Health-related Quality Of Life Research Articles

The Health-Related Quality of Life Among Stroke Survivors With Post-COVID Conditions Living in the United States.

It is widely recognized that a considerable number of COVID-19 survivors continue to experience post-COVID conditions (PCCs). Given that stroke survivors face a heightened risk of PCCs compared to the general population, our objective was to assess the impact of PCCs on the health-related quality of life (HRQL) among stroke survivors in the United States. We used the Behavioral Risk Factor Surveillance System data 2022. Respondents with a history of COVID-19 infection and stroke were selected and classified based on whether they experienced PCCs. Finally, the HRQL-related items, including self-reported general health (SRGH), the number of days with compromised mental and physical health, and the daily efficiency, were compared between the two groups. Overall, 3988 respondents (42.8% aged above 64 years old, 45.8% men) were enrolled. Compared to stroke survivors without PCCs, those with PCCs had significantly worse SRGH and a higher number of days with compromised mental and physical health. However, although multivariate regression analysis supported the adverse impact of PCCs on the SRGH of stroke survivors, the results were not statistically significant (aOR=1.32,CI95%:[0.98-1.78],p=0.070). Fatigue and dyspnea emerged as the most significantly associated symptoms with impaired SRGH. Additionally, lower education and annual household income level, smoking, lack of physical activity, and comorbidities including diabetes, heart, and pulmonary disease were associated with a higher prevalence of unfavorable SRGH among stroke survivors with PCCs. Our study highlights that PCCs might be associated with worse SRGH. Lower education, income, and physical activity, smoking, and comorbidities were associated with a higher rate of unfavorable SRGH among stroke survivors with PCCs.

Women who experience heavy menstrual bleeding: prevalence and characteristics from young adulthood to midlife, Australia, 2000-2021: a longitudinal cohort survey study.

To estimate the prevalence of heavy menstrual bleeding among Australian women from young adulthood to midlife (22-48 years) and investigate the characteristics of women who experience this condition; to investigate the relationship of heavy menstrual bleeding and health-related quality of life. Longitudinal cohort survey study (Australian Longitudinal Study on Women's Health, ALSWH). Australia; baseline cohort of 14 247 women born during 1973-1978, recruited in 1996; eight post-baseline surveys undertaken at 3-year intervals, 2000-2021. Self-reported frequency of heavy menstrual bleeding during the preceding twelve months (never/rarely, sometimes, often); frequency of heavy menstrual bleeding by socio-demographic, behavioural, health, and reproduction-related characteristics; mean physical and mental health-related quality of life scores (36-item Short Form health survey, SF-36) by frequency of heavy menstrual bleeding. Results are weighted to adjust for oversampling of participants from rural and remote areas. Data for 11 311 respondents to at least one ALSWH post-baseline survey were included in our prevalence analysis. The prevalence of sometimes or often experiencing heavy menstrual bleeding increased from 17.6% at age 22 years (124 of 691 respondents) to 32.1% at 48 years (359 of 1132 respondents); theproportion who reported often experiencing the condition increased from 6.1% (45 participants) to 12.1% (136 participants). The likelihood of often experiencing heavy menstrual bleeding increased with bodymass index (40 kg/m2 or greater v 18.5-24.9 kg/m2: risk ratio [RR], 2.27; 95% confidence interval [CI], 1.93-2.67), and was greater for respondents who reported low iron levels (RR, 2.26; 95% CI, 2.03-2.51) or endometriosis (RR, 2.29; 95% CI, 2.06-2.54). Similar associations were seen for sometimes experiencing heavy bleeding. Mean health-related quality of life scores for women who reported heavy menstrual bleeding were lower in all domains and for the summary mental health and physical health scores than for women who reported never or rarely experiencing the condition; the differences were greater for women who often experienced heavy menstrual bleeding. Heavy menstrual bleeding was reported by large minorities of women of reproductive age, and the proportion increased with age. Many women experience symptoms that have a substantial impact on their physical and mental health-related quality of life.

Health-related quality of life after liver transplantation

Background: Mongolian citizens in need of liver transplant treatment have been receiving the treatment abroad since 2004, and in Mongolia since 2011. As the number of years of life after liver transplantation increases, it is important to better understand the factors that influence patient’s quality of life during those years, and what can be done to modify them. (1) Quality of life reflects how the interaction between socio-economic and environmental factors influences social and human development. (2) Studies on work capacity have shown that 6% of people after liver transplantation are classified as unable to work based on functional and international disability assessments, (3) while 23-61% are fully employed after liver transplantation. (4)(5) There is a lack of research examining the physical, psychological, and social well-being of patients after liver transplant treatment in Mongolia. Methods: Data were collected from 144 liver transplant cases using descriptive research design and questionnaire method. The study used the SF-36 Health Assessment Questionnaire, which was grouped into 8 groups and the scores were averaged according to the scale. The results of the study were analyzed using SPSS 25.0 software using Pearson’s Chi-square test for differences between groups. Results: Of the total 144 cases included in the study, 81 (56.3%), were male and 63 (43.8%) were female. By age group, 120 (83.3%) are between the ages of 19-60, or working age, and 24 (16.7%) are over 60. Employment after liver transplantation was 41 (28.5%) full-time, 19 (13.2%) part-time, 84 (58.3%) unemployed or there was no statistically significant difference between groups (P=0.024), of which 62 (43%) were willing to work, 17 (12%) were unwilling to work, and 65 (45%) were unknown (0.173) with no statistically significant difference. When assessing health-related quality of life, physical activity was 65.7±27.1, health-related limitations 38.5±40.1, psychological limitations 41.9±43.0, pain 65.5±27.2, psychological average 71.7±19.2, physical energy average 57.8±21.2, moderate, social participation average 68.1±20.6, and health change 85±22.2, indicating that citizens who underwent liver transplant treatment had good health-related quality of life and health change indicators. Conclusion: People who have undergone liver transplant treatment have good health-related quality of life and health-related changes.

Comparison of health related quality of life between end-stage renal disease patients on haemodialysis and continuous ambulatory peritoneal dialysis

Comparison of health related quality of life between end-stage renal disease patients on haemodialysis and continuous ambulatory peritoneal dialysis

"Response to Letter to the Editor from Lin et al.: "Testosterone Treatment, Weight Loss, and Health-related Quality of Life and Psychosocial Function in Men: A 2-year Randomized Controlled Trial".

"Response to Letter to the Editor from Lin et al.: "Testosterone Treatment, Weight Loss, and Health-related Quality of Life and Psychosocial Function in Men: A 2-year Randomized Controlled Trial".

Association of poor sleep quality with clinical variables in nontuberculous mycobacterial pulmonary disease.

The high prevalence of poor sleep quality in patients with chronic respiratory diseases makes it an important clinical topic. However, the prevalence and characteristics of poor sleep quality in those with nontuberculous mycobacterial pulmonary disease and its association with clinical variables remain unclear. This retrospective study involved patients with nontuberculous mycobacterial pulmonary disease between June 2017 and May 2022. The prevalence of poor sleep quality was measured by the Pittsburgh Sleep Quality Index was used to and its association with clinical variables including age, sex, laboratory data, pulmonary function, respiratory symptoms, mental health, health-related quality of life, and physical function was assessed. The median age of 233 participants was 65 years, with poor sleep quality present in 123 patients (52.8%) who were older, female, and unemployed with dyspnea, anxiety symptoms, low health-related quality of life, and low exercise capacity. Many reported that they "cannot get to sleep within 30min," "wake up in the middle of the night or early morning," "have to get up to use the bathroom," "cannot breathe comfortably," or "cough or snore loudly." Multivariate logistic regression analysis indicated a significant association between poor sleep quality, female sex, and low health-related quality of life. Our results suggested that for the patients in this study, a multidisciplinary management that considers poor sleep quality is required and assessment of sleep quality as a screening is needed.

Health-Related Quality of Life in Men with Fractures and Fear of Falling in General Population: A Cross-Sectional Study

Health-Related Quality of Life in Men with Fractures and Fear of Falling in General Population: A Cross-Sectional Study

Letter to the Editor from Lin et al.: "Testosterone Treatment, Weight Loss, and Health-related Quality of Life and Psychosocial Function in Men: A 2-year Randomized Controlled Trial".

Letter to the Editor from Lin et al.: "Testosterone Treatment, Weight Loss, and Health-related Quality of Life and Psychosocial Function in Men: A 2-year Randomized Controlled Trial".

Psychological burden in patients with sellar masses under conservative and surgical management

The aim of this study was to investigate the level of distress and the quality of life of operated and non-operated patients with pituitary tumors. Patients who presented to a neurosurgical center and two endocrinological services for outpatient follow-up after surgical treatment, as well as those under medical therapy or radiological follow-up without treatment, were invited to participate in the study. Sociodemographic, health-related quality of life and clinical data were assessed. Psychosocial factors were measured using the Distress Thermometer (DT), the Hospital Anxiety and Depression Scale (HADS), the Short Form (SF-36), and the Sino-nasal outcome test (SNOT). Thirty-two postoperative patients and thirty conservatively managed patients (n = 21 under medical treatment, n = 9 watch and wait), mean age 53, SD 19; 56% female participated in the study. Prolactinomas (35%) and non-functioning pituitary adenomas (21%) were the most common findings. There were no significant differences between conservative and operative groups in mean DT score (4.7 (SD 2.45) vs. 4.9 (SD 3.0), p = 0.61), HADS anxiety score (6.4 (SD 3.9) vs. 6.0 (SD 4.3), p = 0.76) or depression score (5.7 (SD 4.8) vs. 4.6 (SD 3.6), p = 0.50). For patients with ACTH-producing adenomas, the mean anxiety score was significantly higher (10.3 (SD 1.9) vs. 5.9 (SD 4.0), p = 0.03). The SNOT score correlated significantly with the DT, HADS-A, and HADS-D scores and therefore was associated with higher psychological distress. The level of self-reported distress in patients with sellar processes was not associated with a specific treatment strategy. ACTH-producing adenomas and manifest nasal symptoms were associated with higher psychological distress.

2785 Protocol for a feasibility randomised controlled trial of the OUTDOOR mobility intervention for older adults after hip fracture

Abstract Introduction A high proportion of patients do not regain outdoor mobility after hip-fracture. Rehabilitation explicitly targeting outdoor mobility is needed to enable older adults to resume activities that they value most. The aim of this study is to determine the feasibility of a randomised, controlled trial intended to assess the clinical and cost-effectiveness of an intervention enabling recovery of outdoor mobility post hip-fracture (the OUTDOOR intervention). Method OUTDOOR is a multi-centre, parallel group, randomised, controlled, feasibility trial. Adults 60 years and older, admitted to hospital and planned discharge to home; with self-reported outdoor mobility three-months pre-fracture, surgically treated for hip fracture, who are able to consent and participate, are eligible. Individuals requiring two or more people to support mobility upon discharge are excluded. Screening and consent (or consent to contact) will take place in hospital. Baseline assessment and randomisation will follow discharge. Participants will receive usual care (physiotherapy, occupational therapy), or usual care plus the OUTDOOR intervention. OUTDOOR intervention includes a goal-orientated outdoor mobility programme, therapist-led motivational dialogue supported by a past-patient led videos sharing recovery experiences; and support to transition to independent recovery. Therapists delivering the OUTDOOR intervention will receive training in motivational interviewing, and behaviour change techniques. Patient reported outcome measures—health-related quality of life, daily activities, pain, community mobility, falls related self-efficacy, resource use, and readmission; will be collected at baseline, 6-weeks, 12-weeks, and 6-months (if enrolled early in the trial) post-randomisation. Exercise adherence and intervention acceptability will be collected. Subset of 20 participants will support accelerometery data collection for 10 days at each time point. Trial received approval from East of England—Essex Research Ethics Committee (REF: 23/EE/0246) and the Health Research Authority. Findings will be disseminated to patients, the public, health professionals and researchers through publications, presentations, and social media. Trial registered at ISRCTN16147125.

Anti-melanoma differentiation-associated gene 5 antibody-positive interstitial lung disease masquerading as rheumatoid arthritis-associated interstitial lung disease or overlapping with the same: a phenomenon driven by a probable genetic predisposition.

Rheumatoid arthritis (RA) is a systemic, progressive illness marked by persistent synovitis that causes substantial functional disability. Treatment delays frequently affect health-related quality of life. Extra-articular features are prevalent findings in RA, which leads to significant morbidity and mortality. They are likely due to chronic inflammation and autoimmune nature of RA. Extra-articular manifestations also include interstitial lung disease (ILD). Anti-MDA5 antibodies, though typically associated with dermatomyositis, may also occur with RA, especially in patients with overlapping syndromes, and influence ILD severity. In this case-based review, we highlight the challenges in managing a case of seropositive RA complicated by the coexistence of anti-MDA5 antibody. This review additionally examines the pathophysiology, clinical presentation, diagnosis, therapy, and prognosis of RA-ILD along with that of anti-MDA-5ILD, as well as new studies and recommendations for disease management.

Physical activity, fatigue severity, and health-related quality of life of community-dwelling stroke survivors: a cross-sectional study

BackgroundPhysical inactivity among stroke survivors (SSV) may result from fatigue, physical disabilities, and psychosocial factors, all of which adversely affect health-related quality of life (HRQL). Studies on combined interactions among physical activity (PA), fatigue severity (FS), and HRQL in SSV are scarce. This study was aimed to determine the relationships among PA, FS, and HRQL in community-dwelling SSV and to predict the association with selected socio-demographic and clinical variables.MethodsThis analytical cross-sectional correlation study involved 102 consented community-dwelling SSV. Respondents were purposively recruited from physiotherapy outpatient clinics of selected secondary and tertiary hospitals in southwest Nigeria. PA, FS, and HRQL of the SSV were assessed using the Stroke Physical Activities Questionnaire (SPAQ), Fatigue Severity Scale (FSS), and Stroke-Specific Quality-of-Life (SS-QoL) scale, respectively. Information on respondents’ socio-demographic and clinical characteristics was also collected. Data were analyzed using descriptive and inferential statistics at p < 0.05 significance level.ResultsRespondents’ mean age was 59.98 ± 11.59 years. The majority were females (52.9%), had ischemic stroke (72%), and with right-side weakness (54%) of over 6 months (80%). Respondents’ mean scores on SPAQ, FSS, and SS-QoL scales are 1867.47 ± 1817.93 MET min/week, 31.94 ± 11.29, and 156.47 ± 26.62, respectively. There were no significant associations between selected socio-demographic/clinical variables and physical activity levels except in gender (χ2 = 6.737; p = 0.034), fatigue severity except in side of affectation (χ2 = 5.839; p = 0.054), and HRQL except in level of education (χ2 = 23.497; p = 0.001) and side of affectation (χ2 = 7.389; p = 0.007). There was a moderate and significant correlation (R = 0.426; p < 0.05) among PA, FS, and HRQL. Regression analysis revealed no significant associations with the socio-demographic/clinical variable except the side of affectation for HRQL, low (R = 0.223) level of prediction of socio-demographic/clinical variables for PA (F 8, 93 = 0.607; p > 0.05), and fair (R = 0.326) level of prediction for FS (F 8, 93 = 1.386; p > 0.05).ConclusionModerate correlations among fatigue severity, physical activity, and health-related quality of life in stroke survivors suggested that enhancing one domain can benefit others, while the limited predictive ability of socio-demographic and clinical variables highlighted the need to consider cultural and psychological factors in post-stroke outcomes.

Relations between trajectories of weight loss and changes in psychological health over a period of 2years following bariatric metabolic surgery.

This study aimed to identify trajectories of BMI, obesity-specific health-related quality of life (HR-QoL), and depression trajectories from pre-surgery to 24months post-bariatric metabolic surgery (BMS), and explore their associations, addressing subgroup differences often hidden in group-level analyses. Patients with severe obesity (n = 529) reported their HR-QoL and depression before undergoing BMS, and at 12 and 24months post-operation. Latent Class Growth Analysis was used to identify trajectories of BMI, HR-QoL and depression. BMI and HR-QoL improved significantly for all patients from pre-surgery to 24months post-operation, though some patients deteriorated in their outcomes after 12months. Three distinct trajectories of BMI were identified: Low (35.4%), Medium (45.5%), and High (19.2%), and of HR-QoL: High (38.4%), Medium (43.4%), and Poor (18.1%). Three trajectories of depression were extracted: Low/none (32.4%), Medium-low (45.3%), and Worsening (22.3%). The association between the trajectories of BMI and depression was significant, but not between the BMI and HR-QoL trajectories. Specifically, the Low BMI trajectory patients were more likely to follow the Worsening depression trajectory and reported poorer preoperative psychological health than the other two BMI trajectories. Patients following the most favourable weight loss trajectory may not manifest psychologically favourable outcomes (i.e., Worsening depression), and preoperative characteristics do not consistently describe post-surgical BMI trajectories. Clinicians should tend to patients' mental wellbeing besides weight loss post-BMS. The study findings emphasize the significance of incorporating psychological health as an essential component of surgical outcomes.

Associations of environmental and personal factors, participation and health-related quality of life with physical activity and sedentary behavior in people with subarachnoid hemorrhage: a cross-sectional accelerometer-based study

Purpose To explore associations of environmental and personal factors, participation, and health-related quality of life (HR-QoL) with physical behavior (PB) after subarachnoid hemorrhage (SAH). Materials and Methods PB, expressed in duration and distribution of physical activity (PA; walking, running, cycling) and sedentary behavior (SB; lying/sitting) and PA intensity was assessed with the Activ8 accelerometer during 7 days. Environmental and personal factors (social influence, health-condition, illness-perception, self-efficacy, fatigue, mood, kinesiophobia, cognition, coping, sleep), participation and HR-QoL, were assessed with validated questionnaires. Correlation analyses were conducted. Results In total 39 SAH survivors participated on average 9.6 months post-SAH onset, mean age was 53.2 years (SD = 13.2) and 59% were women. Moderate correlations were found (r = 0.300-0.500, p < 0.05): worse illness-perception, cognition, fatigue, social support, participation, and HR-QoL were associated with worse PA outcomes. Additionally, higher age, unemployment, smoking, longer hospital stay, aneurysmal-SAH, and discharge to outpatient rehabilitation were associated with worse PA outcomes. Worse cognition, participation, smoking, more severe SAH and longer hospital stay were associated with worse SB outcomes. Conclusions Targeting illness perception, cognition, fatigue, and social support, might improve PB post-SAH, which may improve participation and HR-QoL. In smokers (former/current), unemployed, older or more severely affected individuals, improving PB might be more challenging. Implications for rehabilitation Both environmental and personal factors were associated with poorer physical behavior (PB) after subarachnoid hemorrhage (SAH). Poorer PB was associated with worse participation and HR-QoL in SAH survivors. Targeting social support, illness perception, fatigue and cognition may improve PB after SAH. Improving PB in SAH survivors who smoke or have been smoking, are unemployed, older, or more severely affected, might be challenging.

Bridging Gaps: Enhancing Sleep and Health Disparities in Latino Families with Young Adults with Autism Using a Culturally Adapted Intervention.

The present study examined the effects of a culturally adapted intervention, ¡Iniciando! la Adultez, on sleep and health-related quality of life (HRQoL) in Latino young adults with autism spectrum disorder (ASD) and their Spanish-speaking parents. The intervention targeted the transition to adulthood, a period associated with increased challenges in sleep and HRQoL, particularly for underserved Latino populations. Participants included 26 young adults and 38 parents who completed assessments at baseline and post-treatment. The results indicated significant improvements in several HRQoL domains for both groups, with young adults reporting enhanced emotional well-being, social functioning, and general health. Parents experienced notable improvements in subjective sleep quality, sleep latency, and global sleep quality, alongside enhanced emotional well-being and general health. Correlational analyses revealed significant associations between baseline sleep quality and post-treatment HRQoL, acculturative stress, and mental health outcomes, suggesting the interconnectedness of these factors. Parents generally reported poorer sleep and HRQoL than young adults at both time points, highlighting the ongoing challenges they face. Despite some improvements, overall sleep quality remained suboptimal, emphasizing the need for further refinement of interventions. This study underscores the importance of culturally tailored approaches in addressing the unique needs of Latino families affected by ASD and highlights the potential benefits of such interventions in improving sleep and HRQoL. Future research should explore the long-term sustainability of these improvements and address the remaining gaps in sleep quality. The findings contribute to a growing body of evidence supporting the need for culturally sensitive interventions in promoting well-being in marginalized communities.

P-1559. Comparing Patient and Clinician Perceptions of Health-Related Quality of Life in Hospitalized Patients with Complicated Urinary Tract Infections: A Qualitative Descriptive Study

Abstract Background There is limited research directly comparing patient and clinician-reported health-related quality of life (HRQoL) in bacterial infections. In this qualitative study, we compared patient and their treating clinician perceptions of HRQoL in complicated urinary tract infections (cUTI). Table 1 Methods Hospitalized patients with cUTI (defined by FDA guidance and determined by chart review) in an academic healthcare system in the Southeastern U.S. were interviewed 10-20 days after urine culture. Clinicians who cared for these patients for ≥2 days were eligible for interview, occurring 7-30 days after qualifying urine culture. Semi-structured, individual interviews were conducted between 10/2022–5/2023 by two interviewers via phone or Zoom. Interviews were informed by the Wilson and Cleary model of HRQoL and performed until saturation and information power were achieved. Rapid, matrix, and team-based qualitative techniques were used to facilitate analysis and presentation, summarizing within and across patient-clinician dyads (1 patient and 1 treating clinician) or triads (1 patient and 2 treating clinicians). Table 2 Results We interviewed 12 patients and 16 treating clinicians, comprising 8 patient-clinician dyads and 4 triads. Patient and clinician characteristics are reported in Tables 1 and 2. Our analysis identified four key concepts (Table 3): 1) The full range of impact of cUTI symptoms on patient functioning (e.g., emotional, cognitive functioning) was not consistently recognized by clinicians, 2) Clinicians’ perceptions of HRQoL were particularly influenced by infection characteristics, comorbidities, and other diagnoses, 3) Overall clinicians think HRQoL is important but approach their role in addressing HRQoL with varied experience and comfort, and 4) Different terms and level of detail were used by patients and clinicians to describe the impact of the cUTI. Table 3 Conclusion While patients and clinicians both recognize that cUTIs impact HRQoL, there are important differences in how patients and clinicians perceive and describe this impact. Understanding how patient and clinician perceptions of HRQoL diverge can help improve design of patient-centered trials and identify areas for enhanced patient-clinician communication. Disclosures Engels N. Obi, PhD, Merck &amp; Co., Inc.: Employee|Merck &amp; Co., Inc.: Stocks/Bonds (Public Company) Alexandre H. Watanabe, PharmD, Merck &amp; Co., Inc.: Employee|Merck &amp; Co., Inc.: Stocks/Bonds (Public Company) Emre Yucel, PhD, Merck: I am a full time Merck Employee and own stocks in the retirement plan provided by Merck.|Merck: Stocks/Bonds (Public Company) Hayden Bosworth, PhD, BeBetter therapeutics: Grant/Research Support|Boehringer Ingelheim: Advisor/Consultant|Boehringer Ingelheim: Grant/Research Support|Elton John Foundation: Grant/Research Support|Esperion: Grant/Research Support|Hilton foundation: Grant/Research Support|Improved Patient Outcomes: Grant/Research Support|Merck: Grant/Research Support|NHLBI: Grant/Research Support|Novo Nordisk: Grant/Research Support|Otsuka: Grant/Research Support|Pfizer: Grant/Research Support|Preventric Diagnostics: Board Member|sanofi: Advisor/Consultant|sanofi: Grant/Research Support|Veterans Health Administration: Grant/Research Support|Walmart: Advisor/Consultant Helen Boucher, MD, ASM: Honoraria|Elsevier: Honoraria|Sanford Guide: Honoraria Deborah Collyar, B.Sci, Apellis Pharmaceuticals, Inc.: Advisor/Consultant|Kinnate Biopharma: Advisor/Consultant Sarah B. Doernberg, MD, MAS, Basilea Pharmaceutica: Grant/Research Support|F2G Limited: Grant/Research Support|Genentech: Advisor/Consultant|Gilead Biosciences: Grant/Research Support|Janssen/J+J: Advisor/Consultant|Pfizer, Inc: Grant/Research Support|Regeneron, Inc: Grant/Research Support|Shinogi: Grant/Research Support Vance G. Fowler, MD, MHS, Affinergy: Advisor/Consultant|ArcBio: Stocks/Bonds (Private Company)|Armata: Advisor/Consultant|Astra Zeneca: Advisor/Consultant|Astra Zeneca: Grant/Research Support|Basilea: Advisor/Consultant|Basilea: Grant/Research Support|ContraFect: Advisor/Consultant|ContraFect: Grant/Research Support|Debiopharm: Advisor/Consultant|Destiny: Advisor/Consultant|EDE: Grant/Research Support|Genentech: Advisor/Consultant|Genentech: Grant/Research Support|GSK: Advisor/Consultant|Janssen: Advisor/Consultant|Karius: Grant/Research Support|MedImmune: Grant/Research Support|Merck: Grant/Research Support|sepsis diagnostics: Patent pending|UptoDate: Royalties|Valanbuio: Stocks/Bonds (Private Company)|Valanbuio: Stocks/Bonds (Private Company) Heather King, PhD, Merck Sharp &amp; Dohme LLC, a subsidiary of Merck &amp; Co., Inc., Rahway, NJ, USA.: Grant/Research Support

P-654. Health-related Quality of Life Associated with Pneumococcal Disease – A Global Targeted Literature Review and Meta-Analysis

Abstract Background Pneumococcal disease (PD) is a group of infections that can have a significant yet poorly understood impact on health-related quality of life (HRQoL). This meta-analysis aims to quantify the HRQoL impact of PD. Methods Original research studies reporting health utility, disutility, quality-adjusted life year (QALY), or QALY decrement associated with PD were identified through a global targeted literature review in MEDLINE (March 2023). Health utilities and QALYs were converted to QALY decrements per episode using reported or imputed duration of illness. QALY decrements for different PD categories were estimated using random effects models, with heterogeneity assessed using τ2 and I2 statistics. Results The literature review identified 27 original utility studies of PD from 19 countries published in 1993-2021. These studies used various utility estimation methods, including direct methods (e.g., standard gamble, time trade-off, visual analogue scale) and indirect methods (e.g., EQ-5D, Health Utilities Index). Estimates (95% confidence intervals) of QALY decrement per episode derived from the meta-analyses in adults (≥18 years) were 0.033 (0.027, 0.040) for meningitis, 0.019 (0.011, 0.027) for bacteremia/sepsis, 0.018 (0.011, 0.024) for inpatient pneumonia, and 0.007 (0.006, 0.009) for outpatient pneumonia. The corresponding values in children (0-17 years) were 0.029 (0.019, 0.039), 0.016 (0.008, 0.024), 0.026 (0.010, 0.042), and 0.013 (0.007, 0.020). The estimates for acute otitis media (AOM) and recurrent AOM in children were 0.004 (0.002, 0.006) and 0.007 (0.003, 0.010), respectively. Significant heterogeneity was observed across studies for nearly all PD categories, largely due to variations in methods. Conclusion PD has a substantial negative impact on HRQoL in children and adults. The extent of impairment varies widely across PD categories, with the greatest impairment observed in meningitis, bacteremia/sepsis, and inpatient pneumonia. The review reveals significant heterogeneity in methods and results across studies. Studies incorporating more recent data and using standard methods are needed to accurately estimate the impact of PD on HRQoL and inform cost-effectiveness analyses of vaccines that prevent PD. Disclosures Min Huang, PhD, Merck &amp; Co., Inc.: Employee|Merck &amp; Co., Inc.: Stocks/Bonds (Public Company) Hela Romdhani, PhD, Analysis Group, Inc.: Employee|Merck &amp; Co., Inc.: I am an employee of Analysis Group, Inc., a consulting company hat has provided paid consulting services to Merck &amp; Co., Inc. Jipan Xie, MD, PhD, XL Source, Inc.: Jipan Xie is an employee of XL Source, Inc., which received research funding from Analysis Group, Inc. for this study. Yan Song, PhD, Analysis Group, Inc.: Employee|Merck &amp; Co., Inc.: I am an employee of Analysis Group, Inc., a consulting company hat has provided paid consulting services to Merck &amp; Co., Inc. Sun Lee, PharmD, MPH, Analysis Group, Inc.: Employee|Merck &amp; Co., Inc.: I am an employee of Analysis Group, Inc., a consulting company hat has provided paid consulting services to Merck &amp; Co., Inc. Daisy Liu, MS, Analysis Group, Inc.: Employee|Merck &amp; Co., Inc.: I am an employee of Analysis Group, Inc., a consulting company hat has provided paid consulting services to Merck &amp; Co., Inc. Elamin Elbasha, Ph.D., Merck &amp; Co., Inc.: Employee|Merck &amp; Co., Inc.: Stocks/Bonds (Public Company) Salini Mohanty, DrPH, MPH, Merck &amp; Co., Inc.: Employee|Merck &amp; Co., Inc.: Stocks/Bonds (Public Company) Donna Rowen, PhD, Costello: I have received financial payment in return for advice or training on utility estimation.|Merck &amp; Co., Inc.: I have received financial payment in return for advice or training on utility estimation.|Novartis: I have received financial payment in return for advice or training on utility estimation.|Novo Nordisk: I have received financial payment in return for advice or training on utility estimation.|Sanofi: I have received financial payment in return for advice or training on utility estimation. Matthew S. Kelly, MD, MPH, Invivyd: Advisor/Consultant|Merck &amp; Co., Inc.: Advisor/Consultant|Merck &amp; Co., Inc.: I am an employee of Duke University Medical Center, which received grant funding from Merck &amp; Co., Inc.

Comparative Improvement in Health-Related Quality of Life with Advanced Therapies for Moderate-to-Severe Crohn's Disease: A Network Meta-Analysis.

The comparative efficacy of advanced therapies to improve health-related quality of life (HR-QoL) in Crohn's disease (CD) is unknown. We aimed to compare the impact of approved advanced therapies for moderate-to-severe CD on HR-QoL. We searched MEDLINE, Embase, and Cochrane CENTRAL from inception to December 2023. We included randomized controlled trials (RCTs) that assessed approved advanced therapies for the treatment of adults with moderate-to-severe luminal CD. The primary outcome was change from baseline in the Inflammatory Bowel Disease Questionnaire (IBDQ). Pairwise random-effects meta-analyses were conducted, and we reported results as mean differences (MD) for continuous outcomes and risk ratios for binary outcomes, with corresponding 95% confidence intervals (CI). A random-effects frequentist network meta-analysis was conducted, and the competing interventions were ranked using the P-score. Our search strategy 34 records that fulfilled our eligibility criteria. In pairwise meta-analysis, advanced therapies were associated with improvements in IBDQ score (MD 16.07, 95% CI 12.59 - 19.54) after induction. In network meta-analysis, upadacitinib 45mg ranked first for change in IBDQ after induction (MD 23.10, 95% CI 14.41 - 31.78, P-score 0.86). For maintenance studies, advanced therapies showed a significant improvement in IBDQ score in pairwise meta-analysis (MD 12.72, 95% CI 10.47 - 14.97). Infliximab 10mg/kg ranked first for change in IBDQ after maintenance (MD 24.91, 95% CI 12.99 - 36.83, P-score 0.90). Advanced therapies were associated with improvements in HR-QoL after induction and maintenance. Upadacitinib 45mg and infliximab 10mg/kg ranked highest after induction and maintenance, respectively.

Post COVID-19 infection and quality of life of healthcare workers at Sahloul University Hospital of Sousse in Tunisia.

Since the COVID-19 pandemic, health care workers (HCWs) faced an enormous physical and mental burden, sometimes altering their quality of life due mainly to persistent challenges stemming from their frontline position. Todetermine the prevalence of post-COVID-19 syndrome, and its impact on the Health-Related Quality of Life (HRQoL) among HCWs. This is an exhaustive cross-sectional study with analytical scope, conducted among all HCWs of the University Hospital Sahloul of Sousse, Tunisia, who have contracted COVID-19 between September 2020 and 30 March 2021 (N=529 cases).The post-covid medical check-up was carried out three months after the acute phase of the COVID-19 infection (December 2020 to June 2021). HRQoL was assessed using the SF-12 (12-item Short Form Health Survey) questionnaire. Bivariate study and multiple linear regressions were performed to identify the different factors influencing the quality of life of HCWs. During the study period, 529 HCWs were diagnosed with SARS CoV-2 infection, out of them 249 participants were included (47% participation rate). Post covid-19 syndrome was reported in 65% of cases. A low overall quality of life (QoL) score was reported in 28.6% of cases. Low physical and mental composite scores were reported in 34.3% and 29.4% of cases respectively. In the multiple linear regression analysis, gender, post COVID-19 syndrome and time off work were significantly associated with SF12 scores. In our study, HCWs experienced a significant deterioration in HRQoL after COVID-19 with a high incidence of post-COVID-19 syndrome. The need of long-term follow-up after SARS-CoV-2 infection remains essential to support HCWs and mitigate long-term impacts.

Malnutrition in patients with advanced head and neck cancer: Exploring the Global Leadership Initiative on Malnutrition (GLIM) criteria, energy balance and health-related quality of life.

Head and neck cancer (HNC) involves several tumor locations, the most common of which are the oropharynx and oral cavity. Patients with HNC are at high risk of developing malnutrition. Together with treatment, the tumor location contributes to difficulties in eating and swallowing, which can lead to a negative energy balance and weight loss. This study aimed to examine malnutrition via the Global Leadership Initiative on Malnutrition (GLIM) criteria, explore the different combinations of the GLIM criteria, study changes in body energy content and evaluate health-related quality of life (HRQoL) in patients with locally advanced HNC. Malnutrition was diagnosed via the GLIM criteria. Body weight, muscle mass, body fat, C-reactive protein (CRP) levels, energy intake, use of enteral feeding tubes or parenteral nutrition were assessed, and HRQoL scales from the European Organization for Research and Treatment of Cancer (EORTC), including the Quality of Life Questionnaire-Core 30 (QLQ-C30) and the Quality of Life Questionnaire-Head and Neck 35 (QLQ-HN35), and the M.D. Anderson Dysphagia Inventory (MDADI) were completed at baseline, 6 weeks and at 3, 6 and 12 months after the start of treatment. Body composition was measured via dual-energy X-ray absorptiometry, and body energy content was calculated. Eighty patients were included. The prevalence of malnutrition varied over time and peaked at the end of treatment at 71%, and at this time, the most common combination of the GLIM criteria was weight loss + reduced food intake + inflammation (31%), followed by weight loss + reduced muscle mass + reduced food intake + inflammation (20%). At the end of treatment patients were in a negative energy balance, and compared to baseline, body weight, body fat, and muscle mass had decreased with 6.0% (p<0.0001), 5.9% (p<0.0001), and 8.0% (p<0.0001) respectively. At the 3-month follow-up, the reduction in muscle mass had ceased, despite a negative energy balance, and patients started to regain muscle mass. At 12 months body weight had decreased with 7.4% (p<0.0001), body fat with 18.9% (p<0.0001), and muscle mass with 2.4% (p<0.0001) compared to baseline. Patients with malnutrition reported significantly worse HRQoL on a majority of the 16 quality of life scales at all time points, except at the end of treatment, when no significant differences were found between malnourished and nonmalnourished patients. Patients with advanced HNC receiving combined treatment experience major nutritional problems, and malnutrition is common at the end of treatment. Inflammation-driven muscle depletion during treatment is challenging, but it seems possible to recover muscle mass after treatment. Patients with malnutrition reported worse HRQoL at all time points, except at the end of treatment, when all patients' quality of life was very negatively affected.