Health-related Quality Of Life Information Research Articles

Unveiling the Moderating Factors in the Relationship between Physical Activity and Health-Related Quality of Life among University Students during COVID-19: A Mixed Study Design.

This study examines the moderating effects of various factors on the relationship between physical activity (PA) and health-related quality of life (HRQoL) among 287 female college students during the COVID-19 pandemic. Data were collected through an online questionnaire covering health issues, PA, self-esteem, HRQoL, and sociodemographic information, supplemented by semi-structured interviews and focus groups with six participants. Results showed that 46% of respondents had good HRQoL, and 38% were physically active. The interactions of age, socioeconomic status (SES), and academic performance with PA on HRQoL were insignificant. However, physical and mental health problems significantly moderated the PA-HRQoL relationship, accounting for 1% and 4% of the variance, respectively. The qualitative analysis highlighted the need for student activity clubs and mental health support to enhance coping strategies and overall HRQoL. In conclusion, age and SES did not moderate the PA-HRQoL relationship, while physical and mental health issues did. Programs targeting students with health problems are crucial to improving their physical and mental health, thereby enhancing their well-being.

Can we collect health-related quality of life information from anticoagulated atrial fibrillation participants who have recently experienced a bleed? An observational feasibility study in primary and secondary care in Wales and through a UK online forum

ObjectiveTo evaluate the feasibility of recruiting participants diagnosed with atrial fibrillation (AF) taking oral anticoagulation therapies (OATs) and recently experiencing a bleed to collect health-related quality of life (HRQoL) information.DesignObservational...

Health-related quality of life of pediatric brain tumor survivors after treatment in Jordan.

The number of cancer survivors and survivorship are increasing. Health-related quality of life (HRQOL) has not been widely studied in low-and-middle-income countries (LMICs). The aim of this study is to explore HRQOL of childhood brain tumor survivors and its determinants in Jordan. Health-related quality of life information was collected from 80 patients treated at the King Hussein Cancer Center and their parents using the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales questionnaire in Arabic. Multivariable linear OLS regression models were used to analyze correlates of HRQOL and compare differences between child- and parent-reported responses. Health-related quality of life scores reported by survivors and by parents were positively correlated on all subscales and total PedsQL scores (r = 0.59, P = .001). Survivors reported better HRQOL in cognitive subscale (β = 0.56, P = .03) and worse HRQOL in work subscale (β = 0.43, P = .04), but no significant differences in the physical, emotional, and social subscales and total PedsQL scores. Significant predictors of HRQOL reported by parents and by children were different. Supratentorial tumor location was associated with a 10.97-unit lower physical HRQOL score, and recurrence of tumors predicted a 17.5-unit lower total HRQOL score, indicating worse quality of life. Male gender (β = 14.9, P = .002) and diagnosis of hypopituitarism (β = 16.1, P = .03) were associated with better HRQOL. Furthermore, patients that only had radiotherapy treatment had better emotional HRQOL (β = 32.9, P = .006) compared to patients that had combined radiotherapy and chemotherapy. This study provides evidence on determinants of HRQOL of pediatric brain tumor patients in Jordan. Future studies need to capitalize on the findings of this study to institute a system for regular assessment of quality of life of pediatric cancer patients in Jordan and other countries with similar health care systems and sociocultural backgrounds.

Health-related quality of life after first venous thromboembolism in individuals aged 70 years and older

BackgroundThere is limited information on short- and long-term effects of venous thromboembolism (VTE) on health-related quality of life (HRQoL) in the elderly. ObjectivesTo assess change in generic HRQoL and disease-specific HRQoL in patients 1 year after the VTE. MethodsThe Age and Thrombosis, Acquired and Genetic risk factors in the elderly (AT-AGE) study is a 2-center case-control study performed in Leiden, the Netherlands, and Vermont, United States, among individuals aged ≥70 years. We measured generic HRQoL using the 36-item Short Form Health Survey (SF-36) and disease-specific HRQoL using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms Questionnaire (VEINES-QoL/Sym) and the Pulmonary Embolism–Specific Quality of Life Questionnaire (PEmb-QoL). All patients completed these questionnaires shortly after their VTE and 1 year later, while controls completed the 36-item Short Form Health Survey questionnaire once. Linear regression for change in quality of life scores was performed and adjusted for potential confounders. ResultsFor the current analysis, we included patients who were visited twice (n = 316) and controls (n = 427) with HRQoL information. Mean age of patients and controls was similar (78.8 vs 75.5 years). In patients who survived at least 1 year after the VTE, generic HRQoL improved for both summary scores, but it did not reach the level of the age-matched controls: physical and mental summary scores increased by 5.6 and 5.5 points, respectively, but compared with controls, remained 8.2 and 6.4 points lower. For disease-specific HRQoL, the Pulmonary Embolism–Specific Quality of Life Questionnaire overall score decreased from 21.7% to 15.2%, indicating improved HRQoL. Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms Questionnaire scores did not change over time. ConclusionOverall, the quality of life of patients with VTE was worse than that of controls after 1 year, indicating a long-term impact of VTE diagnosis in the elderly.

Inequality in quality-adjusted life expectancy by educational attainment in Norway: an observational study

BackgroundHealth inequalities are often assessed in terms of life expectancy or health-related quality of life (HRQoL). Few studies combine both aspects into quality-adjusted life expectancy (QALE) to derive comprehensive estimates of lifetime health inequality. Furthermore, little is known about the sensitivity of estimated inequalities in QALE to different sources of HRQoL information. This study assesses inequalities in QALE by educational attainment in Norway using two different measures of HRQoL.MethodsWe combine full population life tables from Statistics Norway with survey data from the Tromsø study, a representative sample of the Norwegian population aged ≥ 40. HRQoL is measured using the EQ-5D-5L and EQ-VAS instruments. Life expectancy and QALE at 40 years of age are calculated using the Sullivan-Chiang method and are stratified by educational attainment. Inequality is measured as the absolute and relative gap between individuals with lowest (i.e. primary school) and highest (university degree 4 + years) educational attainment.ResultsPeople with the highest educational attainment can expect to live longer lives (men: + 17.9% (95%CI: 16.4 to 19.5%), women: + 13.0% (95%CI: 10.6 to 15.5%)) and have higher QALE (men: + 22.4% (95%CI: 20.4 to 24.4%), women: + 18.3% (95%CI: 15.2 to 21.6%); measured using EQ-5D-5L) than individuals with primary school education. Relative inequality is larger when HRQoL is measured using EQ-VAS.ConclusionHealth inequalities by educational attainment become wider when measured in QALE rather than LE, and the degree of this widening is larger when measuring HRQoL by EQ-VAS than by EQ-5D-5L. We find a sizable educational gradient in lifetime health in Norway, one of the most developed and egalitarian societies in the world. Our estimates provide a benchmark against which other countries can be compared.

Health-related quality of life of Kuwaiti adults living with diabetes.

Diabetes is known to compromise patients' health-related quality of life (HRQoL). It is important to understand the HRQoL of Kuwaiti nationals living with diabetes and identify factors that negatively affect it. This study included 1,182 Kuwaiti nationals with diabetes, aged 18-80 years. Patients' demographic and HRQoL information was collected using the EuroQol EQ-5D-5L instrument. Mean values for each EQ-5D subscale were worst for mobility (1.9) and pain/discomfort (1.8). Most patients reported having no problems in self-care (84.4%). Older adults were most likely to report severe problems with mobility (p < 0.001). Females were more likely to report severe problems with anxiety and depression than males (p < 0.006). The EQ visual analog scale (EQ VAS), which reports perceived overall health on a 0-100 scale, showed a mean of 74.7 (±19.6). Patients with comorbidities and/or complications perceived their health to be worse, with VAS scores significantly lower (p < 0.001). Other factors that negatively affected VAS scores were being female, obesity, insulin usage, and lower levels of education. In conclusion, patients with diabetes who have comorbidities and/or complications perceived their health to be worse. Further research is required to evaluate if current diabetes management interventions help improve patients' HRQoL.

Evaluation of the Value of Chemotherapy

A pharmacist is "a person prepared to formulate, dispense, and provide clinical information on drugs or medications to health professionals and patients." A pharmacist is one member of the health care team, and he/she plays a key role in providing quality health and pharmaceutical care to the public. Health-related quality of life (HRQoL) is a useful indicator of a patients' overall health, and it can be estimated by questionnaire survey as patient-reported outcome. The development of an innovative method that extracts HRQoL data from compounding information from pharmacies and pharmacy department in hospital may be useful for a patient-centered medical care. In the near future, pharmacists will have to demonstrate their ability to create value for drug therapy by collecting HRQoL information that corresponds to the national policy of cost-effectiveness. In particular, evaluation of the value of chemotherapy is a problem involving education, clinical techniques, and society, so all pharmacists should work on this as a national topic.

Health-related quality of life and associated factors among non-melanoma skin cancer patients: a cross-sectional study.

Non-melanoma skin cancer (NMSC) is a common malignant tumor that can lead to disability and a high recurrence rate, thus affecting the health-related quality of life (HRQoL) of patients. However, the HRQoL and its associated factors among Chinese patients with NMSC remain unknown. Considering HRQoL is a comprehensive indicator to assess an individual's health and well-being, as well as to provide a basis for future treatment decisions and care interventions, we investigated Chinese NMSC patients to assess the status of HRQoL, and to explore the associated factors of HRQoL. This cross-sectional study was conducted at the largest dermatology hospital in China from November 2017 to February 2022. Participants were over 18 years, diagnosed with NMSC by pathological examination, and able to provide informed consent. A consecutive sampling technique was used and 202 eligible patients with NMSC were surveyed. Dermatology Life Quality Index, general information questionnaire, Athens Insomnia Scale, and Self-rating Anxiety Scale were used to measure their HRQoL and relevant information. Descriptive statistics, non-parametric test and Spearman's correlation analyses were used to compare the differences and assess the relationships between participants' demographic and clinical factors, sleep, anxiety, and HRQoL. Multiple linear regression analysis was performed to identify factors associated with HRQoL. A total of 176 NMSC patients (mean age 66 years, including 83 males and 93 females) were included. The median score of HRQoL was 3 [1, 7], and 116 (65.9%) NMSC patients' HRQoL was negatively affected. The score of the symptom and feeling domain was the highest 2 [1, 3], NMSC patients with squamous cell carcinoma and extramammary Paget disease had a significantly lower HRQoL than patients with basal cell carcinoma (P<0.05). Primary skin diseases, long-term history of mechanical stimulation, poor sleep, and anxiety were the associated factors of the HRQoL, comprising 43.5% of the total variance. Most patients with NMSC live with poor HRQoL in China. It is necessary to provide timely assessment and develop targeted strategies to improve NMSC patients' HRQoL, such as multiple forms of health education, psychological care for the target population, and effective measures to improve patients' sleep.

Rate versus rhythm control in patients with newly diagnosed atrial fibrillation: Effects of the treatment timing on health status outcomes

Recent randomized clinical trials have demonstrated that applying rhythm control during the early stage of atrial fibrillation (AF) may lead to improved clinical outcomes. However, the effects of this modality on health-related quality of life (HRQoL) have not been fully investigated. We aimed to assess the association between the AF stage, determined by the time between AF diagnosis and referral to the cardiology clinic, and HRQoL outcomes. Using an outpatients-based multicenter AF registry (n=3,313), we analyzed 2,070 patients with AF diagnosed within 5 years. The patients were divided into 2 groups according to AF stage: early and late AF (AF duration ≤1 and >1 year, respectively). All patients had HRQoL information collected at baseline and 1 year after their initial treatment (assessed via the Atrial Fibrillation Effect on Quality-of-Life-overall summary [AFEQT-OS] score, with higher scores reflecting better HRQoL). The change in AFEQT-OS was adjusted for patient characteristics using a generalized linear mixed model. The early AF group (n=1,644) was older (early, 68.5 ± 11.1, late, 64.4 ± 10.6 years, P < .001) and had more heart failure (early, 19.9%, late, 12.7%, P < .001) than the late AF group (n=426). At 1 year after treatment, the adjusted changes in AFEQT-OS were similar in patients with rhythm (adjusted difference [SE], early, 8.4 [1.2], late, 7.2 [1.4], P=.15) or rate (early, 4.0 [0.7], late, 2.3 [1.4], P=.16) control, regardless of AF stage. Furthermore, the improvement in HRQoL was similar between early and late AF in patients undergoing catheter ablation (early, 10.2 [2.1], late, 9.8 [2.4], P=.78), whereas a significant difference was observed in those receiving antiarrhythmic drug therapy alone (early, 10.2 [1.4], late, 3.5 [2.2], P < .001). Rhythm control therapy provided clinically meaningful improvements in HRQoL, regardless of AF stage. For patients with impaired HRQoL, AF duration should not be a deterrent to treatment, especially catheter ablation.

Relationship among health-related quality of life and global ancestry, clinical and socioeconomic factors in type 1 diabetes in an admixed Brazilian population

We aimed to evaluate the Health-related quality of life (HRQoL) of Type 1 diabetes mellitus (T1D) patients in an admixed Brazilian population. This is a cross-sectional study with 152 T1D patients. HRQoL information was obtained from two self-completed questionnaires: Short Form-6 dimensions and EuroQol-5 dimensions with visual analog scale. For inference of global ancestry, the panel of 46 autosomal informational insertion/deletion ancestry markers was used. Demographic and socioeconomic data, presence of chronic complications, glycemic control level, and type of treatment were obtained. Patients with good HRQoL were: male, under 18 years old, had health insurance, less than 5 years of diagnosis, practiced physical activity, without hypoglycemia in the last 30 days, absence of retinopathy and nephropathy, a participant in educational activities, used analogous insulin, monitoring blood glucose, observed maximum adherence to treatment and came from the secondary service. Global ancestry and self-reported color/race did not influence HRQoL indexes. Our study is the first to measure HRQoL, global ancestry and recognize the impact of T1D on the lives of patients in the State of Maranhão, Brazil. The results validate the need to provide T1D patients with continuous training on self-management and self-monitoring, aiming for better results in metabolic control and, subsequently, in the prevention of acute and chronic complications, in order to generate positive impacts on the quality of life of this population. We understand that global ancestry in a highly mixed population such as ours did not influence the HRQoL of these patients.

Abstract 5867: Examination of race/ethnicity differences in patient reported outcomes (PROs) among elderly female breast cancer patients in the SEER-MHOS database

Abstract We use regression models to examine baseline differences in physical and mental health PROs [Physical and Mental Component Summary T-scores (PCS/MCS: are linear transformations of the 0-100 possible range scoring for 8 SF-36/VR-12 sub-scales, with mean of 50 and standard deviation (SD) of 10, normed to the US population)] among non-Hispanic black (NHB), non-Hispanic white (NHW), and Hispanic elderly female patients, with newly diagnosed breast cancer (BC) between 2010-2015 in the Surveillance, Epidemiology and End Results-Medicare Health Outcomes Survey (SEER-MHOS) database (a cancer registry that provides value health-related quality of life information on patients enrolled in Medicare Advantage). The study analytic sample consisted of 11,765 NHW, 1,988 NHB and 1,361 Hispanic women with overall mean age and BMI of 50.1 years (SD: 10.5) and 27.5 kg/m^2 (SD: 6.6), respectively. Compared with NHW both NHB and Hispanic women had significantly elevated BMI [NHB risk difference (RD) 3.43, 95% CI: 3.09, 3.77; Hispanic RD 0.84, 95% CI: 0.44, 1.24]; but significantly lower age at diagnosis [NHB RD -2.86, 95% CI: -3.36, -2.37; Hispanic RD -1.67, 95% CI: -2.26, -1.09]. Compared with NHW, both crude PCS and MCS scores were significantly worse for NHB and Hispanic women [PCS: NHB RD -4.26, 95% CI: -4.87, -3.65; Hispanic RD -3.29, 95% CI: -4.01, -2.56; MCS: NHB RD -3.79, 95% CI: -4.37, -3.22; Hispanic RD -4.09, 95% CI: -4.76, -3.43]. These differences also persisted after adjustment for BMI and age [compared with NHW, PCS: NHB RD -2.09, 95% CI: -2.76, -1.43; Hispanic RD -3.26, 95% CI: -4.06, -2.45; MCS: NHB RD -3.2, 95% CI: -3.86, -2.54; Hispanic RD -4.21, 95% CI: -4.99, -3.43]. There were however no significant differences in PCS or MCS scores between NHB and Hispanic women after adjustment for age and BMI. Our results show that elderly NHB and Hispanic women with BC in the SEER-MHOS database are significantly more likely to have poorer physical and mental outcomes compared with NHW. However, this PRO disparity was not evident between NHB and Hispanic women and requires further exploration. Citation Format: Kendra R. Krebsbach, Chloe L. Stallion, Keith A. Dookeran. Examination of race/ethnicity differences in patient reported outcomes (PROs) among elderly female breast cancer patients in the SEER-MHOS database [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5867.

Health-related quality of life of female sex workers living with HIV in South Africa: a cross-sectional study.

IntroductionHealth‐related quality of life (HRQoL) is an important HIV outcome beyond viral suppression. However, there are limited data characterizing HRQoL of key populations, including female sex workers (FSW) living with HIV.MethodsWe used baseline data (22 June 2018–23 March 2020) of FSW who were diagnosed with HIV and enrolled into a randomized trial in Durban, South Africa. HRQoL information was collected by a generic preference‐accompanied tool with five domains (EQ‐5D), and summarized into a single score (range 0–1), which represents health utility. We employed multivariable beta regression models to identify determinants of HRQoL and to estimate subgroup‐specific HRQoL score. Using external estimates of life expectancy and population size, we estimated the number of quality adjusted life years reduced among FSW living with HIV in South Africa associated with violence and drug use.ResultsOf 1,363 individuals (mean age: 32.4 years; mean HRQoL score: 0.857) in our analysis, 62.6% used drugs, 61.3% experienced physical or sexual violence and 64.6% self‐reported taking antiretroviral treatment (ART). The following were associated with a reduction in the average marginal HRQoL score: older age (per decade: 0.018 [95% confidence interval (CI): 0.008, 0.027]), drug use (0.022 [0.007, 0.036]), experience of violence (0.024 [0.010, 0.038]) and moderate (vs. no) level of internalized stigma (0.023 [0.004, 0.041]). Current ART use was associated with a 0.015‐point (–0.001, 0.031) increase in the HRQoL score. The estimated mean (95% CI) HRQoL scores ranged from 0.838 (0.816, 0.860) for FSW who used drugs, experienced violence and were not on ART; to 0.899 (0.883, 0.916) for FSW who did not use drugs nor experience violence and were on ART. Our results can be translated into a reduction in 37,184 and 39,722 quality adjusted life years related to drug use and experience of violence, respectively, in South Africa.ConclusionsThese results demonstrate the association of ART with higher HRQoL among FSW and the need to further address structural risks, including drug use, violence and stigma. Population‐specific estimates of HRQoL score can be further used to calculate quality‐adjusted life years in economic evaluations of individual and structural interventions addressing the needs of FSW living with HIV.Clinical Trial RegistrationNCT03500172 (April 17, 2018).

Extracting Health-Related Quality of Life Information from Patient Language in Thyroid Cancer Using BERT

Extracting Health-Related Quality of Life Information from Patient Language in Thyroid Cancer Using BERT

Acceptability to making a self-assessment using a tablet computer and health-related quality of life in ambulatory breast cancer patients

ObjectiveThe purpose of this study was to examine patient acceptability to making self-assessments of their health conditions using a tablet computer-based questionnaire and identify associations between acceptability and health-related quality of life (HR-QOL). MethodsThis study used a convenience sample of 54 patients with breast cancer being treated in an outpatient setting. Participants made self-assessments using a tablet computer-based questionnaire and upon completion they received a report of their results. The HR-QOL self-assessment questionnaire comprised three standardized instruments. Participants gave interviews and completed a survey at home. A follow-up, paper–based HR-QOL self-assessment was completed one month later. ResultsMaking a self-assessment with a tablet computer was acceptable to most participants, and several factors were identified to be associated with self-assessment making and patient HR-QOL. Participants' who were experiencing symptoms, interference, deteriorating physical function, and unsatisfactory levels of well-being were more favorably disposed toward making a self-assessment. At the one-month follow-up survey, however, participants’ subjective well-being and physical function had decreased on average. ConclusionsPatients found the HR-QOL self-assessments easy to complete in the clinical setting, and those with symptoms were particularly interested in completing the assessment. However, simply providing HR-QOL information to patients only (and not to staff) was insufficient to improve HR-QOL long-term, which decreased for participants over the month following the initial HR-QOL self-assessment. Thus, the findings of this study encourage the integration of HR-QOL self-assessments into clinical care at the time of the clinic visit, so they can be used in real time to improve HR-QOL.

How are Child-Specific Utility Instruments Used in Decision Making in Australia? A Review of Pharmaceutical Benefits Advisory Committee Public Summary Documents.

Measuring and valuing health-related quality of life (HRQOL) in children can be challenging but is an important component for providing decision makers with accurate information to fund new interventions, including medicines and vaccines for public subsidy. We review funding submissions of medicines made to the Pharmaceutical Benefits Advisory Committee contained in public summary documents to examine the use of child-specific HRQOL measures in decision making in Australia. A sample frame of medicines used by children was derived from four sources. Public summary documents relating to these medicines were searched in the Pharmaceutical Benefits Advisory Committee web resources for whether they related to children (aged under 18 years) and contained HRQOL information and/or cost-utility analyses. Data about the use of utilities in decision making were extracted and analysed. Of the 1889 public summary documents available, 62 public summary documents (29 medicines) contained information pertaining to children and utilities. Of these, four public summary documents included child-specific HRQOL measures, 16 included adult HRQOL measures, 11 included direct elicitation and the HRQOL source was not defined in 31 documents. Excluding documents using child-specific HRQOL measures, we considered that in 85% of medicines, decision making uncertainty might have been reduced by using child-specific HRQOL measures. Despite the growing literature on economic analysis in paediatric populations, the use of child-specific HRQOL measures in submissions to the Pharmaceutical Benefits Advisory Committee was minimal. Submissions involved inconsistent approaches, use of adult measures and weights, and substantial gaps in evidence. We recommend the consistent use of child-specific measures to improve the evidence base for decisions about medicines for children in Australia.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40273-021-01107-5.

P06.03 Child, parent, and clinician selection of patient-reported outcome measures to use in pediatric neuro-oncology outpatient follow-up clinics

Abstract BACKGROUND Survivors of childhood brain tumours are at risk of poor health-related quality of life (HRQoL). Appropriate and relevant measures can be used to monitor HRQoL so that timely interventions may be made for issues thus identified. We had previously selected patient-reported outcome measures (PROMs) with good psychometric properties that had emerged as well-suited for this use in two systematic reviews. The aim of the present study was to ascertain the views of families regarding the suitability of the selected measures for use in paediatric neuro-oncology follow-up clinics. These views were then used to inform the choice of PROMs for use on the KLIK PROM portal, a website designed to gather HRQoL information from families. MATERIAL AND METHODS As part of the PROMOTE study, we used a multi-centre, multi-informant, cross-sectional, qualitative methods research design. Using ‘think aloud’ audio-recorded interviews, children aged 8–17 years diagnosed within the previous five years with a brain tumour, off treatment and receiving outpatient care, and their parents, were shown a total of nine PROMs and asked to express their views on which they preferred. Detailed notes were made of all audio-recordings by two independent researchers. The final choice of PROMs to be included on the KLIK PROM portal was agreed through discussion of the PROMs selected by families with an expert panel of clinicians, researchers, and parent representatives. RESULTS 16 children and 17 parents participated and of these 2 children and 2 parents did not express a preference. The Pediatric Quality of Life Inventory (PedsQL) Core module was the most popular among the children and parents with 7/14 (50%) of children selecting it as either their 1st or 2nd choice citing that they liked the questions and felt them to be most relevant to them, and 8/15 (53%) of parents citing that it was easy, quick and simple, the wording was easy, and they liked the questions about emotional, social, and school functioning. The least popular questionnaires, with no participants selecting them as first choices, were the Kidscreen-10 and the Health Utilities Index. The latter 2 were selected only as 2nd or lower choices by 1 child and 3 parents respectively. CONCLUSION The PROMs that were finally selected for the KLIK PROM portal were the parent- and child-report PedsQL-Core measures of HRQoL due to their good psychometric properties, family and clinician preference and perceived relevance to follow-up care, and for clinical utility on the KLIK PROM portal.

Nutritional Status and Health-Related Quality of Life among Knee and Hip Osteoarthritis Patients under Rehabilitation Care in Kuala Nerus, Terengganu, Malaysia.

Introduction:The World Health Organisation (WHO) has estimated that 80% of people with osteoarthritis (OA) have movement limitations while 25% of them cannot perform their major daily activities, thus resulting in a decline of their nutritional status and quality of life (QOL). Therefore, this study aimed to compare the nutritional status and health-related quality of life (HRQOL) of OA patients between gender and age group.Material and Methods:A cross-sectional study was conducted on 131 OA patients in Rehabilitation Health Organisation, Terengganu. Socio-demographic, clinical, lifestyle histories, 24-hour dietary intake and HRQOL were assessed using a structured questionnaire.Results:Knee and/or hip OA patients recruited consisted of 19.1% of men and 80.9 % of women collectively with a mean age of 61.81 (9.28) years ranging from 38 to 83 years. The percentages of underweight, normal, overweight, and obese patients were 1.5%, 12.2%, 36.7%, and 49.6%, respectively. Further assessment of HRQOL showed that the highest mean score was obtained by the social functioning (SF) domain of 41.25 (27.16), while the mental domain scored the least mean score of 21.15 (20.92). In terms of gender breakdown, the males had significantly greater weight and height but lower body fat (BF) compared to their female counterparts, as well as a significantly higher energy, carbohydrate and protein intake. According to the age group, patients aged < 60 years had significantly greater weight, height, and BF than those aged ≥ 60 years.Conclusion:This study is an important baseline reference for proper OA management and prevention by providing crucial nutritional status and HRQOL information.

Health-related quality of life among dentists in Middle-East countries – A cross-sectional study

Background: Health-related quality of life (HRQoL) is an essential concept for all health professionals. It is used to assess material, physical, social, emotional, and productive well-being. Health professionals investigate the HRQoL for their patients but rarely for themselves. Aim: To investigate the HRQoL among dentists in Middle-East countries. Materials and Methods: A multicenter and multi-regional stratified sample of 339 dentists (220 females and 119 males) with a mean age of 37 ± 9 years and 13 ± 8 years of experiences in dental practices in Middle-East countries participated in the study. HRQoL was assessed using the short form-8 (SF-8) health survey. The study group was examined based on HRQOL differences in age, gender, income, and overall QoL. The IBM® SPSS Statistics version 21 (IBM Corp., Armonk, USA) statistical software package was used for data analysis. The Spearman correlation coefficient and independent t-tests were used and significance was set at P ≤0.05. Results: The study observed that HRQoL among Middle East dental practitioners were within the published accepted general population range, in both physical component summary and mental component summary summaries of SF-8. The study also observed that gender differences had no role in terms of HRQoL among dental practitioners (P = 0.64). Conclusions: The study concluded that dentists have a positive HRQoL and no gender differences in HRQoL along with their years of dental practice. It is important that rehabilitation specialists have enough HRQoL information on different health-care professionals and geographical distribution to enable them to adopt an appropriate strategy and healthcare polices for a better outcome.

Burden of Illness of Sickle Cell Disease in Countries of the Middle East: A Systematic Literature Review

Background: Sickle cell disease (SCD) is a group of hereditary hemolytic disorders characterized by abnormal hemoglobin molecules that distort red blood cells (RBCs) into a rigid, sickle-like shape. The global burden of SCD is substantial. In North America and Europe, the incidence and prevalence of SCD range from approximately 0.00008% to 0.274% and 0.01% to 0.05%, respectively. In these regions, the median age at death for patients with the disease ranges from 40 to 60 years, and childhood mortality has steadily dropped in recent years. Sickle cell disease is more common in certain ethnic groups and is most prominent in malaria-endemic regions, as individuals who are heterozygous for the sickle cell mutation are relatively protected against malaria infection. One such region is the Middle East, where the incidence and prevalence rates of SCD in some countries are amongst the highest in the world, and childhood mortality rates for patients with SCD are relatively high. However, the overall burden of illness-encompassing various aspects of disease and their impact on costs and health outcomes-is largely uncharacterized for SCD in Middle Eastern countries. Understanding the burden of illness of SCD in this region could help to inform and prioritize health care policies and assist in the allocation of health care resources. Objective: To understand the burden of illness of SCD in Middle Eastern countries by identifying available information using a systematic literature review (SLR). Methods: A systematic literature search of English-language studies published within five years of the search date (July 2018) was conducted using PubMed and EMBASE databases. Pre-defined population, intervention, comparator, and outcomes (PICO) criteria were used to identify relevant studies conducted in Middle Eastern countries. All patient populations with SCD receiving any approved or guideline-recommended medical interventions were of interest. Studies that reported any outcomes related to burden of illness such as epidemiology, treatment patterns, prognosis, health-related quality of life (HRQoL), and economic information were included. All study types were included except for case reports and conference meeting minutes. Results: Twenty-three studies from Middle Eastern countries met the inclusion criteria (Figure 1). Of these studies, eight were from Saudi Arabia, one was from the United Arab Emirates, six were from Bahrain, three were from Lebanon, one was from Oman, one was from Kuwait, and three were from Egypt. Epidemiological information was captured for six countries, treatment pattern information was captured for three countries, disease prognosis information was captured for six countries, HRQoL information was captured for two countries, and cost information was captured for one country. Overall, the incidence and prevalence of SCD in Middle Eastern countries both ranged from approximately 0.04% to 2.1%. Vaso-occlusive crises (VOC), acute chest syndrome (ACS), acute splenic sequestration events, viral infections, and anemic/hemolytic events were the most common causes of hospitalization; however, the rates generally differed between countries. Limited information was available for disease prognosis; factors related to high mortality included age, frequency of hospitalizations, and length of stay in the ICU. Information on HRQoL was even further limited; only two studies captured by the search reported this type of data. In these two studies, SCD patients experienced a reduced QoL compared with non-diseased controls. The reported reductions in QoL for SCD patients were associated with poor education, age of onset of ACS and blood transfusion in the three-month period preceding the study, and specific physical symptoms including fever and pain. Finally, the only published economic information identified by the search was the cost of screening for SCD with high-performance liquid chromatography (HPLC) in Lebanon ($3.50 per newborn). Conclusions: Substantial data gaps across all aspects of burden of illness were identified. Moreover, the data captured-especially for HRQoL and costs-were limited and reported in very few countries. These findings highlight the importance of further characterizing the burden of illness of SCD in the Middle East, where the incidence and prevalence rates of the disease are relatively high. Disclosures Bailey: Novartis: Employment. Gibbs:Novartis: Employment. Dani:Novartis: Employment. Mendell:Novartis: Consultancy. Thompson:Novartis: Consultancy.

Regional multidisciplinary team intervention programme to improve colorectal cancer outcomes: study protocol for the Yorkshire Cancer Research Bowel Cancer Improvement Programme (YCR BCIP)

IntroductionAlthough colorectal cancer outcomes in England are improving, they remain poorer than many comparable countries. Yorkshire Cancer Research has, therefore, established a Bowel Cancer Improvement Programme (YCR BCIP) to improve...