Health-related Quality Of Life Profile Research Articles

Health-related quality of life in Chinese medical staff: a latent profile analysis.

To investigate subgroups of health-related quality of life (HRQoL) in the Chinese medical staff and identify the demographic factors associated with these profiles. 574 Chinese medical staff were surveyed online. HRQoL was measured by using the 36-Item Short Form Health Survey, Version 2. Latent profile analysis (LPA) was used to identify the profiles of HRQoL. The associations between HRQoL profiles and covariates were assessed using multinomial logistic regression. Three HRQoL profiles were developed: low HRQoL at 15.6%, moderate HRQoL at 46.9%, and high HRQoL at 37.6%. Multinomial logistic regression showed night shift times, aerobic exercise conditioning, and personality type significantly predicted the profile membership. Our findings develop earlier approaches that only used total scores to evaluate this group's HRQoL and help them with tailored interventions to promote better HRQoL.

Subjective HRQoL in Patients with Sleep Apnea Syndrome Who Underwent PAP Therapy in a Rehabilitation Setting: A Longitudinal Study

Obstructive sleep apnea (OSA) is often associated with decreased health-related quality of life (HRQoL). The aims of this study were to evaluate HRQoL, the clinical and psychological profile of suspected or verified OSA patients, and the impact of PAP therapy at 1-year follow-up. At T0, OSA-suspected subjects underwent clinical, HRQoL, and psychological assessment. At T1, OSA patients underwent PAP therapy in a multidisciplinary rehabilitation setting. At 1 year follow-up, OSA patients were evaluated for the second time. At T0, OSA patients (n = 283) and suspected OSA subjects (n = 187) differed for AHI, BMI, and ESS. At T0, the PAP-treatment group (n = 101) showed moderate-severe anxious (18.7%) and depressive (11.9%) symptoms. At 1 year follow-up (n = 59), the sleep breathing pattern had normalized and there was a reduction of ESS scores and anxious symptoms. There was also an improvement in HRQoL (0.6 ± 0.4 vs. 0.7 ± 0.5, p = 0.032; 70.4 ± 19.0 vs. 79.2 ± 20.3, p = 0.001) and in satisfaction with sleep quantity (52.3 ± 31.7 vs. 71.4 ± 26.2, p = 0.001), sleep quality (48.1 ± 29.7 vs. 70.9 ± 27.1, p = 0.001), mood (58.5 ± 24.9 vs. 71.0 ± 25.6, p = 0.001), and physical resistance (61.6 ± 28.4 vs. 67.8 ± 27.4, p = 0.039). Considering the impact of PAP treatment on patients' psychological and HRQoL evaluations that we observed, our data are valuable for unveiling different profiles characterizing this clinical population.

Patterns of Health-Related Quality of Life among Stroke Survivors: A Longitudinal Study.

Six months poststroke is critical for optimizing stroke survivors' recovery and improving their health-related quality of life (HRQoL). Understanding HRQoL profiles in specific domains can provide a more typical plan for stroke survivors. This pilot study aimed to explore the HRQoL patterns among 39 stroke survivors within 6 months following diagnosis. The results revealed that there were four patterns based on HRQoL domains. Pattern 1: energy, family role, mobility, self-care, social role, and work/productivity domains likely to improve; Pattern 2: language and vision domains likely to improve and be stable; Pattern 3: thinking and upper extremity function domains likely to worsen and improve later; and Pattern 4: mood and personality domains likely to worsen and be constant. Health care providers can apply these results by continuing to assess and provide care to stroke survivors focusing on functional status, cognitive status, and depression over time. Further study should explore the factors predicting HRQoL.

Health-Related Quality of Life and Financial Burden of Ethiopian Patients with Chronic Myeloid Leukemia Receiving Tyrosine Kinase Inhibitors

Background Assessment of health-related quality of life (HRQoL) of patients with chronic myeloid leukemia (CML) treated with modern tyrosine kinase inhibitors (TKIs) is critical to support informed decision-making. However, HRQoL data currently available mainly stems from patients enrolled in high-income countries. Little is known about HRQoL of patients with CML living in low-income African countries and on the potential impact of financial difficulties experienced by these patients. Purpose The main objective of this study was to examine prevalence of clinically relevant problems and symptoms of Ethiopian patients with CML. A secondary objective was to investigate the impact of financial burden on HRQoL profile of these patients. Methods This was an observational cross-sectional study conducted at Tikur Anbessa Hospital (Addis Ababa), which is the only Ethiopian center providing TKI therapy to CML patients from all over the country. Adult patients (at least 18 years old) with a confirmed diagnosis of CML were eligible for this study. At study entry, HRQoL was assessed with the EORTC QLQ-C30 and the QLQ-CML24 questionnaires. Prevalence of clinically important problems and symptoms, at the patient level, was examined using established criteria for the use of the EORTC QLQ-C30 in routine clinical practice. This prevalence reflects the number of patients indicating limitations of everyday life, worrying, or need for help or care related to a specific symptom or functional impairment (Giesinger JM. J Clin Epidemiol. 2020;118:1-8). For descriptive purposes, EORTC QLQ-CML24 scores of Ethiopian patients were compared to that of patients included in the validation study of this questionnaire, who were mainly enrolled from high-income countries (Efficace F, et al Leuk Lymphoma. 2021;62:669-678). Multivariable linear regression analysis was performed to examine the association between financial difficulty (EORTC QLQ-C30) on "impact on daily life" scale (EORTC QLQ-CML24) while controlling for key potential observed confounding factors. The study was approved from ethical committee of the institution and all patients provided informed consent. Results Between February 2021 and June 2021, 395 patients were consecutively enrolled. Median age of patients was 39 years (range 18-82) and there were 62.8%, and 37.2% of males and females' patients respectively. Median time since diagnosis was 3.9 years (range 0.2-16) and 94% were diagnosed in chronic phase (CP) of the disease. The majority of patients (92.7%) were in treatment with imatinib and, overall, 82.3% were in complete hematologic response but unknown molecular remission status. The majority of patients (82.8%) were not able to afford follow-up BCR-ABL tests to monitor molecular response. The top three most prevalent clinically important problems were found for physical functioning (60%), emotional functioning (40%) and social functioning (38%). Pain was the most prevalent clinically important symptom reported by 43% of patients. Notably, 89% of patients reported relevant financial difficulties. Mean EORTC QLQ-C30 global health status/QoL score of patients with higher financial difficulties was 14 points lower (worse) than those with lower financial difficulties (P<0.001). Gender specific descriptive comparison of Ethiopian patients with CML patients mainly from high-income countries, revealed worse mean scores in key domains of the EORTC QLQ-CML24. For example, male Ethiopian patients reported a higher (worse) mean score (+25.2 points) than male patients from high-income countries (Table 1). In the multivariable analysis, higher financial difficulty, was associated (P<.001) with a greater impact on daily life (EORTC QLQ-CML24) and this was independent of other key variables including: age, sex, time since diagnosis, comorbidity, distance to hospital as well as fatigue and symptom burden. Conclusions Financial burden is a major problem affecting a large proportion of Ethiopian patients with CML receiving TKIs. Our findings also suggest that financial difficulties of these patients are also associated with worse HRQoL outcomes. Future studies are needed to assess whether efforts to reduce financial burden in these patients could improve HRQoL and facilitate adherence to therapy, thereby maximizing TKIs efficacy. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Association of IMWG frailty score with health-related quality of life profile of patients with relapsed refractory multiple myeloma in Italy and the UK: a GIMEMA, multicentre, cross-sectional study

The clinical management of patients with relapsed or refractory multiple myeloma is challenging and there is a paucity of tools to help clinicians make more informed decisions for the most suitable treatment options. We aimed to investigate the clinical utility of the International Myeloma Working Group (IMWG) frailty score in the setting of relapsed or refractory multiple myeloma, by examining its ability to capture different patient-reported health-related quality of life profiles. We did a cross-sectional analysis of a prospective observational study of patients with relapsed or refractory multiple myeloma in Italy and the UK (30 hospitals across northern, central, and southern Italy, and one hospital in London, UK). Inclusion criteria were age 18 years or older and patients who had received at least one previous line of therapy and no more than five lines. Participants were excluded if they had a psychiatric disorder or major cognitive dysfunction, or any grade 3 or higher adverse event within 2 weeks before study entry. On study initiation, physicians had to assess frailty according to the IMWG criteria, which included the Charlson Comorbidity Index, the Katz Activity of Daily Living, and the Lawton Instrumental Activities of Daily Living. Patients were asked to complete patient-reported outcome measures, including the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 (EORTC QLQ-C30) and its validated multiple myeloma module (QLQ-MY20). A multivariable linear regression model was used to assess the mean differences in health-related quality of life scores between frailty groups to account for key potential confounding factors. Overall, between Nov 13, 2017, and Nov 15, 2021, 415 patients with relapsed or refractory multiple myeloma, with a median age of 69·8 years (IQR 62·8-75·2) were enrolled. The median time since diagnosis was 4·4 years (IQR 2·5-7·1) and most patients (351 [85%]) had received at least two previous lines of therapy. According to the IMWG frailty score, 200 (48%) were classified as fit, 112 (27%) were classified as intermediate-fit, and 103 (25%) patients were classified as frail. Each frailty group was associated with a distinct health-related quality of life profile, with most notable differences between fit and frail patients. The largest clinically meaningful adjusted differences between fit and frail patients by the EORTC QLQ-C30 questionnaire were observed for physical functioning (Δ=-19·0 [95% CI -25·6 to -12·5; p<0·0001), fatigue (Δ=16·7 [9·7 to 23·7]; p<0·0001), insomnia (Δ=13·4 [4·1 to 22·6]; p=0·0047), and dyspnoea (Δ=12·5 [4·6 to 20·4]; p=0·0021). The most prevalent clinically important symptom in the overall population was pain; however, its prevalence varied between IMWG frailty groups at 70·9% in frail patients, 55·9% in intermediate-fit patients, and 50·5% in fit patients. Our findings show the clinical utility of the IMWG frailty score in the setting of relapsed or refractory multiple myeloma, in helping to distinguish between groups of patients with distinct health-related quality of life profiles. Further research is needed to examine the value of patient-reported outcome data in improving assessment of frailty in the setting of relapsed or refractory multiple myeloma. Fondazione GIMEMA Franco Mandelli Onlus and Amgen.

EORTC QLQ-C30 general population normative data for Italy by sex, age and health condition: an analysis of 1,036 individuals

BackgroundGeneral population normative values for the widely used health-related quality of life (HRQoL) measure, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire – Core 30 (EORTC QLQ-C30), are available for a range of countries. These are mostly countries in northern Europe. However, there is still a lack of such normative values for southern Europe. Therefore, this study aims to provide sex-, age- and health condition-specific normative values for the general Italian population for the EORTC QLQ-C30.Material and methodsThis study is based on Italian EORTC QLQ-C30 general population data previously collected in an international EORTC project comprising over 15,000 respondents across 15 countries. Recruitment and assessment were carried out via online panels. Quota sampling was used for sex and age groups (18‍–‍39, 40–49, 50–59, 60–69 and ≥ 70 years), separately for each country.We applied weights to match the age and sex distribution in our sample with UN statistics for Italy. Along with descriptive statistics, linear regression models were estimated to describe the associations of sex, age and health condition with the EORTC QLQ-C30 scores.ResultsA total of 1,036 respondents from Italy were included in our analyses. The weighted mean age was 49.3 years, and 536 (51.7%) participants were female. Having at least one health condition was reported by 60.7% of the participants. Men reported better scores than women on all EORTC QLQ-C30 scales but diarrhoea. While the impact of age differed across scales, older age was overall associated with better HRQoL as shown by the summary score. For all scales, differences were in favour of participants who did not report any health condition, compared to those who reported at least one.ConclusionThe Italian normative values for the EORTC QLQ-C30 scales support the interpretation of HRQoL profiles in Italian cancer populations. The strong impact of health conditions on EORTC QLQ-C30 scores highlights the importance of adjusting for the impact of comorbidities in cancer patients when interpreting HRQoL data.

Health-related quality of life profile of Indonesian children and its determinants: a community-based study

BackgroundAssessing health-related quality of life (HRQOL) and its determinants in children may provide a comprehensive view of child health. The study aimed to assess the HRQOL in Indonesian children and its determinants.MethodsWe conducted a community-based cross-sectional study in the Sleman District of Yogyakarta Special Province, Indonesia, from August to November 2019. We recruited children aged 2 to 18 years old using the Sleman Health and Demography Surveillance System sample frame. We used the validated Indonesian version of Pediatric Quality of life Inventory™ (Peds QL™) 4.0 Generic core scale, proxy-reports, and self-reports, to assess the HRQOL.ResultsWe recruited 633 proxies and 531 children aged 2–18 years. The mean total score of self-report and proxy-report were 89.9+ 8.5 and 93.3 + 6.4. There was a fair to moderate correlation between self-reports and proxy-reports, with intra-class correlation ranging from 0.34 to 0.47, all p < 0.001. Half of the children (49.4% from proxy-report and 50.1% from self-report) reported having acute illness during the last month. Based on proxy-reports, multivariate regression analysis demonstrated lower HRQOL for children with acute health problems, younger age, history of low birth weight, abnormal delivery, lower fathers’ educational level, and government-paid insurance for low-income families.ConclusionSociodemographic determinants of a child’s HRQOL, acute health problems, and low birth weight were associated with lower HRQOL in the general pediatric population. In low- and middle-income countries where acute infections and low birth weight are still prevalent, its prevention and appropriate interventions should improve child health.

Health-related quality of life profile of patients with immune thrombocytopenia in the real life is impaired by splenectomy.

The impact of splenectomy on health-related quality of life (HRQoL) in patients with immune thrombocytopenia (ITP) remains scarcely explored. Therefore, we evaluated HRQoL with the 36-Item Short-Form Health Survey (SF-36) in an internal cohort of 69 chronic ITP patients, overall and by type of treatment. Of these patients, 26 patients were splenectomized, while other patients were treated medically with thrombopoietin-receptor agonists (TPO-RAs) or immunosuppressive treatment. We also compared HRQoL of the splenectomized patients (internal cohort) with an external cohort of 63 splenectomized ITP patients and the general population. The median follow-up was 10 years (range 1-20). Splenectomized patients had a worse overall HRQoL profile than those who received medical therapy either with TPO-RAs or other treatments (OT), with clinically meaningful differences registered in several domains. These included physical functioning (Δ = - 17.0 and Δ = - 15.2, for TPO-Ras and OT, respectively, p = 0.065), role physical (Δ = - 9.7 and Δ = - 13.8, p = 0.483), and bodily pain (Δ = - 14.2 and Δ = - 18.8, p = 0.053). Compared to the general population, both internal and external splenectomized cohorts had an impaired HRQoL profile. Further studies on HRQoL in splenectomized ITP patients are needed to better understand the long-term impact of this surgical procedure.

Correlates of health-related quality of life in primary caregivers of perinatally HIV infected and HIV exposed uninfected adolescents at the Kenyan Coast

BackgroundMothers and other primary caregivers play a crucial role in looking after perinatally HIV infected, and HIV exposed uninfected adolescents in sub-Saharan Africa. Day- to-day caregiving in the context of limited instrumental support and added biomedical risk (HIV seropositivity) may expose these caregivers to adverse states of health. Unfortunately, very few studies have examined their health-related quality of life (HRQoL). Our study documents the HRQoL profile, and associated factors in primary caregivers of perinatally HIV infected, perinatally HIV exposed but uninfected and HIV unexposed/uninfected adolescents aged 12–17 years at the Kenyan Coast.MethodsThis was a cross-sectional analysis of 485 primary caregivers: 195 of perinatally HIV infected adolescents, 128 of perinatally HIV exposed but uninfected adolescents and 162 of HIV unexposed/uninfected adolescents. All caregivers completed a self-report measure of HRQoL (having 8 subscales), depressive symptoms, and parenting stress. They also provided their sociodemographic information and that of the care recipients. We used one-way analysis of variance to assess statistical differences among the groups. Linear regression analyses were used to identify correlates of HRQoL.ResultsOverall, caregivers of HIV unexposed/uninfected adolescents reported significantly higher mean HRQoL scores than the other caregivers in the overall HRQoL domain and majority of the subscales. There were no statistical differences in the overall HRQoL scores and most subscales between caregivers of HIV exposed adolescents. Linear regression analyses across the sample indicated that depressive symptoms, increasing age of caregiver, and caring for an adolescent perinatally exposed to HIV were significantly associated with reduced HRQoL at both the overall and sub-scale level. Having a professional job relative to subsistence farming was the only factor associated with improved overall HRQoL. At subscale level, higher socioeconomic status correlated positively with HRQoL while being a grandparent, level of education, parenting stress were negatively associated with HRQoL.ConclusionsCaregivers in this sample, especially those who are ageing, at risk of mental ill-health, and taking care of adolescents perinatally exposed to HIV, appear to be vulnerable to poor quality of life. Inclusive and multi-component interventions tailored to the caregivers' psychosocial and mental needs will potentially enhance their quality of life.

The prevalence and risk of symptom and function clusters in colorectal cancer survivors.

Our purpose was to describe the prevalence and predictors of symptom and function clusters in a diverse cohort of colorectal cancer survivors. We used data from a cohort of 909 adult colorectal cancer survivors. Participants were surveyed at a median of 9months after diagnosis to ascertain the co-occurrence of eight distinct symptom and functional domains. We used factor analysis to identify co-occurring domains and latent profile analysis (LPA) to identify subgroups of survivors with different symptom and function clusters. Multinomial logistic regression models were used to identify risk/protective factors. Factor analysis demonstrated a single underlying factor structure that included all eight health domains with depression and anxiety highly correlated (r = 0.87). The LPA identified three symptom and function clusters, with 30% of survivors in the low health-related quality of life (HRQOL) profile having the highest symptom burden and lowest functioning. In multivariable models, survivors more likely to be in the low HRQOL profile included being non-White, female, those with a history of cardiac or mental health conditions, and chemotherapy recipients. Survivors less likely to be in the low HRQOL profile included those with older age, greater financial well-being, and more spirituality. Nearly one-third of colorectal cancer survivors experienced a cluster of physical and psychosocial symptoms that co-occur with clinically relevant deficits in function. Improving the identification of risk factors for having the highest symptom and lowest function profile can inform the development of clinical interventions to mitigate their adverse impact on cancer survivors' HRQOL.

The Accuracy of the International Myeloma Working Group Frailty Score in Capturing Health-Related Quality of Life Profile of Patients with Relapsed Refractory Multiple Myeloma

The Accuracy of the International Myeloma Working Group Frailty Score in Capturing Health-Related Quality of Life Profile of Patients with Relapsed Refractory Multiple Myeloma

Health-related quality of life profiles, trajectories, persistent symptoms and pulmonary function one year after ICU discharge in invasively ventilated COVID-19 patients, a prospective follow-up study

BackgroundHealth-related quality of life (HRQoL) impairment is often reported among COVID-19 ICU survivors, and little is known about their long-term outcomes.We evaluated the HRQoL trajectories between 3 months and 1 year after ICU discharge, the factors influencing these trajectories and the presence of clusters of HRQoL profiles in a population of COVID-19 patients who underwent invasive mechanical ventilation (IMV). Moreover, pathophysiological correlations of residual dyspnea were tested. MethodsWe followed up 178 survivors from 16 Italian ICUs up to one year after ICU discharge. HRQoL was investigated through the 15D instrument. Available pulmonary function tests (PFTs) and chest CT scans at 1 year were also collected. A linear mixed-effects model was adopted to identify factors associated with different HRQoL trajectories and a two-step cluster analysis was performed to identify HRQoL clusters. ResultsWe found that HRQoL increased during the study period, especially for the significant increase of the physical dimensions, while the mental dimensions and dyspnea remained substantially unchanged. Four main 15D profiles were identified: full recovery (47.2%), bad recovery (5.1%) and two partial recovery clusters with mostly physical (9.6%) or mental (38.2%) dimensions affected. Gender, duration of IMV and number of comorbidities significantly influenced HRQoL trajectories. Persistent dyspnea was reported in 58.4% of patients, and weakly, but significantly, correlated with both DLCO and length of IMV. ConclusionsHRQoL impairment is frequent 1 year after ICU discharge, and the lowest recovery is found in the mental dimensions. Persistent dyspnea is often reported and weakly correlated with PFTs alterations. Trial registrationNCT04411459.

Impact of socio-demographic and clinical characteristics on functional disability and health-related quality of life in patients with rheumatoid arthritis: a cross-sectional study from Palestine

BackgroundRheumatoid arthritis (RA) is a chronic autoimmune disorder, which has a significant impact on patients' health-related quality of life (HRQoL), and limits physical function as well as increases pain and fatigue. Therefore, this study aimed to evaluate the HRQoL and functional disability profile of patients with RA in Palestine to determine the socio-demographic and clinical features associated with low HRQoL and functional disability in patients with RA and to investigate the impact of drugs used on functional disability and HRQoL.MethodologyA cross-sectional, observational study conducted at rheumatology clinics in Northern West-Bank, Palestine (Alwatani Hospital—Nablus, Khalil Suleiman Hospital—Jenin, Thabet Thatbet Hospital-Tulkarem, and Darweesh Nazzal Hospital—Qalqilia). EuroQoL-5 Dimension scale (EQ-5D-5L) was used to evaluate HRQoL, Health Assessment Questionnaire, Disability Index (HAQ-DI) to evaluate the functional disability, and the Health Assessment Questionnaire pain visual analog scale (HAQ-VAS) to evaluate pain.Results300 patients were included in the study, 229(76.3%) were females, the mean ± standard deviation age was 49 ± 13.10 years, and the median RA duration (lower–upper quartiles) was 6 (4–12) years. The median EQ-5D-5L index value and Euro QOL visual analogue scale (EQ-VAS) scores were 0.56 and 60, respectively. There was a significant strong positive correlation (R = 0.773; p < 0.001) between the EQ-5D-5L index values and the reported EQ-VAS scores. The median HAQ-DI and HAQ-VAS were 0.94 and 40, respectively. The results of multiple linear regression showed that treatment with biological DMARD (Etanercept), having work, higher income, absence of night pain, and absence of comorbid diseases were significantly associated with higher EQ-5D-5L index score (better HRQoL) and lower HAQ-DI scores (less disability). On the other hand, older age and the presence of morning stiffness were significantly associated with higher HAQ-DI scores (more disability).ConclusionsThis study revealed the impact of treatment, clinical variables, and socio-demographic factors on disability and HRQoL in RA patients. Healthcare providers should be aware of the association between treatment with biological DMARD and improved HRQoL and functional status to make early interventions that reduce disability and improve HRQoL in susceptible patients.

Validity and Responsiveness of the Generic Health-Related Quality of Life Instrument (VetMetrica™) in Cats With Osteoarthritis. Comparison of Vet and Owner Impressions of Quality of Life Impact.

Validity is not an inherent property of a measurement scale and so evidence for validity relating to its use for particular purposes, with defined populations and in specified contexts must be accumulated. We have published the development of a web-based, generic health-related quality of life instrument (VetMetrica™) to measure the affective impact of chronic disease in cats and provided evidence for its validity in a mixed population of cats, some of which, according to veterinary judgement, were healthy and others of which were suffering from chronic conditions likely to affect their quality of life, often with multiple co-morbidities present. The first aim of the current study was to demonstrate the construct validity of the VetMetrica™ generic instrument when used with cats suffering from osteoarthritis, by testing the hypothesis that the health-related quality of life profile of cats with different severities of osteoarthritis would differ and by demonstrating convergent validity between the health-related quality of life profile scores and independently quantified vet-assessed pain and quality of life impact scores. The latter involved simple correlation analysis and investigation of the relationship between health-related quality of life domain scores and vet-assessed scores, when adjusted for other potential explanatory variables including number of comorbidities and age. Responsiveness—the ability to detect clinically relevant change—is an essential quality for an evaluative instrument and it also provides evidence for “longitudinal validity”. Therefore, a second aim of this study was to demonstrate that changes in health-related quality of life domain scores concurred with the clinician's impression of change over time in the health status of cats with osteoarthritis, thus providing evidence for the instrument's responsiveness. Previously, we have reported disagreement between owner and vet impression as to health status in cats in general, but not in relation to any specific disease. Accordingly, the third study aim was to investigate the extent of agreement or disagreement between owner impression of the impact of osteoarthritis on their cats' quality of life and vet impression of such impact. Fifty one percentage of cat owners believed their cats to be perfectly healthy despite a clinician diagnosis of osteoarthritis

Health-related quality of life profiles and their dimension-specific associated factors among Malaysian stroke survivors: a cross sectional study

BackgroundApart from maximizing functional abilities and independence after stroke, improving overall health-related quality of life (HRQoL) should also become part of the stroke treatment and rehabilitation process goals. This study aimed to assess the HRQoL profiles and explore the dimension-specific associated factors of HRQoL among stroke survivors.MethodsThis was a cross-sectional study of stroke survivors attending post-stroke care clinics in three public hospitals in the states of Pahang and Terengganu, Malaysia. The HRQoL was assessed by EuroQol-5 dimension-5 levels. Data on socio-demographic, clinical profiles, malnutrition risk, and physical activity level were collected through an interviewer-administered survey. Descriptive analyses for HRQoL profiles and multiple logistic regression analyses for its associated factors were performed. Crude and adjusted odds ratios were reported.ResultsA total of 366 stroke survivors were recruited with a mean age of 59 ± 11 years. The most -commonly reported health problems were mobility (85%), followed by usual activities (82%), pain/discomfort (63%), anxiety/depression (51%) and self-care (41%). The mean of the EQ visual analogue scale and the median of the EQ5D summary index was reported at 60.3 ± 14.2 and 0.67 ± 0.37, respectively. Malnutrition risk (mobility, usual activities, and self-care), wheelchair users (self-care and usual activities), speech impairment (usual activities and pain/discomfort), number of stroke episodes (self-care and pain/discomfort), body mass index, physical activity level and types of strokes (usual activities), age and use of a proxy (anxiety/depression), working and smoking status (mobility), were factors associated with either single or multiple dimensions of HRQoL.ConclusionRoutine malnutrition screening, tailored program for speech therapy, prevention of recurrent stroke, and physical activity promotion should be addressed and further reinforced in current rehabilitation interventions to improve the HRQoL among stroke survivors in Malaysia.

Health related quality of life of Icelandic patients six months after coronary heart disease incidence

Abstract Funding Acknowledgements Regional Development Institute, Landspitali, Akureyri Hospital; University of Akureyri, Icelandic Nursing Association, KEA, Akureyri Heart Association OnBehalf KRANS-Study research group Background Patients with coronary heart disease (CHD) are likely to have impaired health-related quality of life (HRQoL) due to functional and emotional effects of the disease. Research suggests that HRQoL is an indicator of CHD patient’s health and it has been associated with self-care and risk factor management. Purpose The aim of this study was to assess HRQoL of Icelandic patients with CHD, six months after coronary heart disease incidence and to identify associated factors. Methods Cross-sectional study design was used. Participants were admitted to two main hospitals in Iceland. Data was collected with questionnaires and from patient records in the years 2018 to 2019. HRQoL was assessed with The HeartQoL questionnaire, which comprises 14-items with 10-item physical and 4-item emotional subscales which are scored from 0 (poor) to 3 (better) HRQoL and a global score. Data was analyzed with descriptive and inferential statistics. Results Data from 366 patients with CHD will be presented. Preliminary data analysis shows that patients, (mean age 64 years (SD 8.8), 81% male), had mean global HRQoL score of 2.3 (SD = 0.6). The physical score measured 2.2 (SD = 0.7) and the emotional score 2.4 (SD = 0.7). The mean global HRQoL score were lower in women (t(364) =3.7, p &amp;lt; 0.001) and so were the physical score (t(364) =3.8, p &amp;lt; 0.001). However, the emotional score did not differ between the genders (t(363) =1.9, p = 0.061). Low income patients had lower HRQoL (p &amp;lt; 0.001). While physical HRQoL decreased with age (β= -0.12, p = 0.006), emotional HRQoL increased (β=0.14, p = 0.001). Better HRQoL was associated with more physical activity on global (β=0.28, p &amp;lt; 0.001), emotional (β=0.16, p = 0.001) and physical (β=0.36, p &amp;lt; 0.001) scales. Association between HRQoL and other risk factor profiles will be presented. Conclusion Our findings suggest that among patients with CHD physical activity is associated with better HRQoL. This emphasizes the importance of cardiac rehabilitation and physical activity after discharge from hospital. Special attention should be given to follow up of women and low-income groups.

PCN231 Humanistic and Economic Burden in Patients with Chronic Myeloid Leukemia – A Review of the Literature

Introduction of tyrosine kinase inhibitors (TKIs) has revolutionized the treatment of chronic myeloid leukemia (CML) but an unmet need still exists in patients receiving later lines of therapy. A review was conducted to understand the published evidence on the humanistic and economic burden associated with CML. Literature search of English publications from the last 20 years (2001-2020) was performed in Embase® and Medline® databases. Studies reporting health related quality of life (HRQoL), symptom burden and costs associated with CML patients were included. Twenty-one studies reported humanistic burden, ten studies reported economic burden and two studies reported both humanistic together with economic burden. SF-36 and EORTC QLQ-C30 were the two most commonly used instruments assessing Quality of life (QoL). Physical function was one of the most severely impacted domain with females presenting with worse HRQoL profile than males. Fatigue, musculoskeletal pain, and disturbed sleep were the most frequently reported symptoms. Primary drivers of increased cost burden associated with treatment failure in later lines of therapies were medical services such as inpatient, emergency room, ambulatory and laboratory tests. In USA, average 1 year cost post TKI failure (adjusted to 2012 USD) for patients who failed first-line treatment was $78,677, which increased to $99,624 for patients who failed second-line treatment and was highest for patients failing third-line therapy ($181,029). Patients in later line of TKI therapies had significantly higher resource utilizations. CML patients had significantly impaired HRQoL across all lines of therapies accompanied by increased symptom burden. Economic burden post-TKI failure increases with each sequential line of therapy. Results from the literature suggest the need for treatments that address long-term outcomes including reduced treatment resistance and improved Qol. This will further reduce the economic burden associated with the treatment of CML in later lines of therapy.

Health-Related Quality of Life Profiles in Dialyzed Patients With Varying Health Literacy. A Cross-Sectional Study on Slovak Haemodialyzed Population.

Objectives: Chronic kidney disease (CKD) strongly affects patients’ health-related quality of life (HRQoL), mostly in the advanced stages of CKD. Health literacy (HL) may affect this association, in particular for some aspects of HRQoL. The aim of this study is to compare the profiles of HRQoL in dialyzed patients with varying HL. Methods: We obtained data on HL using the Health Literacy Questionnaire (HLQ) and on HRQoL using the Kidney Disease Quality of Life – Short Form (KDQoL-SF 1.3) in a multicentre cross-sectional study in 20 dialysis clinics in Slovakia (n = 542; mean age = 63.6 years; males: 60.7%). We compared HRQoL for three HL groups using ANOVA and the Kruskal-Wallis test. Results: Patients with low HL reported worse HRQoL than patients with moderate and high HL. The greatest differences between HL groups were found in the scales Effect of kidney disease, Cognitive function, Quality of social interaction, Social support, Dialysis staff encouragement, Patient satisfaction, Physical functioning, Pain, Emotional well-being and Social function. p-values in all cases were <0.001. Conclusion: Patients with low HL have a worse HRQoL in several domains than patients with a higher HL. Increasing HL capacities and better supporting patients with low HL should thus be given priority to support their HRQoL and at least maintain its level.

Trilaciclib prior to chemotherapy and atezolizumab in patients with newly diagnosed extensive-stage small cell lung cancer: A multicentre, randomised, double-blind, placebo-controlled Phase II trial.

Trilaciclib is an intravenous CDK4/6 inhibitor administered prior to chemotherapy to preserve haematopoietic stem and progenitor cells and immune system function from chemotherapy‐induced damage (myelopreservation). The effects of administering trilaciclib prior to carboplatin, etoposide and atezolizumab (E/P/A) were evaluated in a randomised, double‐blind, placebo‐controlled Phase II study in patients with newly diagnosed extensive‐stage small cell lung cancer (ES‐SCLC) (NCT03041311). The primary endpoints were duration of severe neutropenia (SN; defined as absolute neutrophil count <0.5 × 109 cells per L) in Cycle 1 and occurrence of SN during the treatment period. Other endpoints were prespecified to assess the effects of trilaciclib on additional measures of myelopreservation, patient‐reported outcomes, antitumour efficacy and safety. Fifty‐two patients received trilaciclib prior to E/P/A and 53 patients received placebo. Compared to placebo, administration of trilaciclib resulted in statistically significant decreases in the mean duration of SN in Cycle 1 (0 vs 4 days; P < .0001) and occurrence of SN (1.9% vs 49.1%; P < .0001), with additional improvements in red blood cell and platelet measures and health‐related quality of life (HRQoL). Trilaciclib was well tolerated, with fewer grade ≥3 adverse events compared with placebo, primarily due to less high‐grade haematological toxicity. Antitumour efficacy outcomes were comparable. Administration of trilaciclib vs placebo generated more newly expanded peripheral T‐cell clones (P = .019), with significantly greater expansion among patients with an antitumour response to E/P/A (P = .002). Compared with placebo, trilaciclib administered prior to E/P/A improved patients' experience of receiving treatment for ES‐SCLC, as shown by reduced myelosuppression, and improved HRQoL and safety profiles.

The health-related quality of life and psychological profile in patients with oropharyngeal Pemphigus Vulgaris in complete clinical remission: A case-control study.

Pemphigus Vulgaris (PV) is a severe autoimmune blistering disease which may affect the patient's health-related quality of life (HR-QoL) and mood even during quiescent disease activity. We sought to evaluate HR-QoL, quality of sleep (QoS), anxiety and depression in oropharyngeal PV patients (OPV) in complete clinical remission on or off therapy (CCR-on, CCR-off). Thirty OPV patients and 30 healthy controls were enrolled. The Short Form 36 Health Survey Questionnaire (SF-36), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A) were administered. Descriptive statistics, including the Mann-Whitney U test and hierarchical multiple linear regression analysis, were used. The OPV patients had statistically lower scores in the majority of items of the SF-36 and higher scores in the PSQI, HAM-A and HAM-D than the healthy controls (P<.004; P<.001; and P<.001 respectively). Nine (30%) of the OPV patients were poor sleepers (PSQI>5) with higher scores in the SF-36, HAM-A and HAM-D compared with the good sleepers (PSQI<5). No statistically significant difference was detected in the OPV group when comparing patients in CCR-on and CCR-off, or in consideration of the cumulative time of the disease duration. HR-QoL of OPV patients can be impaired even over periods of relatively well-being, therefore, clinicians should monitor periodically their HR-QoL, QoS and psychological profile in order to guide treatments also toward improving their HR-QoL.