author(s):  
María Dolores Herrero-Sánchez ◽  
María del Carmen García-Iñigo ◽  
Blanca Soledad Nuño-Beato-Redondo ◽  
César Fernández-de-las-Peñas ◽  
Francisco Alburquerque-Sendín
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Sleep Quality ◽  
Pain Intensity ◽  
Social Role ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Total Knee

The scope of this paper was to study the relationship between pain intensity, health-related quality of life, disability, sleep quality and demographic data in elderly people with total knee arthroplasty (TKA). 24 subjects who had been subjected to TKA the previous month (4 females; 66 ± 9years) and 21 comparable controls (8 male; 70 ± 9years) participated in the study. Intensity of pain, and highest and lowest pain intensity experienced in the preceding week were collected. The Western Ontario and McMaster Universities index function, quality of life (Medical Outcomes Study Short Form 36), and Pittsburgh Sleep Quality Index were assessed. Age, gender, weight, height, body mass index were also collected. Individuals with TKA presented worse physical function (P < 0.01), social role (P = 0.01), physical performance (P < 0.01), pain (P = 0.04), disability (P = 0.04) and sleep quality (P = 0.03) than the controls. Higher intensity of pain was associated with lower physical function, social role, mental health, vitality and general health, and with higher disability and sleep quality. Disability and sleep quality were negatively associated with several quality of life domains. The associations between the intensity of pain, disability, quality of life and sleep reveal the multidimensional experience of TKA.

scholarly journals Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes (DOMESTICO): rationale and design

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
A. van Eck van der Sluijs ◽  
◽  
A. A. Bonenkamp ◽  
F. W. Dekker ◽  
A. C. Abrahams ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Outcomes ◽  
Human Subjects ◽  
Control Group ◽  
Health Related Quality ◽  
Home Dialysis ◽  
Related Quality ◽  
Health Related ◽  
At Home

Abstract Background More than 6200 End Stage Renal Disease patients in the Netherlands are dependent on dialysis, either performed at home or in a dialysis centre. Visiting a dialysis centre three times a week is considered a large burden by many patients. However, recent data regarding the effects of dialysis at home on quality of life, clinical outcomes, and costs compared with in-centre haemodialysis are lacking. Methods The Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes (DOMESTICO) is a nationwide, prospective, observational cohort study that will include adult patients starting with a form of dialysis. Health-related quality of life, as the primary outcome, clinical outcomes and costs, as secondary outcomes, will be measured every 3–6 months in patients on home dialysis, and compared with a control group consisting of in-centre haemodialysis patients. During a 3-year period 800 home dialysis patients (600 peritoneal dialysis and 200 home haemodialysis patients) and a comparison group of 800 in-centre haemodialysis patients will be included from 53 Dutch dialysis centres (covering 96% of Dutch centres) and 1 Belgian dialysis centre (covering 4% of Flemish centres). Discussion DOMESTICO will prospectively investigate the effect of home dialysis therapies on health-related quality of life, clinical outcomes and costs, in comparison with in-centre haemodialysis. The findings of this study are expected to ameliorate the shared decision-making process and give more guidance to healthcare professionals, in particular to assess which type of patients may benefit most from home dialysis. Trial registration The DOMESTICO study is registered with the National Trial Register on (number: NL6519, date of registration: 22 August 2017) and the Central Committee on Research Involving Human Subjects (CCMO) (number: NL63277.029.17).

scholarly journals Effectiveness of hypnosis for pain management and promotion of health-related quality-of-life among people with haemophilia: a randomised controlled pilot trial

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ana Cristina Paredes ◽  
Patrício Costa ◽  
Susana Fernandes ◽  
Manuela Lopes ◽  
Manuela Carvalho ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Management ◽  
Pilot Trial ◽  
Pain Interference ◽  
Health Related Quality ◽  
Treatment As Usual ◽  
Related Quality ◽  
Health Related ◽  
Randomised Controlled

Abstract Joint deterioration and associated chronic pain are common among people with haemophilia (PWH), having an impact on quality-of-life. Though non-pharmacological strategies are recommended, psychological interventions to promote pain control and quality-of-life have scarcely been tested in haemophilia. This randomised controlled pilot trial aimed to assess feasibility, acceptability and effectiveness of hypnosis for pain management and promotion of health-related quality-of-life (HRQoL) among PWH. Twenty adults were randomised either to four weekly hypnosis sessions plus treatment-as-usual (experimental group; EG) or treatment-as-usual only (control group; CG). Participants completed sociodemographic and clinical assessment, measures of pain, HRQoL and emotional distress before (T1) and after (T2) intervention. Changes were analysed by calculating the differences between T1 and T2, and the groups were compared through independent-sample t tests (or chi-squared). Retention rates (90%) and analysis of patient satisfaction showed good acceptability and feasibility of the intervention. The EG (n = 8) had a higher reduction on pain interference than the CG (n = 10) (d = −0.267). A higher improvement on HRQoL (EQ-5D index: d = 0.334; EQ-5D VAS: d = 1.437) and a tendency towards better haemophilia-related quality-of-life (A36-Hemofilia QoL) were also evident in the EG. This is the first study showing the effectiveness of hypnosis to reduce pain interference and promote HRQoL among PWH.

scholarly journals Impact of Tenofovir/Lamivudine/Dolutegravir (Tld) on the Health-Related Quality of Life and Clinical Outcomes of HIV/AIDS Patients at a Tertiary Health Facility in Niger State

2020 ◽  
Author(s):  
Danjuma Umar ◽  
Bala Waziri ◽  
Umar Ndagi ◽  
Shafiu Mohammed ◽  
Ndagi Usman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Regression Analysis ◽  
Viral Load ◽  
Clinical Outcomes ◽  
Viral Suppression ◽  
Baseline Viral Load ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Abstract Background: Human Immuno-deficiency Virus (HIV) remains a major global public health issue. However, it is now considered a chronic infection which can be managed with new, well-tolerated and efficacious ARVs. The aim of the study was to evaluate the effect of Tenofovir/Lamivudine/Dolutrgravir (TLD) on the HRQoL and viral suppression over a short period.Method: The study was prospective, with a time frame of three (3) months. HRQoL was measured using a disease specific HIV/AID Targeted Quality of Life (HAT-QoL) tool and the clinical outcomes focused on viral load using structured data collection tool.Results: Most of the participants were female (62.1%), currently married 63.2% and no co-morbidity, mean age 43±SD (range 21-77years). There was a statistically significant improvement in HRQoL scores across all domain after 3months of transitioning to TLD. While 8 of the 9 domains namely; overall functions, life satisfaction, health worries, financial worries, medication worries, HIV mastery, Disclosure worries, Provider trust, (p <0.001) sexual function (p =0.015). Improvement was also seen in viral suppression (p <0.001).Using multiple linear regression analysis, predictors for overall HRQol scores include female gender (ᵝ= 3.59, 95%CI 1.30-5.78, p=0.002), older age, >65years (ᵝ= 4.12, 95%CI -1.42,9.67 p=0.08), living with family (ᵝ= -5.80, 95%CI -9.60,-2.00, p=0.003), higher family income, >N100,000 (ᵝ= 6.09, 95%CI 1.75,10.44, p=0.006) and duration on ART (ᵝ=0.52, 95%CI 0.12, 0.91, p=0.01). While determinants of viral suppression using multi-variant logistic regression analysis revealed living with family (AOR=18.03, 95%CI 3.32-97.85, p<0.001), Primary education (AOR= 0.16, 965%CI 0.029,0.93, P=0.041), being employed (AOR=0.16, 95%CI 0.028,0.91, P=0.008), income and baseline viral load (AOR= 0.53, 95%CI 0.44,0.69, p<0.001). However, living with family is major determinant of viral suppression.Conclusion: TLD help improved health related quality of life among HIV infected individual and essential in rapid viral suppression.

scholarly journals The influence of the HEART Camp intervention on physical function, health-related quality of life, depression, anxiety and fatigue in patients with heart failure

2019 ◽  
Vol 19 (1) ◽  
pp. 64-73 ◽  
Author(s):  
Joseph F Norman ◽  
Kevin A Kupzyk ◽  
Nancy T Artinian ◽  
Steven J Keteyian ◽  
Windy S Alonso ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Usual Care ◽  
Physical Function ◽  
Clinical Outcomes ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Secondary Outcomes

Background: Regular exercise training has beneficial effects on quality of life, physical function, depression and anxiety in individuals with heart failure. Unfortunately, individuals with heart failure have low levels of adherence to exercise. Thus, studies are needed to assess intervention strategies which may enhance clinical outcomes. Aim: The aim of this study was to identify the components of the HEART Camp intervention, which contributed to optimizing clinical outcomes. Methods: The Heart Failure Exercise and Resistance Training Camp (HEART Camp) was a randomized controlled trial to evaluate the effect of a multicomponent intervention on adherence to exercise (6, 12 and 18 months) compared to an enhanced usual care group. This study assessed various components of the intervention on the secondary outcomes of physical function, health-related quality of life, depression, anxiety, and fatigue. Results: Individuals participating ( n=204) in this study were 55.4% men and the average age was 60.4 (11.5) years. A combination of individualized and group-based strategies demonstrated clinical improvements, HEART Camp versus enhanced usual care groups, in physical function, positive trends in health-related quality of life and positive changes in the minimally important differences for depression, anxiety, and fatigue. Conclusions: Individualized coaching by an exercise professional and group-based educational sessions were identified as important components of patient management contributing to improvements in the secondary outcomes of physical function, health-related quality of life, depression, anxiety and fatigue.

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