Differences In Quality Of Life Scores Research Articles

RBC-Enhance: A Randomized Pilot Feasibility Trial of Red Cell Transfusion Thresholds in Myelodysplastic Syndromes

RBC-Enhance: A Randomized Pilot Feasibility Trial of Red Cell Transfusion Thresholds in Myelodysplastic Syndromes

Effects of oral contraceptives on the quality of life of women with polycystic ovary syndrome: a crossover randomized controlled trial

Background and objectiveA limited number of studies have evaluated the effects of oral contraceptives (OCs) on the quality of life (QOL) of polycystic ovary syndrome (PCOS) patients. This study aimed to compare the effects of using OCs containing levonorgestrel (LNG) and those containing desogestrel (DSG), cyproterone acetate (CPA) or drospirenone (DRSP) for 6 months on the QOL with PCOS.MethodsIn this crossover randomized controlled 6-arm trial, 200 eligible patients with PCOS scheduled for OC therapy were randomly assigned to one of the 6 study arms. All 6 arms include two 6-month treatment periods, one period with OCs containing LNG, and the other with each of the 3 OCs containing DSG, CPA, or DRSP. Outcomes of interest were the total score of QOL and its domains, which were assessed using a specific and valid health-related quality of life questionnaire for PCOS, which is consisted of six domains, including psychosocial–emotional, self-image, fertility, sexual function, hirsutism, and obesity– menstrual disorders.ResultsFinally, a total of 88 patients were analyzed for this study. The results showed that use of OCs containing DSG, CPA, and DRSP for 3 months was not associated with significant differences in the total scores of QOL compared to those OCs containing LNG, whereas, after 6 months of treatment, patients treated with OCs containing CPA had more improvements in their total scores of QOL, in comparison to OCs containing LNG (P < 0.042). We found no significant differences in QoL domains, including psychosocial–emotional, self-image, fertility, sexual function, hirsutism, and obesity-menstrual disorders after 3–6 months of treatment with DSG, CPA, or DRSP, compared to LNG. The sequence and period effects were not significant in any of the analyses at 3 and 6 months of treatment. The carry-over effect was not significant for most outcomes assessed.ConclusionsThis crossover study demonstrated non-inferiority of OCs with newer generation progestins on different domains of QOL, in comparison with older compounds, although usage of products containing CPA was significantly associated with more improvement in total QOL of PCOS patients, compared to those containing LNG after 6-month of treatment.Trial registrationIRCT201702071281N2.

The effect of nutritional education program on quality of life and serum electrolytes levels in hemodialysis patients: A single-blind randomized controlled trial

ObjectiveTo determine the effect of nutrition education program on hemodialysis patients’ quality of life (QoL) and serum electrolytes levels. MethodsThis study was a randomized controlled trial in which 94 eligible hemodialysis patients were randomly assigned to intervention (n = 48) and control (n = 46) groups. In the intervention group, the patients were trained in healthy nutrition for four weeks. After two months, samples of both groups completed the Kidney Disease Quality of Life Instrument (KDQOL) and Na, K, P, Ca and Mg levels were also measured and compared. ResultsThere were no significant differences in QoL scores and electrolytes between the two groups before intervention (p > 0.05). After intervention the QoL scores in the intervention group were significantly higher than in the control group (p < 0.05). However, after intervention the levels of Na, K, P and Mg in the intervention group were significantly lower than in the control group (p < 0.05). Calcium level was not significantly different between the two groups after intervention (p = 0.16). ConclusionThe results showed that e-learning is effective in improving the QoL and serum electrolytes of hemodialysis patients. Practice ImplicationsThis paper could serve as support for clinical healthcare professionals to improve patient knowledge and QoL through virtual education methods.

Late toxicity and quality of life with prostate only or whole pelvic radiation therapy in high risk prostate cancer (POP-RT): A randomised trial

AimTo report toxicity and quality of life (QOL) outcomes from a randomised trial of prostate only versus whole pelvic radiotherapy in high risk, node negative prostate cancer. Materials/methodsPatients with localised prostate adenocarcinoma and nodal involvement risk > 20%, were randomised to prostate only (PORT, 68 Gy/25# to prostate) and whole pelvis (WPRT, 68 Gy/25# to prostate and 50 Gy/25# to pelvis) arms with stratification for TURP, Gleason score, baseline PSA, and type of androgen deprivation therapy (ADT). Image guided intensity modulated radiotherapy (IG-IMRT) and two years of ADT were mandatory. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities were graded using RTOG grading. QOL was assessed using EORTC QLQ-C30 and PR-25 questionnaire pre-treatment and every 3–6 months post RT. ResultsTotal 224 patients were randomised (PORT 114, WPRT 110) from November 2011 to August 2017. Median follow up was 44.5 months. No RTOG grade IV toxicity was observed. Acute GI and GU toxicities were similar between both the arms. Cumulative ≥ grade II late GI toxicity was similar for WPRT and PORT (6.5% vs. 3.8%, p = 0.39) but GU toxicity was higher (17.7% vs. 7.5%, p = 0.03). Dosimetric analysis showed higher bladder volume receiving 30–40 Gy in the WPRT arm (V30, 60% vs. 36%, p < 0.001; V40, 41% vs. 25%, p < 0.001). There was no difference in QOL scores of any domain between both arms. ConclusionPelvic irradiation using hypofractionated IG-IMRT resulted in increased grade II or higher late genitourinary toxicity as compared to prostate only RT, but the difference was not reflected in patient reported QOL. Clinicaltrials.gov NCT02302105Prostate Only or Whole Pelvic Radiation Therapy in High Risk Prostate Cancer (POP-RT).

Quality of Life in Uveal Melanoma Patients in Ireland: A Single-Centre Survey

Background: Uveal melanoma and its treatment can influence the physical and psychological well-being of patients in a way that differs from other cancers. Factors influencing quality of life (QOL) include visual impairment, changes in appearance, day-to-day functioning, ocular discomfort, and worry regarding disease recurrence. Objective: We aimed to study both general and disease-specific QOL in uveal melanoma patients in Ireland and compare QOL between a plaque radiotherapy group and an enucleation treatment group. This information was sought to enhance our understanding of QOL issues for uveal melanoma patients, in the context of improving care and providing appropriate psychosocial support. Method: The European Organisation for Research and Treatment of Cancer (EORTC) QOL questionnaires QLQ-C30 and QLQ-OPT30 were completed by patients with uveal melanoma treated by enucleation or brachytherapy. Results: 138 of 206 patients completed the questionnaires. There was no significant difference in QOL scores between treatment groups. Thirty-two percent of patients reported concerns about tumour recurrence elsewhere in the body. The brachytherapy group had a significantly higher “role functioning” score (p = 0.030). Enucleation patients were more likely to have problems with appearance (p < 0.0005). Younger patients (12–54 years of age) were more likely to report headaches (p < 0.0005) and problems with reading (p = 0.042), and they had a lower cognitive functioning score (p = 0.003) than those aged ≥55 years. Conclusions: There was no significant difference in reported QOL between treatment groups. Our data identified a number of vulnerable patient subgroups. By anticipating which patients are more likely to suffer in terms of certain aspects of their QOL, we are better able to provide appropriate and timely psychosocial support.

The Effect of Teamwork on Children With Cleft Lip and Palate and Their Mother's Quality of Life.

Maintaining and improving patients' quality of life (QOL) are regarded as the most important aims in health-care systems. These are directly associated with intervention of health-care providers across the world. The aim of the present study was to evaluate the impact of teamwork on frequency of care provided to children with cleft lip and palate and their mothers' QOL. This analytical epidemiology study was conducted on 101 children with cleft lip and palate and their mothers who were divided into 2 groups: a multidisciplinary team and a group of individual providers. Data were collected using convenience sampling. Quality of Life Questionnaire (Short Form-36) was assessed. The statistical analysis was performed using the χ2 test, independent t test, and Mann-Whitney U test in SPSS (20). Both groups were matched. There was a significant statistical difference among the members of multidisciplinary team who received surgery, genetic counseling, and dental care (P ≤ .043) and the individual providers groups. The 2 groups did not have significant difference in receiving the hearing test, speech therapy, and dental care 12 months before the interview. There were significant differences in QOL scores between the multidisciplinary team and the group of individual providers (P = .013). The services provided as a multidisciplinary team leads to a better outcome and improves the QOL of our patients and their families. It is recommended that services should be provided in the team approach for patients with cleft lip and palate.

Rapid rehabilitation nursing in postoperative patients with colorectal cancer and quality of life.

This study investigated the application of rapid rehabilitation nursing in postoperative patients with colorectal cancer (CRC) and its effect on quality of life (QOL). A prospective analysis was performed on 154 patients with CRC, after radical resection in The Central Hospital of Wuhan from February 2011 to April 2015. During the perioperative period, 96 patients (study group) received fast-track surgery (FTS) and 58 patients (control group) received routine surgery. The postoperative data of patients in the two groups were analyzed in terms of the first anus exhaustion time, the first time getting out of bed, first time eating liquid food, first defecation time, the time of drainage tube removal, time of gastric tube removal, time of suture removal, hospital stay and surgical expenses. Visual Analogue Scale (VAS) was used to assess postoperative pain. The re-hospitalization rate, the incidence of complications 30 days after operation, the survival and QOL scores were analyzed. After discharge patients were followed up for 3 years to observe the 3-year overall survival (OS). VAS scores were lower in the study group than that in the control group at 6, 12, 24, 48 and 72 h after operation (P<0.05). The re-hospitalization rate and incidence of complications 30 days after operation were lower in the study group than those in the control group (P<0.05). Before nursing, there was no statistically significant difference in QOL score between the two groups (P>0.05), whereas after 3 and 12 months of nursing, QOL score was significantly higher in the study group than that in the control group (P<0.05). QOL score in the two groups increased with time, and there were differences between the two groups at each time-point (P<0.05). There was no significant difference in the 3-year OS between the two groups (P>0.05). In conclusion, effectively improving patients' psychological state, reducing complications and relieving pain, the FTS during the perioperative period of CRC surgery promotes postoperative rehabilitation, reduces economic pressures and improves QOL.

A IMPACT OF A PHARMACIST-LED EDUCATIONAL INTERVENTION ON QUALITY OF LIFE AMONG PATIENTS WITH ASTHMA

Objectives: Asthma is a chronic disease resulting in reduced quality of life (QoL) of most affected individuals. Training in asthma-related knowledge, inhaler skills, medicine usage, and the prevention of adverse drug events is demonstrated to improve asthma patients’ QoL. Therefore, the research was conducted to evaluate the effectiveness of education intervention undertaken by pharmacists on QoL of patients with asthma.&#x0D; Methods: We conducted a clinical randomized controlled trial among asthmatic outpatients aged 18 years or older in the Department of Screening Respiratory Function, University Medical Center, Ho Chi Minh City, Vietnam. Patients were randomized into an intervention group (IG) and a non-IG (NIG). The clinical pharmacists’ intervention program included training in asthma-related knowledge, inhaler technique, recognition, prevention of adverse drug events, and lifestyle adjustment. Participant screening was conducted using the telephone on a monthly basis. QoL was measured using the Vietnamese Version of the Mini Asthma QoL Questionnaire (MiniAQLQ). The main outcome was the difference in QoL scores between IG and NIG after 3 months follow-up.&#x0D; Results: After 3 months, the number of patients with asthma in the IG and in the NIG was 173 and 96, respectively. QoL mean scores in the IG patients were significantly higher than those in their NIG counterparts (1.79±1.01 vs. 1.06±0.93, respectively, p&lt;0.001). Pharmacist-based interventions overall QoL scores (multivariate-adjusted regression coefficient =0.362; p&lt;0.001).&#x0D; Conclusions: Clinical pharmacist-led counseling can improve asthmatic patients’ QoL.

Quality of Life Is Worse at 6-10 Years after Radioactive Iodine Treatment of Graves’ Disease as Compared with Antithyroid Drugs or Surgery

Quality of Life Is Worse at 6-10 Years after Radioactive Iodine Treatment of Graves’ Disease as Compared with Antithyroid Drugs or Surgery

Assessment of change in quality of life, carcinoid syndrome symptoms and healthcare resource utilization in patients with carcinoid syndrome

BackgroundThere is limited information on changes over time in carcinoid syndrome (CS) symptoms and quality of life (QoL). This study assessed change in CS symptoms and QoL in patients treated with somatostatin analogs (SSAs) using the Functional Assessment of Cancer Therapy-General (FACT-G) and Patient-Reported Outcomes Measurement Information System (PROMIS)-29 instruments.MethodsPatients ≥18 years old with CS symptoms and treated with SSA or non-SSA agents in the United States were recruited through a patient advocacy group to complete a two-part, anonymous online survey. Time point (T) 1 survey was fielded from July–October 2016, and T2 survey followed 6 months later. Clinical characteristics and SSA treatment duration were assessed at T1. FACT-G and PROMIS-29 QoL surveys were administered and CS symptoms were assessed at T1 and T2; proportions of patients not experiencing symptoms were compared by McNemar’s test. Healthcare resource utilization (HRU) was assessed for the T1-T2 interval, and mean difference in QoL score from T1 to T2 by SSA duration was calculated.ResultsOf 117 participants at T1, 89 (76%) completed the T2 survey and served as the study sample; 11 (13%) were treated with SSAs for > 0–2 years, 37 (42%) for > 2–5 years, and 39 (45%) for > 5 years. A higher proportion of patients at T2 vs. T1 reported the following symptoms as not applicable: diarrhea (16% vs. 7%, p < 0.05), flushing (28% vs. 18%, p < 0.05), wheezing (78% vs 66%, p = 0.008). Most patients (89%) had a physical exam and a mean of 7.2 healthcare provider visits between T1 and T2. Patients treated with SSAs for ≤2 years had a mean positive change of 3.7 in their FACT-G total score between surveys, and 6.0 in an additional set of CS-specific questions. Patients receiving SSAs for > 2 years did not appear to associate with a clinically meaningful improvement in QoL score as assessed by FACT-G between T1 and T2; patients also had no clinically meaningful improvement as assessed by PROMIS-29.ConclusionsThere may be clinically important improvement in QoL as measured by FACT-G in patients in earlier years of receiving SSA, which may not appear in later years of SSA treatment.

Quality of Life in Different Chronic Diseases and Its Related Factors.

Background:Quality of life (QoL) is an important tool for evaluating the effect of a disease as well as effects of treatment interventions. The present study is aimed to investigate QoL of the patients with various prevalent chronic diseases in Iran.Methods:In a cross-sectional study, 625 patients with one of the prevalent chronic diseases were assessed. Participants were recruited via convenient sampling method in special clinics of chronic diseases in three educational hospitals in Qazvin, Iran, from May to December 2016. Data were collected using WHOQOL-BREF and demographic questionnaire through interview. Data were analyzed using independent t-test, ANOVA, Pearson's correlation coefficient, and multiple linear regression method.Results:Significant difference in QoL scores was found in different chronic disease; patients with diabetes and hypertension had higher scores and patients with asthma and chronic obstructive pulmonary disease (COPD) had the lowest scores. Multivariate analysis showed that age, economic status, and type of disease were among the significant variables in predicting the QoL of the patients with chronic diseases.Conclusions:Some patients, such as those with asthma and COPD, had less QoL than other patients and should be prioritized while planning for the promotion of healthcare services. Due to the negative effects of economic status on QoL, the financial support programs should be among the major priorities of the patients’ QoL improvement programs.

Effects of High-Dose Pancreatic Enzyme Replacement Therapy on Body Weight, Nutritional Status, and Quality of Life after Pancreaticoduodenectomy

Introduction: Pancreatic enzyme replacement therapy (PERT) are helpful for pancreatic exocrine insufficiency (PEI) patients on the aspect of nutritional status. However, there was no consensus of PERT for PEI patients after pancreatectomy.This study aimed to investigate the effects of PERT on body weight, nutritional status and quality of life (QoL) in patients with acute-onset PEI after pancreaticoduodenectomy. Method: In this randomized, double-blind, multicenter trial, pancreaticoduodenectomy patients with fecal elastase level ≤200 μg/g at preoperative or postoperative examination were randomly assigned. The PERT group received a single capsule of 40,000 IU pancreatin (Norzyme®) thrice a day during meal for 3 months. Protocol completion was defined as taking more than two thirds of the total dose without taking other digestive enzymes. The primary endpoint was body weight change. The secondary endpoint was changes in bowel habits, nutritional parameters, and QoL. Result: Among 304 patients, 151 and 153 were assigned to the PERT and placebo groups, respectively. From these groups, 71 and 93 patients completed the protocol, respectively. In the per-protocol set, the PERT and placebo groups achieved a weight gain of 1.09 kg and weight loss of 2.28 kg at 3 months, respectively, with significant difference in weight (3.37 kg) between both groups (p<0.001). However, no difference was observed in the intention-to-treat set. The prealbumin level showed significant difference (+10.9 mg/dL vs. +7.8 mg/dL, PERT vs. placebo, p=0.002). Poor compliance to PERT was a significant risk factor for weight loss (p<0.001). Furthermore, no difference in QoL scores according to PERT was noted. Conclusion: As a nutritional support, PERT increases weight and nutritional parameters in postoperative patients with PEI. Active education and monitoring are important to maximize effectiveness. NCT 02127021 (ClinicalTrials.gov)

Quality of life evolution in elderly survivors with localized breast cancer treated with radiotherapy over a three-year follow-up

PurposeThis paper studies the Quality of Life (QL) of elderly early-stage breast cancer survivors. The aims are to compare the QL scores of these patients after follow-up with their scores before the start of radiotherapy (RT) and compare QL among different axillary treatment groups. MethodsOf 173 patients over 65 who began treatment and completed the EORTC QLQ-C30 and QLQ-BR23 and the Interview for Deterioration in Daily Living Activities in Dementia (IDDD) before RT, 138 also completed these questionnaires three years after RT.Longitudinal changes in QL were assessed for the whole sample using linear mixed-effect models. Also assessed were differences in QL scores between axillary treatment groups (axillary node dissection ALND, sentinel lymph node biopsy SLNB, and no surgery) at the end of the follow-up (Anova or Kruskal-Wallis) and differences in the evolution of QL from baseline among these groups (linear regression models). ResultsQL scores in the follow-up were high (>70/100 points) in most QL areas, with moderate limitations (>30) in sexual functioning and enjoyment. Five areas (pain, nausea/vomiting, financial impact, breast symptoms and IDDD) improved significantly (<6 points) in the follow-up.The ALND group scored less for the future perspective item (15–20 points) in the follow-up than the other two axillary treatment groups. No differences between the pre-treatment and follow up assessments regarding treatment were found among the axillary treatment groups. ConclusionsOur results suggest that early-stage breast cancer patients adapted well both to their disease and treatments over the follow-up period and to the administration of RT. There were few QL differences between the axillary treatment groups.

Changes in Quality of Life in Indolent Non-Hodgkin Lymphoma 3 Years after Diagnosis

Background:Most indolent non-Hodgkin lymphomas (NHL) are considered incurable and are characterized by relapse and remission. Quality of life (QOL) can be affected by disease burden, side effects of treatment, and psychosocial effects of living with an incurable cancer. However, little is known about QOL in this population. We sought to describe QOL at diagnosis, change in QOL over time, and determinants of QOL in patients with indolent NHL.Methods:Newly diagnosed lymphoma patients were prospectively enrolled within 9 months of diagnosis in the University of Iowa/Mayo Clinic SPORE Molecular Epidemiology Resource. Eligibility criteria included age ≥18 years; exclusion criteria included HIV-positive, non-US residency, and inability to complete surveys in English. All pathology was reviewed by a hematopathologist. Patients with indolent B-cell NHL were included in this analysis. QOL was measured at baseline (BL) and 3 year follow-up (FU3) with the Functional Assessment of Cancer Therapy-General scale (FACT-G), which measures 4 QOL domains: physical, social/family, emotional, and functional well-being (WB), and a single item Linear Analogue Self-Assessment (LASA) for measuring overall QOL. Patients who did not complete ≥80% of FACT-G questions were excluded. Clinical data were abstracted according to a standard protocol and patients were systematically followed for events (progression, re-treatment, and death). CLL patients were excluded for event analysis due to differing definitions of outcome (progression/retreatment vs. time to first treatment). Treatment was defined as any systemic therapy (including chemotherapy, targeted agents, or antibody therapy) or radiation. QOL scores were transformed to a 0-100 scale with 100 representing the best WB or QOL for analysis. Change in QOL was assessed using the raw difference in QOL scores (i.e., FU3-BL) on the 0-100 scale with positive change scores representing improvements; minimally important difference was defined as 7 points on the transformed FACT-G subscales per previously established cutoffs (Yost and Eton, Eval & Health Prof. 2005 Jun;28:172-91). Changes in QOL from BL to FU3 were assessed using one-sample t-test of change scores vs zero.Results:1050 patients with indolent NHL enrolled between 9/02-12/2012 and with both pre-treatment and 3 year QOL were included. QOL was collected after initiation of therapy in 215 patients (20%) and prior to therapy in 835 (80%). Subtype was 41% CLL/SLL, 32% grade 1-2 FL, 14% extranodal marginal zone, and 13% other (lymphoplasmacytic lymphoma and other). Median age was 62 years and 55% were male. At the FU3 assessment, 577 patients (55%) had received treatment, 42 (4%) transformed, and 53 (25%) had an event.Emotional WB significantly improved from BL to FU3 (mean +5.9, SD 13.3, p<0.001) while social/family WB significantly decreased (mean -4.8, SD 20.5, p<0.001). Functional WB, physical WB, overall FACT-G, and overall QOL LASA were not significantly different at FU3. These findings were similar in those who were treated vs. those who were observed. We also assessed the results stratified by non-CLL patients who had progression or retreatment between BL and FU3. In patients with an event in the first 3 years, emotional WB had a significant improvement from BL to FU3 (mean +3.6, SD 13.6, p=0.002) and overall QOL LASA decreased (mean -4.0, SD 20.0, p=0.01). In patients without an event, improvements were reported in functional WB (mean +2.1, SD 18.2, p=0.01), physical WB (mean +2.5, SD 13.9, p=0.001), emotional WB (mean +7.0, SD 15.0, p<0.001), and overall QOL LASA (mean +1.1, SD 11.4, p=0.03), while social/family WB decreased (mean -6.2, SD 20.3, p<0.001). Sensitivity analysis showed that results were consistent in the subset of patients who had BL QOL collected prior to initiating therapy. While many changes were statistically significant, they were small in magnitude; only the improvement in emotional WB in the entire cohort approached clinical significance and met that criterion in those without an event.Conclusions:In this large sample of patients with indolent lymphoma, QOL generally remained stable from diagnosis to FU3 while emotional WB showed improvement, suggesting psychosocial adaptation by the patient. Mean score changes in functional WB, physical WB, emotional WB, social/family WB, and overall QOL were more pronounced in patients without an event in the first 3 years since diagnosis. DisclosuresShanafelt:Hospira: Research Funding; AbbVie: Research Funding; Celgene: Research Funding; GlaxoSmithKline: Research Funding; Genentech: Research Funding; Jannsen: Research Funding; Pharmacyclics: Research Funding.

Quality of life (QOL) in esophageal cancer patients treated with tri-modality therapy: Is the CROSS protocol better?

132 Background: To investigate the impact of trimodality therapy on QOL in esophageal cancer patients and compare the CROSS regimen to neoadjuvant cisplatin/5FU. Methods: In a non-randomized, prospective cohort study, patients undergoing neoadjuvant chemoradiation (CRT) and esophagectomy between June 2012 and Nov 2015, with esophageal adenocarcinoma or squamous cell cancer, T1-4N0-3 (AJCC 7thEd.), completed the EORTC-QLQ-C30 at baseline, end of RT, 6 months, and then annually. A 10-point difference in QOL scores was considered clinically significant. Results: Of 35 patients, 13 received cisplatin/5FU concurrent with 45-50 Gy/25fr; 22 received carboplatin/paclitaxel with 41.4 Gy/23fr (CROSS). Median follow up was 16 months (range 2-49). Questionnaire compliance ranged from 75-100%. Median differences (MD) for physical, role, cognitive, social, &amp; global function, and fatigue, nausea/vomiting (N/V), pain, appetite, &amp; constipation were clinically worse at the end of RT. Statistical worsening was found at the end of RT for global (MD -17, p = 0.001), physical (-17, p = 0.001), role (-33, p = 0.001), &amp; social function (-17, p = 0.003), and for fatigue (28, p = 0.001), N/V (17, p = 0.003), pain (17, p = 0.01), dyspnea (0, p = 0.015), sleep disorder (0, p = 0.049) &amp; appetite (33.3, p = 0.001). Clinical worsening persisted on several domains at 6 months. All scores at 1 year improved at least to baseline, except role functioning (-17, p = 1.0) and appetite (33, p = 0.5) which were clinically, but not statistically worse. No significant difference in QOL was found between cisplatin/5FU and CROSS groups at baseline or end of RT. At 6 months median scores were statistically significantly better for pain, fatigue, role, social, and global functioning in the CROSS group. Global QOL at 1 year remained significantly better in the CROSS group. Higher baseline global QOL was associated with improved OS (p = 0.04) and DFS (p = 0.02). Conclusions: QOL worsened across several domains until 6 months post-RT. Most scores returned to baseline or improved at 1 year except for role functioning and appetite. A larger cohort or controlled trial is needed to confirm our findings of a better long term QOL with the CROSS regimen.

Investigation on quality of life in patients with inflammatory bowel disease and their family members in Fujian Province

Objective To investigate the quality of life (QOL) and its main influencing factors in patients with inflammatory bowel disease (IBD) and their families members in Fujian Province, and to provide an evidence for guiding the clinical strategy. Methods From September 2015 to March 2016, 114 IBD patients who met the standards, their 97 family members, and 113 irritable bowel syndrome (IBS) patients were enrolled. The QOL was assessed with 36-item short form health survey questionnaire(SF-36). T test, inspection rank and Chi-square were performed for statistical analysis in two groups and multiple group. The influence factors of QOL using multiple linear stepwise regression analysis. Results There was no difference in QOL scores between CD and UC patients ((62.82±18.55) vs (62.60±17.94); t=0.065, P=0.948). The QOL scores of IBD patients were lower than those of IBS patients (62.72±18.18 vs 67.25±16.26), and the difference was statistically significant (t=-1.975, P=0.049). The QOL scores of IBD patients with medical insurance were higher than those of patients without medical insurance (67.13±18.18 vs 57.06±16.68), and the difference was statistically significant (t=3.034, P=0.003). The dimension scores of body pain, general health, social function, emotional function, mental health in IBD patients relatives were lower than those of the general population ((72.29±17.27) vs (85.61±18.37), (60.92±17.08) vs (69.55±21.32), (80.80±15.32) vs (86.85±17.07), (68.38±37.38) vs (76.45±38.45), (61.97±15.30) vs (72.65±16.81), respectively), and the differences were statistically significant (t=-7.597, -4.979, -1.870, -2.125, -6.875, all P<0.05). The total QOL scores of families members of IBD patients with operation history was lower than those of without operation history (64.62±16.74 vs 73.98±14.15), and the difference was statistically significant (t=-2.540, P=0.013). Conclusions The QOL of IBD patients was lower than that of IBS patients. and also The QOL relates with payment types for medical care, and the QOL of family members of IBD patients also decreases. Psychological interventions should be in plemented in both IBD patients and their family members in clinical treatment. Key words: Inflammatory bowel diseases; Family members; SF-36; Quality of life

Glucocorticoid Replacement Regimens in Chronic Adrenal Insufficiency: A Systematic Review and Meta-Analysis

Various glucocorticoid (GC) regimens have been used in the treatment of patients with adrenal insufficiency, yet the differences between such regimens on health outcomes are unclear. We performed a systematic review and meta-analysis to compare the effects of GC regimens on quality of life (QoL), bone density, incidence of adrenal crisis, and death. In pediatric studies, we also searched for final adult height. We searched 6 databases through July 2016. Studies were selected and appraised by independent reviewers. Data were pooled using the profile likelihood random-effects model. We included 34 studies. We found no difference in QoL scores between higher (≥30 mg/day of hydrocortisone [HC] equivalence) vs. lower daily doses (<30 mg/day of HC equivalence) (P = .15) or based on frequency of daily dosing (once, twice or thrice daily). Extended-release (1 study), dual-/modified-release (3 studies), and continuous subcutaneous (3 studies) forms of GCs were associated with higher QoL scores. There was no significant association between dose and type of GC and the incidence of adrenal crises. The effect on bone mineral density was heterogeneous. No data were available on mortality or final adult height in children. The quality of evidence was low due to increased risk of bias, imprecision, and heterogeneity. Extended-/dual-release, and continuous subcutaneous forms of GC may be associated with higher QoL scores. However, this is derived from short-term and imprecise evidence, warranting low confidence. AI = adrenal insufficiency BMD = bone mineral density GC = glucocorticoids HC = hydrocortisone QoL = quality of life RCT = randomized controlled trial.

Impact of Underlying Conditions on Zoster-Related Pain and on Quality of Life Following Zoster.

Background:Chronic conditions have been investigated as risk factors for developing zoster, but in patients suffering from zoster, the impact of underlying conditions in zoster-related pain and quality of life (QOL) remains unclear.Methods:We performed a post hoc analysis of a prospective cohort study in immunocompetent zoster patients aged 50 years or older, conducted by general practitioners in Italy between 2009 and 2010. Zoster symptoms, pain intensity and characteristics, and physical and mental health scores were assessed at baseline (zoster diagnosis) and at 1, 3, and 6 months of follow-up.Results:Among 413 patients enrolled in the study, 73% (303/413) suffered from underlying conditions of which 69% (209/303) were aged 65 or older. Cardiovascular diseases (75%), diabetes (24%), and respiratory diseases (17%) were most frequent. One to three months after onset, zoster patients with underlying conditions experienced more intense zoster-related pain than those without. QOL scores were significantly lower in patients with underlying conditions, and age-adjusted difference in QOL scores between the groups increased over time, demonstrating a slower recovery for patients with underlying conditions.Conclusions:In addition to age, the main risk factor of zoster occurrence and severity, the presence of underlying conditions results in more painful and impactful zoster episodes, creating a significant burden for these patients.

Quality of Life in Spanish advanced non-small-cell lung cancer patients: determinants of global QL and survival analyses.

PurposeThis paper studies the Quality of Life (QL) of Spanish advanced non-small-cell lung cancer (NSCLC) patients receiving platinum-doublet chemotherapy, compares our results with those from studies from other cultural areas, and identifies factors associated with global QL and survival prognostic variables.MethodsEORTC QLQ-C30 and QLQ-LC13 questionnaires were completed three times by 39 patients along treatment and follow-up. Univariate and multivariate logistic regression analyses were performed to study global QL determinants (≤50 points considered low global-QL score). Analyses of prognostic variables for death were performed (Cox proportional hazards models).ResultsQL mean scores in the whole sample were moderately high, with limitations (>30) in physical, role, social functioning, emotional areas, fatigue, pain, neuropathy and global QL. Differences with studies from other cultural areas were mainly found in the lower score for dyspnoea (≥15 points). There were no significant differences in QL scores between the first and second assessments. In six areas, the third assessment was lower than the first and second: fatigue, hair loss (>20 points); physical, social functioning, neuropathy (10–20 points); emotional functioning (5–10 points). The best model to explain the chances of low QL includes, as explanatory variables, high emotional functioning as protective factor and fatigue as risk factor (R2 = 0.70). Eight QL areas (four pain-related) and performance status showed a statistically significant association with survival.ConclusionPatients adapted well to their disease and treatments. Platinum-doublet can be administered in advanced NSCLC patients. Our QL data are in line with those from other cultural areas.

Prospective evaluation of quality of life and sexual functioning after radical trachelectomy for early-stage cervical cancer

Objectives: To longitudinally assess quality of life (QOL), sexual functioning, and satisfaction with healthcare decisions in women who have undergone radical trachelectomy for early-stage cervical cancer.Methods: After institutional review board approval, we prospectively enrolled patients with stage IA1-IB1 cervical cancer before undergoing radical trachelectomy to complete validated instruments to assess QOL. These instruments included the General Health-Related QOL (SF-12), the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx), the MD Anderson Symptom Inventory (MDASI), Female Sexual Functioning Index (FSFI), and Satisfaction with Decision (SWD) scale. Instruments were filled out preoperatively (baseline), 4 to 6 weeks postoperatively, at 6 months, at 1 year, and annually thereafter for 4 years. Mixed modeling was used to test for changes from baseline for the survey instruments. A subanalysis was performed comparing QOL scores based on surgical approach.xResults: Thirty-nine patients enrolled in the study, and 35 patients were evaluable. Four patients were excluded because of conversion to radical hysterectomy or limited study participation time. Median age was 30.8 years (range, 21.4–38.7). Median body mass index was 25 kg/m2 (range, 16.1–44.4). Most patients had stage IB1 disease (51%) and underwent robotic radical trachelectomy (69%). The FSFI-arousal (P = .0001), FSFI-lubrication (P < .0001), FSFI-orgasm (P = .0012), FSFI-satisfaction (P = .02), and FSFI-total (P = .002) showed a significant decline at the 4- to 6-week postoperative visit then returned to baseline levels by 6 months. Similarly, the FACT-Cx physical well-being (P < .0001), FACT-Cx social well-being (P < .0001), SF-12 bodily pain (P < .0001), SF-12 physical functioning (P < .0001), SF-12 physical role (P < 0.0001), and SF-12 social functioning (P = .0002) showed a significant decline at the 4-to 6-week postoperative visit then returned to baseline by 6 months. There were no differences in the MDASI or SWD over the follow-up period. There were no differences in QOL scores based on an open versus minimally invasive surgical approach.Conclusions: Several QOL, sexual, and functional assessments decline immediately postoperatively after radical trachelectomy. However, they return to baseline measures by 6 months postoperatively, affording these patients long-term satisfaction with their procedural outcomes regardless of surgical approach. Objectives: To longitudinally assess quality of life (QOL), sexual functioning, and satisfaction with healthcare decisions in women who have undergone radical trachelectomy for early-stage cervical cancer. Methods: After institutional review board approval, we prospectively enrolled patients with stage IA1-IB1 cervical cancer before undergoing radical trachelectomy to complete validated instruments to assess QOL. These instruments included the General Health-Related QOL (SF-12), the Functional Assessment of Cancer Therapy-Cervix (FACT-Cx), the MD Anderson Symptom Inventory (MDASI), Female Sexual Functioning Index (FSFI), and Satisfaction with Decision (SWD) scale. Instruments were filled out preoperatively (baseline), 4 to 6 weeks postoperatively, at 6 months, at 1 year, and annually thereafter for 4 years. Mixed modeling was used to test for changes from baseline for the survey instruments. A subanalysis was performed comparing QOL scores based on surgical approach. xResults: Thirty-nine patients enrolled in the study, and 35 patients were evaluable. Four patients were excluded because of conversion to radical hysterectomy or limited study participation time. Median age was 30.8 years (range, 21.4–38.7). Median body mass index was 25 kg/m2 (range, 16.1–44.4). Most patients had stage IB1 disease (51%) and underwent robotic radical trachelectomy (69%). The FSFI-arousal (P = .0001), FSFI-lubrication (P < .0001), FSFI-orgasm (P = .0012), FSFI-satisfaction (P = .02), and FSFI-total (P = .002) showed a significant decline at the 4- to 6-week postoperative visit then returned to baseline levels by 6 months. Similarly, the FACT-Cx physical well-being (P < .0001), FACT-Cx social well-being (P < .0001), SF-12 bodily pain (P < .0001), SF-12 physical functioning (P < .0001), SF-12 physical role (P < 0.0001), and SF-12 social functioning (P = .0002) showed a significant decline at the 4-to 6-week postoperative visit then returned to baseline by 6 months. There were no differences in the MDASI or SWD over the follow-up period. There were no differences in QOL scores based on an open versus minimally invasive surgical approach. Conclusions: Several QOL, sexual, and functional assessments decline immediately postoperatively after radical trachelectomy. However, they return to baseline measures by 6 months postoperatively, affording these patients long-term satisfaction with their procedural outcomes regardless of surgical approach.