Health-related Quality Of Life Scores Research Articles

Healthy Lifestyle and Quality of Life in Post-Operative Colorectal Cancer Patients: A Five-Month Observational Study.

Health-related quality of life (HRQOL) is an important indicator of treatment effectiveness. An unhealthy lifestyle can have a negative impact on quality of life. This study aimed to investigate changes in health-related lifestyle over time after surgery for colorectal cancer and their impact on HRQOL. Healthy lifestyle habits examined in this study included physical activity, smoking, alcohol consumption, fruit and vegetable intake, sleep, and obesity levels. An observational study design was used. A total of 75 post-operative colorectal cancer patients were recruited from two medical centers in Taiwan. Data were collected through structured questionnaires. Mean HRQOL scores at 1, 3, and 5 months after discharge were 102.5 (SD = 18.8), 102.9 (SD = 20.1), and 103.0 (SD = 18.9), respectively. A generalized estimating equation analysis showed that alcohol consumption (p = 0.009), fruit and vegetable intake (p = 0.020), physical activity (p = 0.023), sleep quality (p < 0.001), and obesity (p = 0.035) were important predictors of post-operative quality of life in patients with colorectal cancer. The impact of smoking on HRQOL did not reach statistical significance. Colorectal cancer patients tend to have better HRQOL after surgery if they stay physically active, eat enough fruits and vegetables, and sleep well.

A comparison of health-related quality of life in chronic intestinal failure and end-stage kidney disease: A cross-sectional study.

There is inequal access to treatment and scarce evidence on how the disease burden in chronic intestinal failure (CIF) compares to other chronic nonmalignant types of organ failure. Therefore, we compared the health-related quality of life (HRQOL) of people with CIF with that of people with end-stage kidney disease (ESKD) receiving hemodialysis (HD). These groups were selected for comparison as they have similar treatment characteristics. We hypothesized that people treated with HD and people with CIF had similarly poor HRQOL. HRQOL was evaluated and compared in a cross-sectional study of adult people with CIF and people with ESKD HD at a tertiary hospital in Denmark, using the Short-Form 36 (SF-36). One hundred forty-one people with CIF and 131 people with ESKD receiving HD were included in the analysis. Both groups reported low scores (<50) for HRQOL on general health, vitality, and role limitation-physical. People with ESKD receiving HD had significantly lower scores than people with CIF regarding physical functioning, general health, and vitality when adjusted for sex and age. No significant difference was found for any other SF-36 domain. HRQOL was similarly and significantly reduced in people with CIF and in people with ESKD receiving HD. People with ESKD receiving HD had significantly poorer HRQOL than people with CIF in some aspects of physical and mental health. Access to home parenteral support treatment varies among countries that typically provide HD, suggesting an inequality in healthcare based on the type of organ failure.

Assessing health-related quality of life of people with diabetes in Nigeria using the EQ-5D-5L: a cross-sectional study

Assessing the health-related quality of life (HRQoL) of people with diabetes is important to evaluate treatment effectiveness and identify interventions that would be beneficial to the patients. This descriptive cross-sectional study aimed to assess the HRQoL of people with diabetes visiting 15 community pharmacies in Akwa Ibom State, Nigeria, and to identify its determinants. The English (Nigeria) version of the EQ-5D-5L was administered to 420 eligible patients between August and September 2021. Data were analyzed with SPSS (IBM version 25.0) and presented descriptively; differences in HRQoL scores were examined using inferential statistics. Statistical significance was set at p < 0.05. Most participants (56.8%) were female; 193 (49.6%) were between the ages of 30 and 49. The median (interquartile range, IQR) for the EQ VAS and EQ-5D-5L index scores, respectively, were 80.0 (65.0–85.0) and 0.77 (0.62–0.90). Most participants reported problems with usual activities (52.7%), pain/discomfort (60.2%), and anxiety/depression (57.6%). The EQ VAS score and EQ-5D-5L utility index were significantly (p < 0.05) associated with respondents' age, marital status, work status, and personal monthly income. The HRQoL of participants was relatively high. Nevertheless, implementing strategies aimed at pain management and providing psychological support for people with diabetes in Nigeria may improve their HRQoL.

Cluster-Based Multinomial Logistic Regression Model for Health-Related Quality of Life Among People Living with HIV in Brazil.

Improvement in treatment options has increased the survival of people living with HIV (PLHIV). Thus, we evaluated the factors associated with better health-related quality of life (HRQoL) among PLHIV in Brazil. This was a cross-sectional study carried out among 349 PLHIV. Data were collected using an interview-based questionnaire, and HRQoL was assessed by the Brazilian version of the WHOQOL HIV BREF instrument. We used non-hierarchical cluster analysis (K-means) to compile the WHOQOL HIV BREF's overall and domain scores into a unique more multidimensional measure for HRQoL consisting of three clusters: poor, fair and good; associations with clusters of better HRQoL were assessed using multinomial logistic regression models. The mean and median overall HRQoL scores were 15.13 (SD = 3.39) and 16, respectively. The reliability and validity of the Brazilian version of the WHOQOL HIV BREF instrument was confirmed among PLHIV in a non-metropolitan, medium-sized municipality of Brazil, which reaffirmed the cross-cultural validity of this instrument. The factors male sex; heterosexual and asexual orientations; higher individual income; undetectable viral load; absence of any comorbidity and presence of an infectious or a chronic comorbidity, with mental illness as the reference; and never having consumed illegal substances were independently associated with good HRQoL. Thus, the compilation of the WHOQOL HIV BREF's overall and domain scores into a unique multidimensional measure for HRQoL, which this study proposed for the first time, may facilitate more robust interpretations and models of predictors. These differentials could simplify HRQoL as an indicator of health and wellbeing to be routinely used as a key outcome in the clinical management of patients and in the global monitoring of health system responses to HIV.

Quality of Life in the Danish Fontan Population is Unchanged Over the Past Decade—A Nationwide Longitudinal Study

AbstractKnowledge about health-related quality of life (HRQoL) over time in Fontan patients is sparse. We aimed to describe HRQoL over a ten-year period in a population-based Fontan cohort. Further, we compared HRQoL in Fontan patients with the general population. In 2011, Danish Fontan patients were invited to participate in a nationwide study assessing HRQoL. Depending on age, 152 participants filled out either the Pediatric Quality of Life Inventory or the 36-Item Short Form Health Survey. After a decade, patients from the initial study were invited to participate in a follow-up study. All were given the same questionnaire as in the first study, plus the 12-Item Short Form Health Survey (SF-12) as part of the Danish National Health Survey. HRQoL over time was described, and SF-12 scores were compared with the general population. A total of 109 Fontan patients completed the questionnaires in both studies. The mean patient age was 14.9 ± 6.6 years and 25.6 ± 6.5 years respectively. Despite an increase in complications, HRQoL did not decrease during the study period. Physical HRQoL scores were lower than mental HRQoL scores at both time points. The SF-12 physical component score was significantly lower in Fontan patients than in the general population (median score 52 vs. 56, p &lt; 0.001), while the SF-12 mental component score was comparable (median score 51 vs. 50, p = 0.019). HRQoL remained stable over a ten-year period in a contemporary Danish Fontan cohort. Still, the physical HRQoL remained significantly lower than that of the general population.

Assessment of quality of life and physical activity in patients with oligoarticular juvenile idiopathic arthritis in remission.

The purpose of this study was to evaluate physical activity (PA) and health-related quality of life (HRQOL) in children with oligoarticular juvenile idiopathic arthritis (JIA) in remission in comparison with healthy peers and to determine the disease-related factors affecting PA levels. This study was conducted with 50 oligoarticular JIA patients in remission and 50 healthy peers between 9 and 14years. Demographic and clinical characteristics, laboratory parameters, and treatments were noted from electronic medical records. HRQOL was assessed with the Pediatric Quality of Life Inventory (PedsQL). PA was evaluated with the Physical Activity Questionnaire for Children (PAQ-C). Oligoarticular JIA patients had significantly lower self-reported median PedsQL scores in the domains of school functioning and social functioning compared to the control group (67.5 (10) vs. 75 (25), p = 0.001 and 70 (15) vs. 85 (26.3), p < 0.001, respectively). The median PAQ-C score was 2.6 (1.1) in patients with JIA and 3 (0.9) in their healthy peers (p = 0.02). The PAQ-C score was 2.8 (1.2) in patients < 8years at the disease onset and 2.3 (1) in those aged ≥ 8years (p = 0.022). There was no significant difference in the number of affected joints, type of affected joint, MTX and biologic agent treatment, and remission with or without drugs with the total score of the PedsQL and PAQ-C. All PedsQL domains were positively correlated with the PAQ-C. Conclusion: Oligoarticular JIA patients demonstrated lower PA and HRQOL scores compared to healthy controls despite favorable disease control. What is Known: • Oligoarticular JIA has fewer functional limitations and disabilities compared to other JIA subtypes. • As JIA can affect all aspects of a child's life, there is a need to improve the quality of life related to the disease. What is New: • It should be considered that patients with oligoarticular JIA may show lower PA and HRQOL scores compared to healthy controls despite favorable disease control. • Since there may be a relationship between PA and HRQOL, factors that may affect PA should be investigated to provide a holistic approach to JIA treatment.

Assessing health-related quality of life among cancer survivors during systemic and radiation therapy in Bangladesh: a cancer-specific exploration

BackgroundEvaluating the effects of cancer diagnosis and treatment on a patient’s overall well-being is crucial and health-related quality of life (HRQoL) is a reliable metric for assessing this impact. Little is known about HRQoL among cancer survivors across various stages and treatments. The study examined individual and clinical factors influencing HRQoL among cancer survivors.MethodsA cross-sectional study was conducted in two specialised cancer care hospitals in Dhaka, Bangladesh. Cancer-diagnosed adults receiving treatment at selected hospitals from January to May 2022 were enrolled. The 5-level EuroQol-5 Dimensions version (EQ-5D-5L) instrument was used to collect HRQoL data. HRQoL scores were derived using UK value sets. The investigation used a multivariable Tobit regression model to determine the association between independent variables and HRQoL scores.ResultsA total of 607 adult patients were enrolled, with 55% being females and 66% aged 36 to 64 years. Reported health problems in five EQ-5D domains include mobility (11%), self-care (11%), usual daily activities (19%), pain/discomfort (21%), and anxiety/depression (46%). Patients with throat, brain, lung, blood, and liver cancer had lower utility scores. Advanced-stage cancer survivors had lower utility scores (β = -49 units, 95% codfidence interval [CI]: -0.75 to -0.22) compared to early-stage survivors. Physically inactive survivors had lower utility scores by 0.41 units (95% CI: -0.51 to -0.30) compared to their counterparts. Private hospital patients had higher utility scores, whereas patients belonged to poor socioeconomic groups scored worse than wealthier ones.ConclusionsThis study highlights the impact of clinical and individual characteristics on HRQoL among cancer survivors. These findings advocate for an enhanced Bangladeshi cancer patient care model through timely interventions or programs, early detection or diagnosis, tailored treatments, and the promotion of physical activity to bolster HRQoL outcomes.

SARS-CoV-2 vaccine hesitancy in patients with heart failure: relationship with patient characteristics and pre-pandemic quality of life – a cohort study

Heart failure (HF) patients are vulnerable to a complicated course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This research analysed the relationship between the decision not to be immunised against SARS-CoV-2, clinical and epidemiological factors, and the pre-pandemic health-related quality of life (HRQoL) of HF patients. Before the onset of the SARS-CoV-2 pandemic, hospitalised HF patients were enrolled as a prospective cohort and interviewed using the World Health Organization's Quality of Life Brief Version questionnaire. On October 30, 2021, the immunisation status was verified. The association of vaccination hesitancy with epidemiological and clinical parameters and pre-pandemic questionnaire results was tested. Subsequently, independence from confounding factors such as age, sex, the New York Heart Association (NYHA) scale, and left ventricular ejection fraction (LVEF) was analyzed. Among the 136 included patients, 77.9% were vaccinated. Unvaccinated patients were younger (51.2±13.2 vs 56.6±10.3; p = 0.018) and more frequently had non-ischaemic aetiology of HF (73.3% vs 46.7%; p=0.013). It was significant after adjustment for age, sex, NYHA class, and LVEF. There was no association of overall HRQoL or domain scores with vaccination status. Younger age as a factor associated with vaccine avoidance in this population is consistent with data from the general population despite higher exposure to the severe course of the disease.

Longitudinal evaluation of health-related quality of life after removal of high-risk melanoma in a setting where adjuvant therapy is not available.

To evaluate health-related quality of life (HRQoL) of people with a high-risk skin melanoma after completion of the primary surgical treatment over time, as well as, to identify factors associated with better HRQoL at the beginning and at the end of follow-up. The study included subjects with histopathologically confirmed high-risk skin melanoma in clinical stages IIC, IIIA, IIIB, and IIIC, in whom clinical and radiographic signs of the disease were not confirmed after primary surgical treatment. The HRQoL was evaluated using Short Form-36 (SF-36) after completion of primary surgical treatment (start of follow-up) and after 6 to 12months (end of follow-up). A total of 71 people completed SF-36 at both points in time. There were no significant differences between the initial and the follow-up total HRQoL score (t = 1.118; p = 0.267). At the start of follow-up, having fewer depressive symptoms, better functional status and lower vitamin D serum levels were associated with a better total HRQoL score. At the end of follow-up, having lower Breslow depth and being employed at the start of follow-up, having fewer depressive symptoms and lower C-reactive protein (CRP) serum levels at follow-up, and not developing metastases over follow-up were associated with a higher total HRQoL scores. The HRQoL of people with high-risk melanoma did not change in the year following the complete removal of the tumor. However, presence of depressive symptoms and metastases seem to have the strongest impact on poorer quality of life after surgery.

Financial toxicity and its implication on quality of life in patients attending the palliative care department in a regional cancer centre: An observational study

In India the cancer burden for 2021 was 26.7 million disability-adjusted life years (DALYs), and this is expected to increase to 29.8 million in 2025 (Kulothungan et al., 2022). According to the World Health Organisation (WHO), cancer is a leading cause of death worldwide, accounting for one in six deaths. As per WHO, palliative care is a strategy that assists both adults and children along with their families in dealing with life-threatening illnesses. Currently, only 14% of those in need of pain and palliative (P&P) care receive it globally (WHO, 2020). Financial toxicity (FT) is the term used to describe the negative effects that an excessive financial burden resulting from cancer have on patients, their families, and society (Desai and Gyawali, 2020). Addressing this gap will require significant adjustments to both demand- and supply-side policies to ensure accessible and equitable cancer care in India (Caduff et al., 2019). Measuring FT along with health-related quality of life (HRQoL) represents a clinically relevant and patient-centred approach (de Souza et al., 2017). Aim and objectiveTo estimate FT and its association with quality of life (QoL). Materials and methodsThis was an observational descriptive study conducted among cancer patients recommended for P&P care. Scores were estimated from September 2022 to February 2023 using official tools: the Functional Assessment for Chronic illness Treatment Compressive Score for Financial Toxicity (FACIT-COST) and the European Organisation for Research and Treatment of Cancer (EORTC) Quality of life Questionnaires for Cancer (QLQ30). ResultsFrom 150 patients (70 males and 80 females, mean age 54.96 ± 13.5 years), 92.6% suffered from FT. Eleven patients (7.3%) were under FT grade 0, 41 (27.3%) were FT grade 1, 98 (65.3%) were FT grade 2, and no patients were under FT grade 3. At criterial alpha 0.05 (95%CI), FT and the global score for HRQoL showed an association. Among inpatient department (IPD) expenses, medication bills contributed the greatest expense at 33%, and among outpatient department (OPD) expenses treatment expenses contributed 50% of the total. Breast cancer (30 cases, 20%) and oral cancer (26 cases, 17.3%) were the most frequent cancers. ConclusionFT measured using the COST tool showed an association with HRQoL. Policy summaryThis paper refers to the insurance policies available for cancer patients irrespective of P&P care treatment.

Assessing Health-related Quality of Life in Children with Chronic Kidney Disease in Indonesia: A Single Tertiary Hospital Study.

Health-related quality of life (HRQOL) is an important patient-reported outcome. However, HRQOL research in pediatric patients with chronic kidney disease (CKD) in developing countries is limited. This cross-sectional study involved children with CKD who attended Dr. Sardjito General Hospital between January 2017 and September 2018. In total, 82 child-parent pairs were enrolled. Total HRQOL scores were significantly lower in children with Stages 3a-5 CKD than in children with Stages 1-2 CKD in the child (69.89 vs. 82.12, P = 0.004) and parent questionnaires (72.26 vs. 81.20, P = 0.02). The scores for the physical, school, and social function domains were significantly decreased. This study showed that children with Stages 3a-5 CKD had significantly lower HRQOL scores compared with children in the Stages 1-2 CKD group. Multidisciplinary teams can provide patient-centered and comprehensive management to optimize HRQOL scores during childhood and in future adult life.

Factors that impact health-related quality of life in 168 myasthenia gravis in West China: Disease severity, social support, and coping style

Background: Myasthenia gravis (MG) is associated with reduced health-related quality of life (HRQOL). This study aimed to investigate factors that impact HRQOL in MG in a patient population in West China. Methods: A series of questionnaires were completed by 168 patients to assess the relationships between HRQOL and social support and coping style. We also evaluated the contributions of clinical characteristics to HRQOL. One-way analysis of variance (ANOVA), correlation and regression analysis were conducted to identify predictors that negatively impact HRQOL in MG. Results: There were significant differences in HRQOL scores among patients with different ratio of disease cost to income each month (F = 5.831, P = 0.001) and frequency of MG symptoms (F = 9.128, P &lt; 0.001). Spearman’s correlation analysis showed that reduced HRQOL had low correlation with Myasthenia Gravis Composite score (r = 0.461, P &lt; 0.001), confrontation (r = 0.312, P &lt; 0.001) and acceptance- resignation coping style (r = 0.433, P &lt; 0.001). Stepwise regression analysis further revealed that acceptance-resignation coping style (β = 0.380, P &lt; 0.001) and MGC score (β = 0.322, P &lt; 0.001) were the main predictors of HRQOL. Conclusions: Our study revealed the factors that impact HRQOL in MG patients and provided the first demonstration that acceptance-resignation is the main independent predictor of poor HRQOL in MG, other than disease severity.

Self-rated Health in Youth with Different Screen Time in Their Adolescence: Tehran Lipid and Glucose Study.

The long-term effects of childhood screen time on health-related quality of life (HRQoL) are still unclear. This study aimed to investigate the relationship between screen time during adolescence and sex-specific HRQoL in early youth. We studied the data from 642 adolescents aged 13-19 years, who participated in the Tehran Lipid and Glucose Study from 2005 to 2011 (baseline) with complete data on HRQoL in their early adulthood (22-28 years at the last follow-up). Physical and Mental HRQoL were assessed using the Iranian version of the short-form 12-item health survey version 2 (SF-12v2). Screen time and leisure-time physical activity were evaluated using the Iranian Modifiable Activity Questionnaire (MAQ). All analyses were conducted in Stata (version 14); MI used the mi impute command. The mean±SD of age, body mass index (BMI), and physical activity in childhood were 16.33±1.27, 23.27±4.63 and 13.77±16.07, respectively. Overall, 35% of boys and 34% of girls had high screen time (HST) in childhood. In general, the HRQoL scores in male participants were higher than in females in both the mental and physical domains. HST in males in childhood was associated with decreased mental health (β=-6.41, 95% CI: -11.52, -1.3 and P=0.014), social functioning (β=-5.9, 95% CI: -11.23, -0.57 and P=0.03) and mental component summary (MCS) (β=-2.86, 95% CI: -5.26, -0.45 and P=0.02). The odds of poor MCS were significantly higher in those with HST compared to their counterparts with low screen time (LST) after adjusting for all potential cofounders. The results of the present study showed the negative effect of screen time during adolescence on HRQoL in early youth. This effect was observed in men, mainly in the mental dimension. Investigating the long-term consequences of screen-time behaviors on self-assessed health in other populations with the aim of effective primary prevention is also suggested.

OP143 Association Of Different Venous Access Device With Health‑Related Quality Of Life Among Patients With Breast Cancer In China

IntroductionFew studies have explored the relationship between different venous access devices and health-related quality of life (HRQoL) among patients with breast cancer in China. This study aimed to evaluate the HRQoL of patients with breast cancer in China who underwent different venous access devices and to estimate the association between type of venous access device and HRQoL.MethodsA multicenter cross-sectional study was conducted in three tertiary hospitals from three major geographical regions in China. The final sample consisted of 472 patients aged from 18 to 78 years. The HRQoL was measured with the EQ-5D-5L scale and the EuroQoL Group visual analog scale. The venous access devices were divided into totally implantable venous access devices (TIVAD), peripherally inserted central catheters (PICC), and other devices. The multivariate regression analyses were used to explore the association between type of venous access device and HRQoL.ResultsOf 472 participants, 352 (75%) used the TIVAD device, 89 (19%) used the PICC device, and 31 (7%) used other devices. The TIVAD group had the highest EQ-5D-5L values (mean 0.89, standard deviation [SD] 0.178), while the PICC group had the lowest values (mean 0.85, SD 0.239). The EQ-5D-5L values for the other venous access device group was in between (mean 0.88, SD 0.127). However, the multivariate analysis indicated that the VAS and EQ-5D-5L scale dimension scores among patients were not significantly different (P&gt;0.05) for the various central venous access devices.ConclusionsThis study demonstrates a non-significant association between the type of venous access device used and the HRQoL of patients with breast cancer in China. Although patients with a TIVAD experienced more pain during device insertion and access for chemotherapy, the negative effect on HRQoL scores was smaller than for PICCs.

Abstract B129: The association of Covid-19 pandemic restrictions with patient-reported outcomes and lifestyle behaviors among breast cancer survivors: Evidence from a cohort of Black and Hispanic breast cancer survivors in New Jersey

Abstract Purpose: The onset of COVID-19 pandemic restrictions in the US since March 2020 has worsened the disproportionate burden of physical and mental health challenges faced by vulnerable Black and Hispanic breast cancer (BrCa) patients. BrCa survivors experienced delays in their cancer treatments and limited access to supportive care, which may lead to further physical, and psychosocial challenges during an already difficult time. This study aimed to evaluate the association of the COVID-19 pandemic restrictions with patient-reported outcomes (PROs) (i.e. health-related quality of life (HRQoL), sleep, perceived stress, coping and financial toxicity), and lifestyle behaviors (i.e. obesity, smoking, and alcohol) among Black and Hispanic BrCa survivors participating in the Women’s Circle of Health Follow-Up 1 (WCHSFU1) and the New Jersey Breast Cancer Survivors Study (NJBCS), two ongoing population-based studies in New Jersey. Methods: The NJBCS followed similar methods to those in the WCHSFU1. We included a total of 447 Black (npre=364 and npost=83) and 182 Hispanic (npre=102 and npost=80) BrCa survivors who completed a home interview ~24 months post-diagnosis, from 2017 to 2023. The COVID-19 pandemic era was defined as pre- (recruited prior to March 2020) and post-(recruited after March 2020) pandemic. To assess the association of the pandemic with PROs and lifestyle behaviors we employed multivariable adjusted Poisson regression models with robust standard errors to estimate prevalence ratios with 95%CI. Results: Compared to the pre-pandemic group, Black survivors in the post-pandemic group were more likely to be educated, to have higher income, and to be foreign-born, while Hispanic women were significantly more likely to have private insurance and higher HRQoL, physical and emotional well-being mean scores (p&amp;lt;0.05 for all). Adjusted Poisson models indicated that Hispanic women in the post-pandemic group had 1.53 times higher prevalence of low resilience (vs high resilience) (PR:1.53 95% CI: 1.15-2.04), compared to the pre-pandemic group. Whereas Black women in the post-pandemic group reported a higher prevalence of clinically significant sleep disturbance and efficiency (PR: 1.43 95% CI: 1.23-1.68 and PR:1.50 95% CI: 1.30 – 1.73, respectively), compared to the pre-pandemic group. Both Hispanic and Black women in the post-pandemic group showed significantly less perceived stress and a lower prevalence of alcohol consumption. Conclusion: We found heterogeneity in the prevalence of PROs and lifestyle behaviors by pandemic era among Black and Hispanic survivors. Notably, we also noticed differences in demographic characteristics of women participating after the onset of the pandemic, which highlights the importance of considering the impact of the pandemic in all aspects of research, including the interpretation of findings. Continuing research to untangle important factors contributing to racial and ethnic differences in patient characteristics, PROs and lifestyle behaviors post-pandemic in cancer survivorship is warranted. Citation Format: Carola T. Sanchez-Diaz, Nur Zeinomar, Hari S. Iyer, Marley Perlstein, Chi-Chen Hong, Bo Qin, Elisa V. Bandera. The association of Covid-19 pandemic restrictions with patient-reported outcomes and lifestyle behaviors among breast cancer survivors: Evidence from a cohort of Black and Hispanic breast cancer survivors in New Jersey [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B129.

Assessment of quality of life and its affecting factors in osteosarcopenic individuals in the Iranian older adult population: Bushehr Elderly Health (BEH) program

ObjectivesThis cross-sectional study, conducted as part of the Bushehr Elderly Health program stage II in Bushehr, Iran, aimed to evaluate health-related quality of life (HR-QoL) in individuals aged ≥ 60 with osteosarcopenia, a condition characterized by the co-occurrence of osteopenia/osteoporosis and sarcopenia. Given the increasing elderly population worldwide, understanding the HR-QoL of this demographic is crucial, with osteosarcopenia being a significant factor. MethodsThe study enrolled 2369 participants aged ≥ 60 and collected demographic and anthropometric data. Various questionnaires, including the Short Form 12, Patient Health Questionnaire-9, Activities of Daily Living, and Instrumental Activities of Daily Living, were administered. Comparisons were made between individuals with and without osteosarcopenia. Regression models were employed to identify variables associated with HR-QoL in those with osteosarcopenia. ResultsKey findings revealed that 22.5% of participants had osteosarcopenia. Significantly different HR-QoL measures were observed between the 2 groups, especially in physical functioning and physical component summary scores. Male gender, advanced age, and chronic illnesses were linked to lower physical and mental HR-QoL scores among those with osteosarcopenia. In female participants, a history of fractures and physical disability were associated with reduced quality of life. ConclusionsThis study underscores the negative impact of osteosarcopenia on HR-QoL, particularly in male participants, with a focus on physical aspects. It also highlights age and chronic disease as contributing factors to diminished HR-QoL in individuals with osteosarcopenia. These findings emphasize the importance of addressing osteosarcopenia in the elderly population to improve their overall well-being.

The quality of life among children with epilepsy in resource-limited settings: A pilot study in a paediatric neurology clinic at a quaternary care teaching hospital

Background. An important part of holistic care management of children with epilepsy (CWE) is measuring their health-related quality of life (HRQOL). However, little is known about the HRQOL of CWE who live in resource-limited settings, particularly in South Africa. Objectives. To assess the HRQOL of CWE and to identify the possible factors that correlate with HRQOL including demographic variables and epilepsy health-related factors. Methods. A cross-sectional prospective quantitative study was undertaken at the paediatric neurology outpatient clinic at Inkosi Albert Luthuli Hospital (IALCH), a quaternary care teaching hospital in Durban, South Africa. Participants were recruited during the period between December 2019 and February 2020. CWE between 2 and 12 years old with no comorbid syndromic disorder or other chronic diseases accompanied by English-speaking caregivers were included in the study. We used the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) generic core parent-proxy questionnaire modified with separate sociodemographic and epilepsy data collection sheets. Results. One hundred and twenty participants were recruited. The majority of patients (54.2%) had generalised epilepsy. The aetiology of epilepsy was unknown in 40.8% of patients. The most commonly used anti-seizure medication was sodium valproate (39.2%). The mean of the total score of HRQOL (SD) (coefficient of variation %) was 66.7 (24.1 (36.1). School attendance p-value&lt;0.001, financial aid for indigent families p 0.047, monotherapy p&lt;0.001, absence of disability p&lt;0.001 and absence of comorbidity p &lt;0.001were strongly associated with good HRQOL total scores. Conclusion. CWE attending IALCH in Durban, South Africa, have compromised HRQOL scores. The variables that significantly correlate with better HRQOL scores are school attendance, receiving financial aid for indigent families, monotherapy, and absence of disabilities and comorbidities. We recommend a multicentre study that involves a larger number of epileptic children with the employment of the epilepsy-specific PedsQL 4.0 module translated into local languages.

Association of Health-Related Quality of Life and Work Productivity with Clinical Characteristics in Adults with Sickle Cell Disease

Introduction: Adults with sickle cell disease (SCD) suffer from periodic episodes of severe acute pain, chronic pain, fatigue, acute complications, end-organ damage and early mortality. We explored clinical characteristics associated with health-related quality of life (HRQoL) and work productivity and activity impairment (WPAI) in adults with SCD. Methods: Between January 2022 and June 2023, we recruited 87 adults aged ≥18 years with a diagnosis of SCD from four U.S. NASCC recognized SCD centers participating in the Globin Research Network for Data and Discovery ( GRNDaD) registry. We collected data on patient socio-demographics, fatigue, chronic pain, WPAI, and HRQoL measured by EQ-5D-5L and ASCQ-Me via patient survey. Medical history checklist (MHC) score sums 9 SCD complications and treatment history. Clinical charateristis on SCD subtype and baseline hemoglobin were obtained from the medical record. Clinical characteristics and self-reported MHC, chronic pain associated with HRQoL, and WPAI scores were assessed by Student T-tests or Pearson correlation. Results: Mean age was 38.0±13.4 (standard deviation) years, 58.6% of the sample was female, 64.3% had hemoglobin (Hb) SS disease, 73.6% reported chronic pain (experiencing pain on ≥3 days per week in the past 6 months). Mean EQ visual analogue scale (VAS) was 71.3 (lower than the U.S. 35-44 age mean of 81.8). Mean EQ index score was 0.73 (lower than the U.S. 35-44 age group population norm 0.85). Mean fatigue score was 52.1 (range 33.7-75.8) and was negatively correlated with HRQoL scores, indicating higher fatigue correlated with lower patient's self-rated health, including the EQ VAS (correlation coefficient r=-0.49, p&amp;lt;0.0001), EQ index score (r=-0.53, p&amp;lt;0.0001), and all domain of ASCQ-Me scores including pain (r=-0.52, p&amp;lt;0.0001), stiffness (r=-0.55, p&amp;lt;0.0001), sleep (r=-0.43, p&amp;lt;0.0001), emotion (r=-0.65, p&amp;lt;0.0001), and social functioning score (r=-0.64, p&amp;lt;0.0001). Fatigue score was correlated with pain episode frequency (r=0.29, p=&amp;lt;0.001, indicated more frequent pain episodes correlated with higher fatigue), and pain episode severity score (r=0.34, p=0.002). Fatigue score also correlated with overall activity impairment due to SCD (r=0.47, p&amp;lt;0.0001). MHC score was negatively correlated with EQ VAS (r=-0.32, p=0.003), EQ index score (r=-0.35, p=0.001), ASCQ-Me pain (r=-0.25, p=0.02), stiffness (r=-0.28, p=0.009), emotion (-0.23, p=0.03), social (r=-0.28, p=0.01), pain episode severity score (r=0.26, p=0.02) and fatigue score (r=0.35, p=0.0009). Hemoglobin was not correlated with HRQoL or fatigue scores. MHC score significantly correlated with overall activity impairment (r=0.22, p=0.04). As compared to patients who had MHC≤2, those with score&amp;gt;2 had significantly lower mean EQ-VAS, EQ index score, ASCQ-Me domain impacts in pain, stiffness, sleep, emotion, social funtioning, and pain episode severity, but higher fatigue score and greater absenteeism. Patients who reported chronic pain had significantly lower mean EQ VAS, EQ index score, ASCQ-Me domain impacts in pain, stiffness, sleep, emotion, social functioning, higher pain episode frequency, pain episode severity, and fatigue score, greater presenteeism score (impairment while working), overall work productivity loss and overall activity impairment than those without chronic pain. SCD subtype was not associated with HRQoL and fatigue scores. Conclusions: Hemoglobin and SCD subtype were not significantly associated with HRQoL and fatigue in this sample (possibly due to selection bias, where higher functioning patients were more likely to be selected for study participation). Fatigue in adults with SCD is moderately correlated with EQ-5D-5L scores, ASCQ-Me domains on pain, stiffness, sleep, emotion, and social functioning, as well as overall activity impairment, but weakly correlated with pain episode frequency and severity. MHC had weak correlation with EQ-5D-5L scores, ASCQ-Me domains on pain, stiffness, emotion, and social, and activity impairment. Individuals who had higher fatigue score, MHC score≥2, and reported chronic pain showed lower HRQoL and higher impairment of work productivity and activity. Future analyses will explore how multiplicity problems that SCD patients suffer impact HRQoL and work productivity and activity impairment in longitudinal data, which will identify the opportunity on intervention to improve patient care.

Health-Related Quality of Life in Polish Patients with Multiple Myeloma Treated in the Phase 3 ATLAS Trial of Post-Transplant Maintenance with Carfilzomib, Lenalidomide, Dexamethasone or Lenalidomide Alone

Introduction Results of the unplanned interim analysis of the ATLAS trial (Dytfeld, Lancet Oncology 2023) suggest a progression-free survival benefit of carfilzomib, lenalidomide, and dexamethasone (KRd) post-transplant maintenance over single-agent lenalidomide (R). Use of triplet combination, with frequent hospital visits and repeated intravenous infusions raises questions about its long-term tolerability and the impact on health-related quality of life (HRQoL) compared with relatively convenient and well-tolerated single-agent oral lenalidomide. Here, we present a descriptive, longitudinal assessment of HRQoL in Polish patients with multiple myeloma treated in the ATLAS trial. Methods ATLAS is an ongoing phase 3 trial that randomized 180 patients with newly-diagnosed multiple myeloma after ASCT to receive maintenance therapy with KRd or R. In the KRd arm, patients with standard-risk cytogenetics who achieved MRD-negativity after cycle 6 de-escalated therapy to receive R alone after cycle 8. HRQoL assessment was not required by the study protocol, however, the FACT/GOG-Ntx questionnaires were collected according to local protocols for post-transplant data collection at 7 Polish sites at screening (approximately 3 months post-transplant) and after cycles (C) 6, 12, 18, 24, 30, and 36. Therefore, the modified intention-to-treat (mITT) population in this analysis consisted of 134 patients enrolled in these sites. The domains evaluated by the FACT/GOG-Ntx questionnaire include physical well-being (PWB), social well-being (SWB), emotional well-being (EWB), functional well-being (FWB), and neurotoxicity (Ntx). The outcomes are summarized in FACT/GOG-Ntx Trial Outcome Index (TOI, combining PWB, FWB, and Ntx), FACT-G Total Score (PWB, SWB, EWB, and FWB), and FACT/GOG-Ntx Total Score (all five domains). Based on previous reports, the minimally important difference (MID) was defined as a change of at least 10% of the instrument range (Tremblay, BMC Cancer 2021). Student's t-test was used for comparisons between normally distributed variables and Wilcoxon rank-sum test for not normally distributed. Rates of patients experiencing MID were compared using chi-square test. Results HRQoL questionnaires were available for 123 out of 134 patients (92%). The numbers of completed questionnaires at screening, C6, C12, C18, C24, C30, C36 were 115 (86% of randomized patients / 86% of expected patients), 111 (83%/86%), 102 (76%/85%), 93 (69%/85%), 82 (61%/86%), 74 (55%/87%), and 56 (42%/80%), respectively. Throughout the analyzed timepoints, the mean PWB, SWB, EWB, FWB, NTx scores (Figure 1), FACT/GOG-NTx TOI, FACT-G Total Score, and FACT/GOG-Ntx Total Score (Figure 2) did not differ between the two study arms. A similar pattern was observed in the changes in individual patient scores compared to baseline. During the treatment course, the rates of patients experiencing a decrease in HRQoL scores, reaching the MID threshold in at least one evaluation, were consistent in both groups - 19 out of 59 (32%) patients treated with KRd and 20 out of 52 (38%) patients in the R arm (p=0.49) in the FACT/GOG-NTx TOI, 23/59 (39%) in the KRd arm and 21/52 (40%) in the R arm in the FACT-G Total Score (p=0.88), and 24/59 (41%) in the KRd arm and 19/52 (37%) in the R arm in the FACT/GOG-Ntx Total Score (p=0.65). Similarly, there were no differences in the respective results in terms of patients experiencing an increase in HRQoL scores, reaching the MID threshold in at least one evaluation - 8 out of 59 (14%) patients treated with KRd and 11 out of 52 (21%) patients in the R arm (p=0.28) in the FACT/GOG-NTx TOI, 10/59 (17%) in the KRd arm and 13/52 (25%) in the R arm in the FACT-G Total Score (p=0.29), and 8/59 (14%) in the KRd arm and 6/52 (12%) in the R arm in the FACT/GOG-Ntx Total Score (p=0.75). Conclusions The results of this analysis do not imply a negative impact of post-transplant maintenance with carfilzomib, lenalidomide, and dexamethasone compared to single-agent lenalidomide on the HRQoL.

Self-Reported Moderate-to-Vigorous Physical Activity: Its Association with Health-Related Quality of Life in a Large Cohort of People with Chronic Diseases

The aim of this study was to investigate the dose–response relationship between physical activity and health-related quality of life (HRQoL) in a large population-based sample of people with chronic disease. We analysed the data of 29,271 adults (15,315 women) who were diagnosed with chronic diseases and participated in the Welsh Health Survey (Wales, UK; data collection 2011–2015). Participants were classified, based on their weekly minutes of moderate-to-vigorous physical activity (MVPA), into four groups as follows: inactive (no MVPA), insufficiently active (&lt;150 min/week), sufficiently active (≥150–&lt;300), and very active (≥300). The main outcome was HRQoL measured via the Short-Form 36 Health Survey (SF-36). This study found a curvilinear association between MVPA and HRQoL and a dose–response relationship for the perception of general health and vitality domains. Compared to inactive participants, those who were very active had higher HRQoL scores (coefficient = 12.54; 95% confidence interval [CI] 11.39–13.70), followed by sufficiently active (coefficient = 11.70; 95% CI 10.91–12.49) and insufficiently active (coefficient = 9.83; 95% CI 9.15–10.51) participants. The fully adjusted regression model showed curvilinear associations between MVPA and the domains of SF-36. Future research should find ways to motivate people with chronic diseases to engage in physical activity. The evidence to support regular exercise in individuals with chronic diseases in all age groups is strong and compelling, and patients should be encouraged to regularly devote more time to physical activity in order to improve their health and well-being.