Generic Health-related Quality Of Life Questionnaires Research Articles

Health related quality of life in individuals with asthma related symptoms

Background: Where evidence is required for disease-area prioritisation (e.g. by national policymakers), impact on health related quality of life (HRQoL) can be considered equitably across diseases using quantitative data from generic HRQoL instruments. Before this can take place, it must be shown that the instrument captures HRQoL impairment associated with each disease area. Aim: To ascertain whether the HRQoL impairment associated with respiratory disease can be represented by responses to EQ-5D, a generic HRQoL questionnaire. Method: EQ-5D and a respiratory health questionnaire were sent to 10,471 adults registered with two general practices in Manchester, UK. EQ-5D examines 5 domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) and includes an overall rating via visual analogue scale. Societal valuations of domain responses were also considered. Results: HRQoL was substantially reduced in respondents who were likely to have obstructive airways disease (mean EQ-5D index 0.63 compared to 0.82, t-test P<0.001; mean EQ-5D vas 62.7 compared to 77.6, t-test P<0.001) and was negatively associated with respiratory symptoms, older age and female gender. The association with respiratory problems remained following stratification by age and gender. The deficit in HRQoL associated with increasing age was more pronounced in those likely to have obstructive airways disease. Conclusion: HRQoL measured using EQ-5D is substantially reduced in respondents with respiratory symptoms enabling use of the instrument in inter-disease comparisons.

Improving Health-Related Quality of Life in Gastro-Oesophageal Reflux Disease

Gastro-oesophageal reflux disease (GORD) is a common, chronic disorder that can progress to erosive or ulcerative oesophagitis and other complications. Uncomplicated GORD can be defined using criteria that combine symptom assessment and the impact of symptoms on well being or quality of life. The extent of impairment of health-related quality of life (HRQL) in GORD patients has been evaluated using generic HRQL questionnaires, GORD-specific quality of life questionnaires or a combination of the two types of instruments. The impact of GORD on HRQL in affected individuals is proportional to the frequency and severity of heartburn, and is greater than that associated with many other chronic diseases. In the treatment of GORD, the goal should be complete symptom resolution as this has been shown to be associated with a clinically significant improvement in HRQL. Both drug treatment and surgical intervention have been successful in improving HRQL of patients with GORD when complete symptom resolution can be attained.

Change in Generic and Disease-Specific Health-Related Quality of Life during a One-Year Period in Patients with Newly Detected Chronic Obstructive Pulmonary Disease

Background: Although the health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD) has been assessed by generic or disease-specific HRQoL measures, the responsiveness of the generic HRQoL measures is generally weak. Objectives: To investigate the responses generated by generic and disease-specific HRQoL questionnaires, we prospectively followed the clinical course of patients with newly detected COPD after the initiation of treatment. Methods: A prospective, longitudinal study with a 1-year follow-up was designed. The forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), the Nottingham Health Profile (NHP) as a generic HRQoL measure, and the Chronic Respiratory Disease Questionnaire (CRQ) as a disease-specific HRQoL measure were measured at baseline and at 3, 6, and 12 months after the initiation of standard treatment. Results: Eighty-two patients completed the study. The FEV₁, FVC, and NHP and CRQ scores improved significantly during the first 3 months (p < 0.05). During the last 6 months, although the FEV₁ declined (p < 0.05), the HRQoL assessed by the NHP and CRQ remained elevated. Except for the score on the social isolation section of the NHP at 12 months, all HRQoL scores at 6 and 12 months were significantly improved compared to baseline (p < 0.05). Conclusion: In new patients with COPD, the NHP as well as the CRQ was able to detect changes in the HRQoL associated with effective medical interventions. The influence of the changes in airflow limitation on the HRQoL was weak.

Changes in health related quality of life among patients treated for eating disorders.

To prospectively investigate changes in the perception of health-related quality of life (HRQoL) among eating disorder patients after 2 years of treatment and follow-up and clinical predictors of change. One hundred and thirty-one consecutive subjects were recruited from an eating disorder outpatient clinic. Subjects completed a generic HRQoL questionnaire, the Short Form-36 (SF-36), as well as the Eating Attitudes Test (EAT-40) to measure symptom severity and the Hospital Anxiety and Depression scale (HAD), at the first visit and after 24 months. Perception of HRQoL, measured by the SF-36, showed significant improvement in all but the role emotional domain after 2 years. The greatest improvements were observed in the physical function and social function domains, followed by mental health and vitality. Despite significant improvement in the summary mental health scale, scores after 2 years of treatment and follow-up were still below normative population values of women aged 18-34. Severity of eating disorder symptoms and presence of anxiety or depression at baseline significantly affected improvement in various SF-36 domains. Despite improvements in perception of HRQoL, eating disorder patients were more dysfunctional in all domains of the SF-36 even after 2 years of treatment and follow-up compared with women in the general population, and the severity of eating disorder symptoms was correlated with degree of dysfunction.

The health-related quality of life in eating disorders.

This study investigated the perception of health-related quality of life (HRQoL) in ambulatory patients with eating disorders in relation to the severity of eating symptomatology and psychological comorbidity. One hundred ninety-seven study patients were consecutively recruited at the Eating Disorders Outpatient Clinic. Short Form-36 items (SF-36), a generic HRQoL questionnaire, the Eating Attitudes Test (EAT-40), and the Hospital Anxiety and Depression Scale (HAD) were used to measure different aspects of HRQoL. The results of the SF-36 were compared with the norms of the Spanish general population for women 18-34 years of age. Patients with eating disorders were more dysfunctional in all areas of the SF-36 compared with women in the general population. There were no differences among the eating disorder diagnostic groups. Higher scores on the EAT-40 and the HAD were associated with a perception of greater impairment on all SF-36 subscales. The evaluation of HRQoL in these patients confirms the impact of these disorders on daily life in areas not directly related to eating disorders. The SF-36 is useful for discriminating among different levels of severity of eating disorders and other psychological comorbidities of these patients.

The quality of life of elderly diabetic patients

The objective of this study was to evaluate the health-related quality of life (HRQoL) of elderly diabetic patients. A cross-sectional, questionnaire survey of diabetic subjects aged 65–84 years ( n=177 respondents) from three community health centers in Stockholm County. The HRQoL was assessed by the Swedish Health-Related Quality of Life Survey (SWED-QUAL), a generic HRQoL questionnaire adapted from the Medical Outcomes Study (MOS) and consisting of 67 items covering broad aspects of the HRQoL. Diabetic subjects were compared with age- and gender-matched controls from a random standard population sample (SPS) of the Swedish population. Medical data on the diabetic subjects were extracted from medical records. The HRQoL, as regarded 7 of the 13 scales, was poorer in diabetic subjects than in the SPS controls. These scales were “general health perceptions,” “physical functioning,” “satisfaction with physical health,” “role limitations due to physical health,” “pain,” “sleep problems,” and “role limitations due to emotional health.” Atheromatous complications and nonvascular disease were significant predictors of a poor HRQoL. “Cognitive functioning” was the only HRQoL scale on which diabetic subjects with high levels of HbA 1c (HbA 1c>7.0%) scored worse than those with acceptable levels (HbA 1c<7.0%). In our study, elderly diabetic subjects had a poorer HRQoL than the general population, especially regarding physical health. Poor metabolic control was associated with reduced cognitive function.

The health‐related quality of life of diabetic patients with psychiatric disorders

AbstractPsychiatric disorders are more common in diabetic than in non‐diabetic subjects. The purpose of the present study was to evaluate the effects of psychiatric disorders on the health‐related quality of life (HRQOL) of diabetic patients, using the Swedish Health‐Related Quality of Life Survey (SWED‐QUAL), a generic HRQOL questionnaire developed from the Medical Outcomes Study (MOS). A total of 413 diabetic patients (including both type 1 and type 2) were contacted, and 289 replied to the questionnaire.Diabetic patients with a psychiatric disorder (n = 38) showed a decreased HRQOL on three out of 13 scales (p&lt;0.01) compared with diabetic patients with no psychiatric disorder (n = 251), ie on ‘role limitations due to emotional health’, ‘sleep problems’, and ‘cognitive functioning’. Compared with the standard population sample (SPS) controls, diabetic patients with psychiatric disorders showed a decreased HRQOL on ten scales, and patients with no psychiatric disease on six scales (p&lt;0.01). The use of psycho‐active drugs was associated with a worse outcome with respect to the HRQOL, ie in 24.4% of the diabetic patients, compared with 14.8% with a psychiatric disorder.The conclusion is that patients with psychiatric disorders are a large subgroup in the diabetes population and that these disorders have a considerable impact on the HRQOL, thus demanding special efforts towards better care.