Impact of Transcranial Direct Current Stimulation in Pain, Fatigue, and Health Quality of Life of Patients with Idiopathic Inflammatory Myopathies: A Randomized, Double-Blind, Sham-Controlled Crossover Clinical Trial

The impact of non-motor symptoms on the health-related quality of life in patients with functional movement disorders

Quality of Life and Outcomes in Multiple Myeloma Patients

Timing of quality of life assessment in cancer clinical trials: fine tuning remains a challenge

The aim of this study is to evaluate the relationship between clinical severity and functionality, occupational performance, and health-related quality of life in patients hospitalized with pulmonary embolism. Pulmonary embolism patients were grouped by clinical severity using the Pulmonary Embolism Severity Index. Those scoring ≥160 were in the high-severity group (HSG); those scoring < 160 in the low-moderate group (LMSG). The main variables were functionality assessed by the World Health Organization Disability Assessment Schedule (WHODAS), self-perception of occupational performance assessed by the Canadian Occupational Performance Measure (COPM), pain and fatigue assessed by a Visual Analogue Scale (VAS), and health-related quality of life assessed by the EuroQol-5Dimensions (EQ-5D). Patients were evaluated at hospital admission and at 1-month and 3-month follow-up. At admission, there were significant differences between groups in the WHODAS and health-related quality of life in favor of the LMSG. At 1-month and at 3-month follow-up, there were significant differences between the LMSG and HSG in WHODAS, COMP, NRS pain, fatigue and EQ-5D scores in favor of the LMSG. An association exists between clinical severity and mid-term functionality, self-perception of occupational performance, pain, fatigue, and health-related quality of life in PE patients.

Background: Considering the prevalence of migraine and its detrimental effects on functioning, physical health, and quality of life as well as its psychosocial and social risks. The purpose of this study was to compare the effectiveness of mindfulness-based stress reduction treatment with treatment based on acceptance and commitment to the severity of pain and health-related quality of life in migraine patients. Methods: In this study, a semi-experimental design used with pre-test, post-test, a 3-month follow-up, and a control group. Using purposive sampling and considering the inclusion criteria, 45 patients with migraine diagnosis selected from among those referring to the neurology department of Imam Hossein hospital in Tehran. They were then randomly assigned to two experimental groups and a control group. The first experimental group received group therapy based on mindfulness (n = 15; 90-minute sessions), the second experimental group received acceptance and commitment based intervention (n = 15; 90-minute sessions), and the control group (n = 15) received no intervention. All subjects responded to pain intensity and health-related quality of life questionnaires before the intervention (pre-test), after the intervention (post-test), and 3 months after the intervention (follow-up). One-way ANOVA analyzed the collected data. Results: The findings showed that mean scores for the 2 experimental groups were significantly different from the control group in the post-test and follow-up phases in terms of severity of pain and health-related quality of life, while the mean scores for the two experimental groups did not differ significantly. The results emphasize the importance of these interventions for chronic diseases and offer new horizons in clinical interventions. Conclusion: The results of this study showed that mindfulness-based stress reduction therapy and acceptance and commitment therapy could positively affect the severity of pain and health-related quality of life in migraine patients, and any of them can be used to improve the variables mentioned above.

Health Related Quality of Life for Stone Formers

Health Related Quality of Life Outcomes in Patients Treated for Metastatic Kidney Cancer: A Pilot Study

Background:Rheumatoid arthritis (RA) is an autoimmune inflammatory condition that adversely affects health-related quality of life (HRQoL) by causing joint damage, pain, functional impairment, and fatigue.Objectives:The aim of this study was to assess the impact of biological disease-modifying antirheumatic drugs (bDMARDs) on fatigue, functional disability, and HRQoL in an Egyptian cohort with RA.Methods:This observational analytical prospective cohort study included RA patients who needed to start bDMARDs immediately after the enrolment visit at two Rheumatology and Immunology Units. Clinical, therapeutic, and laboratory data were assessed at baseline and 4 months after administration of bDMARDs, along with the Functional Assessment of Chronic Illness Therapy-Fatigue 13 items, Health Assessment Questionnaire Disability Index (HAQ-DI), and Short Form-12 Health Survey (SF-12) questionnaires.Results:A total of 85 patients with RA were included (mean age: 41.7 years). Most of the participants were female (87.1%). The most commonly administered bDMARDs were adalimumab (n = 26), golimumab (24), and etanercept (15). After bDMARD administration, there was significant improvement in the severity of fatigue (P <0.001, 95% CI: 14.59, 20.29) and median HAQ-DI scores (from 1.68 to 0.68; P <0.001, 95% CI: −1.06, −0.92). The number of patients with severe to very severe disability decreased significantly from 29 at baseline to 4 after 4 months after administration of bDMARDs (P <0.001). Additionally, the SF-12 domains showed significantly better scores after 4 months compared with baseline.Conclusions:Administration of bDMARDs is associated with significant improvement in fatigue, functional disability, and health-related quality of life in patients with rheumatoid arthritis.

Aims/Background The evaluation of health-related quality of life in patients undergoing maintenance haemodialysis has garnered increasing attention. The modified creatinine index, a surrogate marker for muscle mass, has been linked to various clinical outcomes. However, the relationship between modified creatinine index and health-related quality of life in maintenance haemodialysis patients remains unclear. This study aims to elucidate the association between modified creatinine index and health-related quality of life in individuals receiving maintenance haemodialysis. Methods This cross-sectional study included 217 maintenance haemodialysis patients. Health-related quality of life was assessed using the Kidney Disease Quality of Life Instrument. Collected data included general patient information, laboratory results, and haemodialysis-related parameters. The modified creatinine index was calculated based on gender, age, single-pool Kt/V (spKt/V), and pre-dialysis serum creatinine levels. Multiple linear regression models and smooth curve fitting were used to investigate the relationship between modified creatinine index and health-related quality of life. Subgroup analyses and interaction tests were performed to identify potential effect modifiers. Results The 217 maintenance haemodialysis patients had a mean age of 53.66±13.15 years and a median dialysis vintage of 39 (25-84) months; 120 (55.30%) were male. The mean health-related quality of life score was 55.76±10.33, and the mean modified creatinine index was 22.72±2.95 mg/kg/day. After adjusting for confounding factors, an increase in modified creatinine index was associated with an improvement in health-related quality of life (β=0.55, 95% CI: 0.04, 1.06, p = 0.033). No nonlinear relationship was identified between modified creatinine index and health-related quality of life by smooth curve fitting. Subgroup and interaction analyses indicated that the relationship between modified creatinine index and health-related quality of life was stable and not significantly influenced by age, gender, dialysis vintage, diabetes status, or body mass index (p > 0.05). Conclusion Modified creatinine index is positively correlated with health-related quality of life in maintenance haemodialysis patients, suggesting its potential utility in evaluating patient quality of life. Modified creatinine index could be clinically useful to improve the predictability of health-related quality of life in maintenance haemodialysis patients.

Haematological malignancies (HM) comprise of nearly 10% of all cancers. In oncology, the Health- related quality of life (HRQOL) measure assesses the physical, social and mental health aspects of patients undergoing treatment. There is lack of Indian data on HRQOL in patients with haematological malignancies. The main objective of our study was to assess the parameters of quality of life in adult patients undergoing therapy for haematological malignancies. We conducted a cross-sectional study between 1st March 2023 and 31st July, 2023. Patients included for the study were newly diagnosed patients aged ≥ 18 years with haematological malignancy- (lymphoma, leukemia, and multiple myeloma) and undergoing therapy. Patients with relapsed/refractory disease, palliative care and those on follow up or observation were excluded. The primary objective of our study was to explore the parameters of quality of life in adult patients undergoing therapy for haematological malignancies. The secondary objective was to identify factors which are most influential in affecting the quality of life (QoL) in these subset of patients. European Organisation for Research and Treatment of Cancer (EORTC) QoL questionnaire (QLQ C 30 version 3.0) was used for QoL analysis. A total of 130 patients were eligible for evaluation. The median age of patients was 55 years (Range- 18-78 years). The proportion of males was 1.6:1. The total mean global health status score including health and QoL was 73.5 ± 24.4. On comparison with EORTC reference score for all cancer patients, the global health status functional scale in our study was higher. The highest symptom score was observed for fatigue (40.1 ± 26.1) and lowest for diarrhoea being 5.7 ± 14.7. A similar trend in the symptom scales was seen in the EORTC cohort When age groups were compared, means for global health and physical functioning score had statistically significant difference. Amongst symptom scales, fatigue scores were higher as the ages progressed. Assessment of QoL in patients with haematological malignancies should be integrated into clinical practice, to understand treatment related morbidity and thereby helping in choosing optimal treatment strategy. The online version contains supplementary material available at 10.1007/s12288-024-01829-4.

Background and Aims Lupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus, with significant implications for health-related quality of life (HRQoL). While studies on HRQoL in LN are increasing, many have relied on generic instruments that may not fully capture the nuanced physical, emotional, and psychosocial challenges faced by LN patients. Disease-specific tools offer a more comprehensive understanding by addressing aspects unique to LN. This study aimed to evaluate HRQoL in LN patients using the LupusPRO questionnaire, a validated disease-specific tool, and identify demographic, clinical, and socioeconomic factors influencing HRQoL to inform patient-centered interventions. Method This cross-sectional study included 35 adult patients aged ≥18 years with biopsy-confirmed LN, recruited at Loma Linda University Medical Center. HRQoL was assessed using the LupusPRO questionnaire, which provides domain scores ranging from 0 to 100 (higher scores indicate better HRQoL). Demographic, clinical, and socioeconomic data were collected during routine clinic visits. The study was approved by the Institutional Review Board (IRB) at Loma Linda University Medical Center and funded by GlomCon. It represents an ongoing investigation assessing HRQoL in LN patients, with findings presented as an interim analysis. Statistical analyses included descriptive statistics and Shapiro-Wilk tests for normality. Gender differences were analyzed using Mann-Whitney U or independent t-tests, while Kruskal-Wallis tests and one-way ANOVA assessed outcomes by employment and disease severity, with LSD post-hoc tests for significant findings. Multiple linear regression models evaluated predictors of HRQoL, including gender, disease activity, and employment status. Results As part of this interim analysis, data from 35 lupus nephritis patients were analyzed. The study population was predominantly female (n = 30, 85.7%), with a mean age of 40.9 years (SD = 12.9). Over half of the patients were unemployed (n = 19, 54.2%), while smaller proportions were employed full-time (n = 6, 17.1%) or part-time (n = 3, 8.5%), or were students (n = 5, 14.2%). Disease activity, assessed using SLEDAI, was predominantly mild-to-moderate (n = 27, 77.1%), with severe disease observed in 22.8% of the cohort (n = 8). Pain, fatigue, and body image were the most affected HRQoL domains, with mean scores of 56 (SD = 24), 61 (SD = 28), and 54 (SD = 26), respectively. In contrast, satisfaction with care remained consistently high (mean = 88, SD = 21). Male patients reported significantly better fatigue scores (mean = 81, SD = 18) compared to female patients (mean = 57, SD = 29; p = 0.037). Full-time employed patients demonstrated significantly higher physical health (mean = 89, SD = 11; p = 0.009) and fatigue scores (mean = 96, SD = 6; p = 0.026) compared to other groups. Disabled patients, despite poor fatigue outcomes (mean = 38, SD = 18), exhibited high body image (mean = 85, SD = 15) and cognition scores (mean = 100). Patients with mild disease activity reported significantly better physical health scores (mean = 76, SD = 19) compared to those with severe disease (mean = 51, SD = 25; p = 0.038). A declining trend in HRQoL was observed across most domains with increasing disease severity. Multivariate regression identified disease activity as a significant predictor of physical health (β = −0.474, p = 0.003) and fatigue (β = −0.417, p = 0.013). Full-time employment was strongly associated with better physical health (β = 0.488, p = 0.003) and fatigue scores (β = 0.490, p = 0.005), while being a student negatively predicted coping scores (β = −0.555, p = 0.005). Conclusion Lupus nephritis significantly impairs HRQoL, with pain, fatigue, and body image identified as the most affected domains. Employment status and disease activity were key predictors, with full-time employment linked to better HRQoL and higher disease activity associated with poorer outcomes. These findings highlight the need for interventions addressing the physical and psychosocial challenges of LN to improve patient outcomes.

To investigate the association of low-density (lipid-rich) muscle measured by computed tomography (CT) with skeletal muscle function and health-related quality of life in idiopathic inflammatory myopathies (IIMs). Seventeen patients and 10 healthy controls underwent CT of the midthigh to quantify high- (30-100 HU) and low-density (0-29 HU) skeletal muscle areas. Anthropometric measures, body composition, physical activity level, health-related quality of life, skeletal muscle strength, endurance, and fatigue were assessed. Patients were compared against controls. The relationship of anthropometric, body composition, and disease variables with measures of muscle function were examined using Spearman's test on the patient group. Linear regression was used to assess the age- and disease-adjusted relationship of muscle quality to physical function and muscle strength. Patients had higher body fat percentage (P = 0.042), trunk fat mass (P = 0.042), android:gynoid fat (P = 0.033), and midthigh low-density muscle/total muscle area (P < 0.001) compared to controls. Midthigh low-density muscle/total muscle area was negatively correlated with self-reported physical function, strength, and endurance (the Short Form 36 [SF-36] health survey physical functioning [P = 0.004], manual muscle testing [P = 0.020], knee maximal voluntary isometric contraction/thigh mineral-free lean mass [P < 0.001], and the endurance step test [P < 0.001]), suggesting that muscle quality impacts function in IIM. Using multiple linear regression adjusted for age, global disease damage, and total fat mass, poor muscle quality as measured by midthigh low-density muscle/total muscle area was negatively associated with SF-36 physical functioning (P = 0.009). Midthigh low-density muscle/total muscle area is a good predictor of muscle strength, endurance, and health-related quality of life as it pertains to physical functioning in patients with IIMs.

To investigate health-related quality of life in patients with idiopathic inflammatory myopathies (IIMs) compared with those with non-IIM autoimmune rheumatic diseases (AIRDs), non-rheumatic autoimmune diseases (nrAIDs) and without autoimmune diseases (controls) using Patient-Reported Outcome Measurement Information System (PROMIS) instrument data obtained from the second COVID-19 vaccination in autoimmune disease (COVAD-2) e-survey database. Demographics, diagnosis, comorbidities, disease activity, treatments and PROMIS instrument data were analysed. Primary outcomes were PROMIS Global Physical Health (GPH) and Global Mental Health (GMH) scores. Factors affecting GPH and GMH scores in IIMs were identified using multivariable regression analysis. We analysed responses from 1582 IIM, 4700 non-IIM AIRD and 545 nrAID patients and 3675 controls gathered through 23 May 2022. The median GPH scores were the lowest in IIM and non-IIM AIRD patients {13 [interquartile range (IQR) 10-15] IIMs vs 13 [11-15] non-IIM AIRDs vs 15 [13-17] nrAIDs vs 17 [15-18] controls, P < 0.001}. The median GMH scores in IIM patients were also significantly lower compared with those without autoimmune diseases [13 (IQR 10-15) IIMs vs 15 (13-17) controls, P < 0.001]. Inclusion body myositis, comorbidities, active disease and glucocorticoid use were the determinants of lower GPH scores, whereas overlap myositis, interstitial lung disease, depression, active disease, lower PROMIS Physical Function 10a and higher PROMIS Fatigue 4a scores were associated with lower GMH scores in IIM patients. Both physical and mental health are significantly impaired in IIM patients, particularly in those with comorbidities and increased fatigue, emphasizing the importance of patient-reported experiences and optimized multidisciplinary care to enhance well-being in people with IIMs.

Determinants of Quality of Life for Patients With Kidney Stones

Health-related quality of life (HRQoL) is a research priority in chronic diseases. We undertook a systematic review (registration #CRD42015024939) to identify, appraise and synthesize the evidence relating to HRQoL in idiopathic inflammatory myopathies (IIM). A comprehensive search was conducted in August 2015 using CINAHL, EMBase and Pubmed to identify studies reporting original data on HRQoL in IIM using generic HRQoL instruments. Characteristics of samples and results from selected studies were extracted and appraised using a standardized approach. Qualitative synthesis of the results was performed. Ten studies including a total of 654 IIM subjects were included in this systematic review. HRQoL was significantly impaired in all subsets of IIM compared with the general population. Disease activity, disease damage and chronic disease course were associated with poorer HRQoL. Insufficient or conflicting results were found in associations between clinical features, treatment, disease duration and mood or illness perception, and HRQoL in IIM. This study suggests that HRQoL is impaired in IIM. However, due to the paucity and heterogeneity of the evidence to date, robust estimates are lacking and significant knowledge gaps persist. There is a need for studies that systematically investigate the correlates and trajectory of HRQoL in IIM.