Successive switching of antiretroviral therapy is associated with high psychological and physical burden

HIV treatment and management is constantly evolving. This is as a result of more treatment options coming on stream, tolerance changes and progress in treatment management. HIV infection today, in resource-rich countries and in the presence of combination therapies, is experienced as lifelong treatment punctuated by adjustments to antiretroviral therapy (ART) regimens. People who are diagnosed as HIV positive face a number of challenges and changes around the decision to commence treatment, responses to treatment and changes in treatment regimens. This study was set up to examine the experience of switching treatments and the impact of such switches on psychological parameters. The method used was a cross-sectional questionnaire study. A group of 779 HIV-positive clinic attendees at four clinics in London and South East England participated in the study (86% response rate). They provided detail of their treatment switching experiences as well as demographic details, risk and optimism evaluations, quality of life, symptom burden, adherence and disclosure information. The sample ( n=779) comprised 183 (24%) females, 76 (10%) heterosexual males and 497 gay males (66%). Self-reported ethnicity was 67% white, 25% black, 3% Asian and 5% mixed/other ethnicity. One hundred and fifty-five (21%) were ART-naïve and 624 (79%) were ART experienced; 161 (22%) were receiving their first regimen, 135 (18%) had experienced one regimen switch, 196 (26%) had multiple switches and 99 (13.3%) had stopped treatment. Treatment naïve, non-switchers and single switchers generally reported lower symptom burden and higher quality of life. Multiple switchers reported higher physical symptom burden and higher global symptom distress scores. Those who had stopped treatment had significantly lower quality-of-life scores than all other groups. Suicidal ideation was high across the groups and nearly a fifth of all respondents had not disclosed their HIV status to anyone. Reported adherence was suboptimal – 79% of subjects were at least 95% adherent on self-report measures of doses taken over the preceding week. In conclusion, nearly half this clinic sample will have switched treatments. A holistic approach is needed to understand the psychological effects of such switches if lifelong treatment is to be maintained and those on antiretroviral treatment are to attain good quality of life and minimize symptom burden.

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A cross-sectional study on caregivers’ perspective of the quality of life and adherence of paediatric HIV patients to Highly Active Antiretroviral Therapy

10.21203/rs.2.21579/v2 ◽

2020 ◽

Author(s):

Michael Lahai ◽

Peter Bai. James ◽

Noel N. Wannang ◽

Haja R. Wurie ◽

Sorie Conteh ◽

...

Keyword(s):

Quality Of Life ◽

Antiretroviral Therapy ◽

Highly Active Antiretroviral Therapy ◽

Nuclear Family ◽

Strong Association ◽

Hiv Positive ◽

Cross Sectional ◽

Highly Active ◽

Health Domains

Abstract Background: Poor compliance to highly active antiretroviral therapy (HAART) can result in the poor quality of life in children living with HIV/AIDS because of low plasma drug concentration and the possibility of drug resistance. This study evaluates the response of caregivers for determination of adherence and the four quality of life domains in children (aged 14 years and under) on HAART.Methods: We conducted a cross-sectional study of 188 children, each accompanied by their caregivers at Ola During Children's Hospital and Makeni Government Hospital between September and November 2016. Adherence to HAART and Quality of life was assessed using the WHO Quality of life summary questionnaire (WHOQOL-BREF). We obtained ethical approval from the Sierra Leone Ethics and Scientific Review Committee. Results: The study revealed 5.9% adherence amongst paediatric patients, and a strong association of adherent patients(p=0.019*) to the physical health domain (mean=64.61 SD=8.1).Caregiver HIV status showed a strong association with the physical (mean=58.3, SD=11.7 and p=0.024*), and psychological health domains (mean=68.2, SD=14.7 and p=0.001). Caregiver type (mother/father/sibling) accompanying child to hospital also showed strong associated with the physical (mean=58.0, SD=10.6, p <0.001), psychological (mean 68.2 SD=14.81 p <0.001) and environmental health domains (mean=59.7, SD=13.47, p <0.001). Further regression analysis showed a strong association with physical health domain for HIV positive caregivers (p=0.014) and adherent paediatric patients (p=0.005). Nuclear family also showed a strong association with psychological (p<0.001) and environmental (p=0.001) health domains. Conclusion: This study showed a strong association between the quality of life domains and the involvement of nuclear family caregiver, HIV-positive caregiver and adherence to HAART. Our study suggests that the involvement of any member of the nuclear family, HIV positive parents and patient adherence to therapy can improve the quality of life of paediatric HIV/AIDS patients on highly active antiretroviral therapy in the two hospitals.

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Development of a functional assessment of side-effects to therapy (FAST) questionnaire to assess dermatology-related quality of life in patients treated with EGFR inhibitors (EGFRI): The FAST-EGFRI

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.19532 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 19532-19532 ◽

Cited By ~ 3

Author(s):

L. Wagner ◽

S. E. Lai ◽

M. Aneja ◽

P. Lorusso ◽

R. Perez-Soler ◽

...

Keyword(s):

Quality Of Life ◽

Social Life ◽

Symptom Burden ◽

Physical Symptoms ◽

Self Report ◽

Antitumor Effects ◽

Related Quality ◽

The Impact ◽

Skin Pain

19532 Background: Despite their beneficial antitumor effects, 75–87% patients who undergo EGFRI therapy develop dermatological toxicities (derm tox), including rash, paronychia, hair alterations, and pruritus. The purpose of this study was to develop a patient (pts) self-report questionnaire based on pts and expert (exp) input and to identify the most significant skin tox health-related quality of life (HRQL) factors. Methods: To generate the questionnaire, 20 pts with derm tox to EGFRIs and 12 expert clinicians (>50 treated pts) were asked interview questions and rated 62 items to assess the most bothersome aspects of derm tox and the impact on pts’ skin-specific HRQL. The questionnaire included items from the Skindex-29, a validated skin disease-specific HRQL questionnaire. Items were rated from 0 (not at all important) to 3 (extremely important) (range = 0–3) based on the items’ significance to patients’ HRQL. Both groups were also asked to circle 20 of the most concerning HRQL factors. Results: Eighteen pts and 11 exp completed the questionnaire. Symptoms reported frequently by both pts and exp that affected patients’ HRQL included painful (mean score 2.29 (pts), 2.70, (exp), burning (2.41 (pts), 2.70 (exp)), itchy (2.00 (pts), 2.20 (exp) skin, pain in fingers/toes (2.00 (pts), 2.40 (exp)) increased facial hair (1.93(pts), 1.70 (exp)). Both pts and exp also frequently reported that the patient’s skin condition makes them feel depressed (1.88 (pts), 2.60 (exp)) and makes work or hobbies difficult (2.00 (pts), 2.20 (exp)). The top three most concerning HRQL factors for pts were skin pain, burning and stinging, and irritation, while exp reported depression, skin pain, and derm tox affecting pts’ social life. Conclusions: These results document the trajectory of symptom burden and derm tox HRQL in EGFRI treated pts. These findings underscore that in addition to the psychosocial discomfort, physical symptoms impact HRQL. Further studies to validate the FAST-EGFRI, so that effects on HRQL of interventions against derm tox and differences between agents can be assessed are underway. No significant financial relationships to disclose.

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Nocturia and effect on the quality of life. A study at Ramathibodi Hospital

Insight Urology ◽

10.52786/isu.a.37 ◽

2021 ◽

Vol 42 (2) ◽

pp. 144-153

Author(s):

Potchara Kanammit ◽

◽

Threechada Boonchan ◽

Pokket Sirisreetreerux ◽

Wit Viseshsindh ◽

...

Keyword(s):

Quality Of Life ◽

Treatment Options ◽

Underlying Disease ◽

Cross Sectional Study ◽

Life Questionnaire ◽

Cross Sectional ◽

Long Term Follow Up ◽

A Minor ◽

The Impact

Objective: To investigate the impact and the incidence of nocturia on the quality of life of patients in Ramathibodi Hospital. Materials and Methods: This study was a hospital-based cross-sectional study to measure the QoL of nocturia patients using a Nocturia Quality-of-Life questionnaire (N-QoL). Cronbach’s alpha coefficient was used to explore internal consistency. Pearson’s correlation coefficient (r) was used to determine the strength of the relationship between the scores for each item. Uni- and Multivariate analyses were used to explore the significant parameters. Results: One hundred and fifty-five nocturia patient were included in the study analysis. Most of the questionnaire respondents were male (80.65%) and the vast majority had at least 1 underlying disease requiring long-term follow-up by a physician (86.45%) with a median urination of 3 times per night and a 3 hour median first urination after retiring to bed. From our study questionnaire, most patients responded that they had moderate to good quality of life with a minor inconvenience from nocturia, requiring them to nap during the day on some days. An increasing frequency of urination per night and a first urination of less than 2 hours after retiring is significantly related to low levels of energy the next day, sleep deprivation, worry over treatment options, overall inconvenience and a reduction in quality of life. Conclusion: Our study demonstrated nocturia patients experience a significant reduction in quality of life, and a decrease in quality of sleep. The incidence of urination in the night and the timing of the first urination after bed had more impact on overall quality of life.

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Assessment of quality of life among HIV infected people on antiretroviral therapy in a tertiary hospital, Karnataka

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20211897 ◽

2021 ◽

Author(s):

Anjan Sreeranga ◽

P. Pavithra ◽

Anand D. Meundi

Keyword(s):

Quality Of Life ◽

Antiretroviral Therapy ◽

Rural Areas ◽

World Health ◽

Cross Sectional ◽

Infected People ◽

Significant Difference ◽

Patient Reported ◽

The Impact

Background: With the availability of highly effective antiretroviral treatment, HIV is transforming into a chronic condition, whose management is now experiencing problems of other chronic diseases, where quality of life (QOL) has become an important component of overall assessment of health care and management. This study was conducted with the objective of assessing the QOL and factors influencing it in HIV infected people on antiretroviral therapy (ART).Methods: A cross-sectional study was conducted at district ART center, Hassan. Purposive sampling was used to identify 148 HIV infected people on antiretroviral therapy, who were interviewed using a pretested questionnaire, assessing QOL with the World Health Organization (WHOQOL) HIV‑BREF.Results: The average age of the study population was 37.69 years. Majority of them were males 54.7% compared to 45.3% of females. Most of them resided in rural areas (87.8%). The educational status of the subjects was poor with 33.8% of them being illiterates. The mean score was highest for spirituality and social relationships domain and least for psychological domain. Age, education and socioeconomic status did not have any influence on the QOL. There was significant difference between QOL scores and clinical stages. Individuals in stage I and II had better scores compared to stage 3 and 4. QOL scores decreased with decreasing CD4 count.Conclusions: Our findings suggest that patient-reported measures of health status and related concepts may help provide a feasible, reliable and valid method to assess the impact of HIV/AIDS improve patient outcomes.

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Association between cancer stigma, pain and quality of life in breast cancer

Psychology Community & Health ◽

10.5964/pch.v8i1.310 ◽

2020 ◽

Vol 8 (1) ◽

pp. 275-287

Author(s):

Ora Nakash ◽

Leeat Granek ◽

Michal Cohen ◽

Merav Ben David

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Pain Intensity ◽

Self Report ◽

Breast Cancer Patients ◽

Cross Sectional ◽

Convenience Sample ◽

Cross Sectional Design ◽

The Impact

Aim We examined the association between cancer stigma and quality of life. We further explored the role of pain intensity in this association among women with breast cancer in the first months following diagnosis. Methods 105 women with breast cancer within 8 months of diagnosis completed self-report measures assessing cancer stigma, pain intensity and quality of life. Results Our findings show that stigma among breast cancer patients is associated with worse quality of life. Pain intensity partially mediated the relationship between cancer stigma and quality of life. We recruited a convenience sample of women with breast cancer, which may be subject to selection bias. The cross sectional design of the study precludes inferences regarding causality. Conclusions Health professionals should recognize and mitigate the impact of stigma as an important factor that is associated with impaired quality of life among patients with breast cancer. Continued attention should be paid to pain intensity and the complex relationship between stigma and pain in predicting quality of life.

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To assess the adherence to antiretroviral therapy among HIV positive patients attending ART centres in Haryana and its effect on their quality of life

Indian Journal of Community Health ◽

10.47203/ijch.2021.v33i02.016 ◽

2021 ◽

Vol 33 (2) ◽

pp. 314-318

Author(s):

Arundeep Singh ◽

Anshu Mittal ◽

Vishavdeep Kaur

Keyword(s):

Quality Of Life ◽

Antiretroviral Therapy ◽

Art Therapy ◽

Immune Deficiency Syndrome ◽

Deficiency Syndrome ◽

Cross Sectional Study ◽

Adherence Rate ◽

Hiv Positive ◽

Cross Sectional

Background: Acquired immune deficiency syndrome (AIDS) is now considered as a manageable chronic illness with the availability of ART. A high level of adherence (>95%) is required for antiretroviral therapy to be effective. It is a syndrome that builds a vacuum in a person affecting his/her quality of life (QOL) as a whole. Aim& Objective: The aim of our study was to determine adherence and its effect on their quality of life among HIV/AIDS patients attending FIART (Facility Integrated Anti-retroviral therapy) clinic. Materials and Methods: Using a cross-sectional study design, 257 HIV positive patients receiving antiretroviral therapy at Facility integrated anti-retroviral therapy centre Ambala Haryana. QOL of patients taking ART was assessed using WHO-QOL-BREF questionnaire. Results: Of 257 participants, 88.3% were found to be adherent, adherent to ART therapy and ambulatory had better QOL (p < 0.05) than their counterparts from other socio-clinical strata. Mean scores of physical (70.89±7.384), psychological (47.37±9.174), social (51.97±11.119) & environmental domains (52.33±9.081), were having highest in patients those who were adherent (adherence rate >95%) to ART therapy. Conclusion: Adherence to antiretroviral therapy in Haryana India is suboptimal. Intensive adherence counselling should be provided to all patients before initiation of antiretroviral therapy and on every visit to FIART centre.

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Environment and psychosocial factors are more important than clinical factors in determining quality of life of HIV-positive patients on antiretroviral therapy

Tropical Doctor ◽

10.1177/0049475520908180 ◽

2020 ◽

Vol 50 (3) ◽

pp. 180-186

Author(s):

Kanan T. Desai ◽

Prakash B Patel ◽

Anupam Verma ◽

RK Bansal

Keyword(s):

Quality Of Life ◽

Antiretroviral Therapy ◽

Hospital Admissions ◽

World Health ◽

Hiv Positive ◽

Subjective Perception ◽

Western India ◽

Cross Sectional ◽

Suicidal Ideas

Assessing quality of life (QOL) outcome helps to show the effect of antiretroviral therapy (ART) on the subjective perception of its benefits among patients with HIV. A cross-sectional assessment of QOL, using the World Health Organization WHOQOL-HIV, on 204 HIV patients taking ART in western India showed patients with HIV on ART as having the best QOL score in the spiritual domain and the worst in the environment domain. Patients who are single, highly educated, of higher occupational status, with no HIV-positive children, not undergoing frequent hospital admissions, with access to a counsellor for support, who are not stigmatised or discriminated against due to HIV status, who do not have guilt or suicidal ideas, and who are theist, tend to have a better QOL, irrespective of their clinical condition or ART regimen. Patients’ personal perceptions and feelings, societal support or stigma, and sociodemographic status have a more significant influence on QOL than clinical variables.

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Quality of life and perceived health status in surviving adults with univentricular heart

Heart ◽

10.1136/hrt.86.1.69 ◽

2001 ◽

Vol 86 (1) ◽

pp. 69-73

Author(s):

Z Saliba ◽

G Butera ◽

D Bonnet ◽

P Bonhoeffer ◽

E Villain ◽

...

Keyword(s):

Quality Of Life ◽

Normal Population ◽

Psychosocial Problems ◽

Perceived Health ◽

Univentricular Heart ◽

Cross Sectional ◽

Clinical Variables ◽

Health Measures ◽

The Impact

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.

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Tobacco use in the Myeloproliferative neoplasms: symptom burden, patient opinions, and care

BMC Cancer ◽

10.1186/s12885-021-08439-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sarah F. Christensen ◽

Robyn M. Scherber ◽

Gina L. Mazza ◽

Amylou C. Dueck ◽

Nana Brochmann ◽

...

Keyword(s):

Quality Of Life ◽

Tobacco Use ◽

Myeloproliferative Neoplasms ◽

Myeloproliferative Neoplasm ◽

Symptom Burden ◽

Symptom Assessment ◽

Cross Sectional ◽

Former Smokers ◽

Never Smokers

Abstract Background Patients with Philadelphia-negative Myeloproliferative Neoplasms (MPN) suffer from numerous symptoms and decreased quality of life. Smoking is associated with an increased symptom burden in several malignancies. The aim of this study was to analyze the association between smoking and MPN-related symptom burden and explore MPN patients’ opinions on smoking. Methods A total of 435 patients with MPN participated in a cross-sectional internet-based survey developed by the Mayo Clinic and the Myeloproliferative Neoplasm Quality of Life Group. Patients reported their demographics, disease characteristics, tobacco use, and opinions on tobacco use. In addition, MPN-related symptoms were reported via the validated 10-item version of the Myeloproliferative Neoplasms Symptom Assessment Form. Results Current/former smokers reported worse fatigue (mean severity 5.6 vs. 5.0, p = 0.02) and inactivity (mean severity 4.0 vs. 3.4, p = 0.03) than never smokers. Moreover, current/former smokers more frequently experienced early satiety (68.5% vs. 58.3%, p = 0.03), inactivity (79.9% vs. 71.1%, p = 0.04), and concentration difficulties (82.1% vs. 73.1%, p = 0.04). Although not significant, a higher total symptom burden was observed for current/former smokers (mean 30.4 vs. 27.0, p = 0.07). Accordingly, overall quality of life was significantly better among never smokers than current/former smokers (mean 3.5 vs. 3.9, p = 0.03). Only 43.2% of the current/former smokers reported having discussed tobacco use with their physician, and 17.5% did not believe smoking increased the risk of thrombosis. Conclusion The current study suggests that smoking may be associated with increased prevalence and severity of MPN symptoms and underscores the need to enhance patient education and address tobacco use in the care of MPN patients.

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Quality of Life in Opioid Replacement Therapy: A Naturalistic Cross-Sectional Comparison of Methadone/Levomethadone, Buprenorphine, and Diamorphine Patients

European Addiction Research ◽

10.1159/000514192 ◽

2021 ◽

pp. 1-10

Author(s):

Stephanie Paula Elisabeth Guillery ◽

Rainer Hellweg ◽

Golo Kronenberg ◽

Ulrich Bohr ◽

Hagen Kunte ◽

...

Keyword(s):

Quality Of Life ◽

Replacement Therapy ◽

Psychological Functioning ◽

Treatment Options ◽

Chronically Ill ◽

Cross Sectional ◽

Life Improvement ◽

Methadone Patients ◽

Opioid Replacement Therapy

Background: Research on quality of life (QoL) of chronically ill patients provides an opportunity to evaluate the efficacy of long-term treatments. Although it is established that opioid replacement therapy is an effective treatment for opioid-dependent patients, there is little knowledge about physical and psychological functioning of QoL for different treatment options. Objectives: Altogether, 248 opioid-dependent patients receiving substitution treatment with either methadone/levomethadone (n = 126), diamorphine (n = 85), or buprenorphine (n = 37) were recruited in 6 German therapy centers. Methods: Sociodemographic data were collected. QoL – physical and psychological functioning – for different substitutes was assessed using the Profile of the Quality of Life in the Chronically Ill (PLC) questionnaire. Results: Patient groups were similar regarding age and duration of opioid dependence. Employment rate was significantly higher (p < 0.005, φ = 0.22) in the buprenorphine group (46%) compared to methadone (18%). Dosage adjustments were more frequent (p < 0.001, φ = 0.29) in diamorphine (55%) than in methadone (30%) or buprenorphine (19%) patients. Buprenorphine and diamorphine patients rated their physical functioning substantially higher than methadone patients (p < 0.001, η2 = 0.141). Diamorphine patients reported a higher psychological functioning (p < 0.001, η2 = 0.078) and overall life improvement (p < 0.001, η2 = 0.060) compared to methadone, but not compared to buprenorphine patients (both p > 0.25). Conclusion: Measurement of important QoL aspects indicates significant differences for physical and psychological functioning in patients receiving the substitutes methadone/levomethadone, diamorphine, and buprenorphine. This could be relevant for the differential therapy of opioid addiction.

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