Health-related Quality Of Life Loss Research Articles

Bariatric Surgery: An Opportunity to Improve Quality of Life and Healthy Habits.

Bariatric surgery therapy (BST) is an effective treatment for obesity; however, little is known about its impacts on health-related quality of life (HRQoL) and related factors. This study aimed to evaluate changes in HRQoL and its relationship with weight loss, depression status, physical activity (PA), and nutritional habits after BST. Data were obtained before and 18 months postprocedure from 56 obese patients who underwent BST. We administered four questionnaires: Short Form-36 health survey for HRQoL, 14-item MedDiet adherence questionnaire, Rapid Assessment of PA (RAPA) questionnaire, and Beck's Depression Inventory-II. Multivariable linear regression analysis was used to identify factors associated with improvement in HRQoL. After the surgery, MedDiet adherence and HRQoL improved significantly, especially in the physical component. No changes in PA were found. Patients without previous depression have better mental quality of life, and patients who lost more than 25% of %TBWL have better results in physical and mental quality of life. In the multivariable analysis, we found that %TBWL and initial PCS (inversely) were related to the improvement in PCS and initial MCS (inversely) with the MCS change. In conclusion, BST is an effective intervention for obesity, resulting in significant weight loss and improvements in HRQoL and nutritional habits.

Dry eye symptoms and health-related quality of life among Chinese individuals: a national-based study

AimsTo assess the impact of dry eye symptoms (DESs) on health-related quality of life (HRQOL) among Chinese residents.MethodsA total of 21 916 participants were involved in this nationwide cross-sectional study....

Health utilities and health‐related quality of life of patients with keratinocyte skin cancers

AbstractBackgroundHealth utilities and health‐related quality of life (HRQoL) have not been adequately examined in patients with basal and squamous cell carcinomas (or keratinocyte skin cancers KCs) repeatedly treated for multiple skin cancers and who require ongoing medical surveillance.ObjectivesOur aim was to assess whether health utilities and HRQoL in an Australian population‐based sample of patients recently treated for multiple KCs were poorer compared to patients with single or no KCs.MethodsSelected from the QSkin Study, a cross‐sectional analysis of 680 patients was undertaken involving data linkage of survey and administrative claims data. Health utility was measured using the EuroQol‐5D 5‐level (EQ‐5D‐5L) while HRQoL was assessed using the Basal and Squamous Cell Carcinoma Quality of Life (BaSQoL) instrument. Scores were summarised by sociodemographic and skin cancer profiles and stratified by skin cancer group (i.e., naïve or zero, single, multiple KCs). Generalised linear models with Poisson family and log link functions were used for multivariate analyses.ResultsThe mean EQ‐5D‐5L score was slightly worse for people with multiple KCs (mean: 0.88, SD: 0.14) versus single KCs (mean: 0.90, SD: 0.16) versus none (mean: 0.91, SD: 0.11). Mean scores were not significantly different across skin cancer group after adjustment for number of comorbidities and self‐reported health. BaSQoL domain scores indicated having KCs had little impact on quality of life with mean total scores ranging from 0.27 for the ‘appearance’ domain to 1.15 for the ‘other people’ domain out of a maximum (worst) score of 3.ConclusionsEven among persons chronically afflicted with multiple KCs and ongoing surgical and nonsurgical treatments, health utility and HRQoL losses were minimal and similar to those people without KCs.

Economic burden and health-related quality-of-life among infants with respiratory syncytial virus infection: A multi-country prospective cohort study in Europe.

Respiratory syncytial virus (RSV) causes a considerable disease burden in young children globally, but reliable estimates of RSV-related costs and health-related quality-of-life (HRQoL) are scarce. This study aimed to evaluate the RSV-associated costs and HRQoL effects in infants and their caregivers in four European countries. Healthy term-born infants were recruited at birth and actively followed up in four European countries. Symptomatic infants were systematically tested for RSV. Caregivers recorded the daily HRQoL of their child and themselves, measured by a modified EQ-5D with Visual Analogue Scale, for 14 consecutive days or until symptoms resolved. At the end of each RSV episode, caregivers reported healthcare resource use and work absenteeism. Direct medical costs per RSV episode were estimated from a healthcare payer's perspective and indirect costs were estimated from a societal perspective. Means and 95% confidence intervals (CI) of direct medical costs, total costs (direct costs+productivity loss) and quality-adjusted life-day (QALD) loss per RSV episode were estimated per RSV episode, as well as per subgroup (medical attendance, country). Our cohort of 1041 infants experienced 265 RSV episodes with a mean symptom duration of 12.5days. The mean (95% CI) cost per RSV episode was €399.5 (242.3, 584.2) and €494.3 (317.7, 696.1) from the healthcare payer's and societal perspective, respectively. The mean QALD loss per RSV episode of 1.9 (1.7, 2.1) was independent of medical attendance (in contrast to costs, which also differed by country). Caregiver and infant HRQoL evolved similarly. This study fills essential gaps for future economic evaluations by prospectively estimating direct and indirect costs and HRQoL effects on healthy term infants and caregivers separately, for both medically attended (MA) and non-MA laboratory-confirmed RSV episodes. We generally observed greater HRQoL losses than in previous studies which used non-community and/or non-prospective designs.

Prospective study of loss of health-related quality adjusted life years in children and their families due to uncomplicated and hospitalised varicella.

Although usually benign, varicella can lead to serious complications and sometimes long-term sequelae. Vaccines are safe and effective but not yet included in immunisation programmes in many countries. We aimed to quantify the impact on health-related quality of life (HRQoL) in terms of quality-adjusted life years (QALY) in children with varicella and their families, key to assessing cost-utility in countries with low mortality due to this infection. Children with varicella in the community and admitted to hospitals in Portugal were included over 18months from January 2019. Children's and carers' HRQoL losses were assessed prospectively using standard multi-attribute utility instruments for measuring HRQoL (EQ-5D and CHU9D), from presentation to recovery, allowing the calculation of QALYs. Among 109 families with children with varicella recruited from attendees at a pediatric emergency service (community arm), the mean HRQoL loss/child was 2.0days (95% CI 1.9-2.2, n=101) (mean 5.4 QALYs/1000 children (95% CI 5.3-6.1) and 1.3days/primary carer (95% CI 1.2-1.6, n=103) (mean 3.6 QALYs /1000 carers (95% CI 3.4-4.4). Among 114 families with children admitted to hospital because of severe varicella or a complication (hospital arm), the mean HRQoL loss/child was 9.8days (95% CI 9.4-10.6, n=114) (mean 26.8 QALYs /1000 children (95% CI 25.8-29.0) and 8.5days/primary carer (95% CI 7.4-9.6, n=114) (mean 23.4 QALYs/1000 carers (95% CI 20.3-26.2). Mean QALY losses/1000 patients were particularly high for bone and joint infections [67.5 (95% CI 43.9-97.6)]. Estimates for children's QALYs lost using the CHU9D tool were well correlated with those obtained using EQ-5D, but substantially lower. The impact of varicella on HRQoL is substantial. We report the first measurements of QALYs lost in hospitalised children and in the families of children both in the community and admitted to hospital, providing important information to guide vaccination policy recommendations.

Changes in quality-adjusted life expectancy in Belgium, 2013 and 2018

IntroductionNo information is available in Belgium on life expectancy adjusted for health-related quality of life (HRQoL). Quality-adjusted life expectancy (QALE) captures the multidimensionality of health by accounting for losses in mortality and HRQoL linked to physical, mental, and social impairments. The objective of this study is to estimate for Belgium QALE, the changes in QALE between 2013 and 2018 and the contribution of mortality, HRQoL and its dimensions to this trend.MethodsThe Belgian Health Interview Survey (BHIS), a representative sample of the general population, included the EQ-5D-5L instrument in 2013 and 2018. The tool assesses HRQoL comprising five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) using a 5-level severity scoring to define a large variety of health states. The Sullivan method was used to compute at different ages QALE by gender using mortality data from the Belgian statistical office and average EQ-5D scores from the BHIS. QALE was calculated for 2013 and 2018, and changes in QALE over time were decomposed into mortality and ill-health effect.ResultsIn 2018, QALE at age 15 years (QALE15) was 56.3 years for women and 55.8 years for men, a decrease from 2013 by 0.7 year for women and a stagnation for men. In men, the decrease in mortality counterbalanced the decline in HRQoL. The decline in QALE in women is driven by a decrease in mortality rates that is too small to compensate for the substantial decline in HRQoL before the age of 50 years. In women at older ages, improvements in HRQoL are observed. In women, QALE15 is decreasing due to an increase in pain/discomfort, anxiety/depression and problems in usual activities. In men at age 15, the pain/discomfort and anxiety/depression domains contributed to the stagnation. QALE65 increased somewhat, due to an improvement in self-care and mobility for both genders, and usual activities and anxiety/depression in men only.ConclusionThe strength of QALE as member of the family of composite indicators, the health expectancies, is the multidimensional structure of the underlying health component, including both ill-health with different health domains as levels of severity. The ability to decompose differences in the health expectancy not only into a mortality and health component but also into the different health dimensions allows to better inform on general population health trends. Next, compared to other health expectancy indicators, QALE is more sensitive to changes at younger ages.

The lifetime costs of perinatal depression and anxiety in Brazil

BackgroundEach year, an estimated 860,000 Brazilian women experience depression and anxiety perinatally. Despite well-known devastating impacts of these conditions on mothers and children, they remain neglected in low- and middle-income countries. Knowing the costs of untreated perinatal depression and anxiety can inform decision-making. MethodsSimulation modelling is used to examine lifetime costs of perinatal depression and anxiety for a hypothetical cohort of women and their children, followed until children are aged 40 years. Costs are measured from a societal perspective, including healthcare expenditure, productivity and health-related quality of life losses; 2017 data are taken from country-specific sources. Present values are calculated using a discount rate of 3 %. ResultsLifetime cost of perinatal depression and anxiety in Brazil are USD 4.86 billion or R$ 26.16 billion, including costs linked to poorer quality of life (USD 2.65 billion), productivity loss (USD 2.16 billion) and hospital care (USD 0.05 billion). When the costs associated with maternal suicide are included, total costs increase to USD 4.93 billion. LimitationsSeveral costs could not be included in the analysis because of a lack of data. The study is reliant of longitudinal data on associations between perinatal depression and anxiety and impacts on mothers and children. Therefore, no causality can be inferred. ConclusionOur findings illustrate the economic rationale for investment in this area. This is the first study that estimates the costs of perinatal mental health problems in a low- or middle-income country setting.

An EQ-5D-5L Value Set for Belgium.

ObjectiveThis study aimed to establish a Belgian EQ-5D-5L value set based on the preferences of the adult Belgian general population.MethodsThe most recent EuroQol Valuation Technology (EQ-VT 2.1) protocol for EQ-5D-5L valuation studies was followed. Computer-assisted personal interviews were carried out in a representative sample of the adult Belgian population. Potential respondents were randomly selected from the National Register using a multistage, stratified, cluster sampling with unequal probability design. Each respondent valued 10 or 11 health states using composite time trade-off (cTTO) and 14 health states in seven paired choice tasks using a discrete choice experiment (DCE). Different model specifications were explored and assessed based on logical consistency, goodness of fit, predictive accuracy and theoretical considerations.ResultsA total of 892 respondents were included in the analyses. The sample was representative of the Belgian adult population in terms of age, sex, region of residence, educational attainment, labour market status, self-assessed health status and health-related quality of life (HRQoL). The preferred model specification was a hybrid (DCE and cTTO data combined) multiplicative eight-coefficient model with intercept random effects and correction for heteroskedasticity. Values range from − 0.532 to 1. Loss of HRQoL is highest in the dimension pain/discomfort, closely followed by anxiety/depression.ConclusionsThis study developed a Belgian EQ-5D-5L value set, based on the preferences of the Belgian adult general population. It provides opportunities for future clinical and economic evaluations in healthcare, for the measurement of patient-reported outcomes and for population health assessments.Supplementary InformationThe online version contains supplementary material available at 10.1007/s41669-022-00353-3.

0547 RLS Patient Odyssey Survey II

Abstract Introduction RLS affects 5%-10% of European and North American adults, with 2%-3% experiencing moderate to severe symptoms. RLS patients, often undiagnosed or improperly treated, experience significant depression in addition to loss of sleep. Methods ODYSSEY II, an online and in-print self-administered questionnaire (respondents primarily from the United States) included validated questions on RLS diagnosis and severity, associated medical conditions, RLS treatment responses, access to RLS care, and standardized PHQ-9 depression measures. RLS status was confirmed using the Cambridge-Hopkins Questionnaire. Analysis included linkage of PHQ-9 depression scores to EQ-5D Health-Related Quality-of-Life (HRQoL) scores using externally validated methods. Results Of 3,003 online or mail-in participants, 2,745 were RLS confirmed, 55% having severe symptoms (IRLS ≥ 21), 86% using medications and 73% reporting histories of dopaminergic augmentation (medication related worsening of symptoms).Of RLS-confirmed respondents, average PHQ-9 depression scores were 8.98 for women (US average 3.72) and 7.22 for men (US average 2.67). Among RLS patients, 29% of males and 40% of females (comparable US averages 11% and 6.5%) had PHQ-9 depression scores ≥ 10 (moderate, moderately severe or severe) a fourfold risk of important (≥ 10 score) depression. Suicidal ideation was reported by 15% of respondents (US average 4.0%). Associated EQ-5D scores show that 37% of all respondents had HRQoL scores below 50% of “full health.”Of six drug classes used to treat RLS, three drug classes had patient-reported efficacy above 60%, but all had patient-reported drawbacks, ranging from weaker efficacy for some patients (alpha-2-delta ligands) to augmentation (dopaminergics, almost three-quarters of patients) and difficulties in obtaining prescriptions (opioids) for others.Respondents reported decade-plus delays from time of symptom onset to diagnosis, and still may remain improperly diagnosed or inadequately treated. Respondents managed by RLSF certified providers reported better outcomes. Conclusion ODYSSEY II documents that depression, suicidal thinking and HRQoL losses are very significant among many RLS patients. Respondents report troubling delays from symptom onset to correct diagnosis. Survey results demonstrate that RLS related symptoms are best improved when patients use RLSF certified providers. Improved education to both primary care providers and patients may also lead to better patient outcomes. Support (If Any) Arbor Pharmaceuticals

Occupational Exposure to Wood Dust and the Burden of Nasopharynx and Sinonasal Cancer in Canada.

Background: Millions of workers around the world are exposed to wood dust, as a by-product of woodworking. Nasopharynx cancers (NPCs) and sinonasal cancers (SNCs) are two cancers that can be caused by occupational exposure to wood dust, but there is little evidence regarding their burden in Canada. Objective: the aim of this study was to estimate the incidence and economic burden of newly diagnosed cases of NPC and SNC in 2011 in Canada, attributable to occupational exposures to wood dust. Methods: calculating the incidence of cancer attributable to occupational exposure involved three steps of defining relative risk, assessing the prevalence of exposure and population modelling. We estimated the lifetime costs of newly diagnosed NPC and SNC from the societal perspective. The three major cost categories that we considered were direct costs (healthcare costs, out-of-pocket costs, and informal caregiving costs), indirect costs (labour productivity/output costs, employer adjustment costs, and home production losses), and intangible costs (health-related quality of life losses). To generate an estimate of economic burden, we used secondary data from multiple sources and applied them to our computational model developed from an extensive literature review. Results: From approximately 1.3 million workers exposed to wood dust, we expected 28%, 43% and 29% were exposed to low, medium, and high levels, respectively. We estimated from 235 newly diagnosed cases of NPC and 245 newly diagnosed cases of SNC, 4.6% (11 cases) and 4.4% (11 cases) were attributed to occupational exposure to wood dust, respectively. Our estimates of the economic burden of occupational NPC and SNC were about CAD 5.4 million (CAD 496,311 per-case) and CAD 6.7 million (CAD 627,437 per-case), respectively. For NPC direct costs constituted approximately 20% of all costs, and indirect and intangible costs accounted for 55% and 25%, while for SNC the breakdown distribution were 16%, 42% and 42%, respectively. Conclusions: Our estimates highlighted the importance of occupational NPC and SNC amongst other occupational cancers, especially in countries with large wood-related industries. This paper also serves the information needs of policymakers who are seeking to make evidence-based decisions about occupational cancer prevention efforts.

Weight Loss in Advanced Cancer: Sex Differences in Health-Related Quality of Life and Body Image.

Weight maintenance is a priority in cancer care, but weight loss is common and a serious concern. This study explores if there are sex differences in the perception of weight loss and its association to health-related quality of life (HRQoL) and body image. Cancer patients admitted to Advanced Medical Home Care were recruited to answer a questionnaire, including characteristics, the HRQoL-questionnaire RAND-36, and a short form of the Body Image Scale. Linear regression analyses stratified by sex and adjusted for age were performed to examine associations between percent weight loss and separate domains of HRQoL and body image score in men and women separately. In total, 99 participants were enrolled, of which 80 had lost weight since diagnosis. In men, an inverse association between weight loss and the HRQoL-domain physical functioning, β = −1.34 (95%CI: −2.44, −0.24), and a positive association with body image distress, β = 0.22 (95%CI: 0.07, 0.37), were found. In women, weight loss was associated with improvement in the HRQoL-domain role limitations due to physical health, β = 2.02 (95%CI: 0.63, 3.41). Following a cancer diagnosis, men appear to experience weight loss more negatively than women do. Recognizing different perceptions of weight loss may be of importance in clinical practice.

S390 Estimating the Indirect and Intangible Costs Associated With Eosinophilic Esophagitis

Introduction: Eosinophilic esophagitis (EoE) is a chronic, inflammatory disease characterized by esophageal eosinophilia and dysfunction. Indirect costs associated with EoE, such as loss of work, and intangible costs associated with reduced health-related quality of life (HRQoL) are not well documented. Methods: We used data from a retrospective, cross-sectional, qualitative study of caregivers of children and adolescents (6–17 years old) plus adults (≥18 years old) with EoE and a prospective, cross-sectional, observational study of adults with EoE and healthy adults in the USA. A human capital approach based on self-reported EoE-associated work patterns (reducing working hours or stopping work), weekly salary estimates and general employment rates was used to estimate the potential lost wages per year (yr) because of EoE. For participants who reduced their working hours, an average reduction of 25% was assumed. Estimated HRQoL loss (from a perfect score of 100) captured by the 36-item short-form survey (8 multi-item domains), was converted into EuroQoL 5-Dimension scores (EQ-5D) using an existing algorithm (Table 1). These were translated into humanistic costs based on the conservative willingness-to-pay US$50,000 per quality-adjusted life year. Results: Overall, 27 caregivers of children and adolescents, plus adults with EoE (caregivers, n = 9; adults, n = 18) and 88 adults (adults with EoE, n = 44; healthy adults, n = 44) were analyzed for indirect and intangible costs, respectively. Among participants, 22.2% (caregivers, 33.3%; adults, 16.7%) reduced their working hours and 33.3% (caregivers, 55.6%; adults, 22.2%) stopped working for pay owing to EoE (Table 1). For caregivers of children and adolescents with EoE, estimated yearly indirect costs associated with EoE were US$2473/yr because of reduced working hours and US$16,487/yr because of stopping work. Estimated yearly indirect costs for adults with EoE were US$1237/yr because of reduced working hours and US$6595/yr because of stopping work (Table 1). Estimated decreases in EQ-5D from perfect health were 11.9 and 4.5 for adults with EoE and healthy adults, respectively; the estimated intangible cost adults with EoE would willingly pay to return to a healthy status was US$3659/yr (Table 1). Conclusion: Substantial EoE-associated indirect and intangible costs are related to lost wages and HRQoL loss for caregivers of children and adolescents plus adults with EoE, demonstrating the high financial burden, and potential associated burden on HRQoL, of EoE.Table 1.: Estimated EoE-Associated Indirect And Intangible Costs For Caregivers Of Children And Adolescents Plus Adults With EoE.

Quality of Life in the Swedish General Population During COVID-19 - Based on pre- and post-pandemic outbreak measurement

The outbreak of the pandemic COVID-19 (Coronavirus) has resulted in various international and national strategies, including non-pharmaceutical interventions (NPIs) such as social distancing and travel bans, which have purportedly mitigated the health loss due to the pandemic but also given rise to a severe economic crisis. Both factors, the pandemic and the NPIs, can be expected to have an impact on the Health-Related Quality-of-Life (HRQoL) of the population. The objective of this study was to estimate the impact on HRQoL of the Swedish adult population during the outbreak of the COVID-19 pandemic. A web-based survey was sent to randomised samples of the adult Swedish population before the outbreak of the pandemic in Sweden in February 2020 (n=1,016) and during the outbreak of the pandemic. The first wave pandemic data was collected in April 2020 (n=1,003), one-month after the outbreak and, the second wave data was collected in January 2021 (n=1,013), after 10-months living under the pandemic. HRQoL was measured using the EQ-5D-5L in the pandemic surveys, whereas the Visual Analogue Scale (VAS) was used in all surveys. The results suggested a reduction in average HRQoL as measured by VAS in the adult Swedish population, with 0.059 points reduction in VAS in April 2020 and 0.074 points reduction in January 2021, compared to the pre-pandemic measurement in February 2020. The loss in HRQoL was significant among respondents in the working age population (<65 years), suggesting that the social and economic impact of NPIs were the primary drivers for this specific cohort. Findings of this study supports a wide public health perspective and future HRQoL measurements at the population level throughout the pandemic. Published: Online September 2021

The impact of childhood RSV infection on children's and parents' quality of life: a prospective multicenter study in Spain

Background Several immunisation candidates against RSV are in late-stage clinical trials. To evaluate the benefits of a potential vaccination programme, both economic and health benefits will be needed. Health benefits are usually measured in Health-related Quality of Life (HRQoL) loss using standardised questionnaires. However, there are no RSV-specific questionnaires validated for children under 2 years, in whom most RSV episodes occur. Therefore, HRQoL estimates are taken from literature or inadequate tools. We determined HRQoL loss and direct costs due to an RSV episode in children younger than 2 years and their caregivers during a month of follow up, using a new questionnaire administered online.Methods An observational prospective multicentre surveillance study was conducted in children aged younger than two years. Children were recruited from 8 primary care centres and 1 hospital in the Valencia region and Catalonia (Spain). RSV-positive cases were obtained by immunochromatographic test. HRQoL was assessed using a new ad-hoc 38 item-questionnaire developed. Parents of infected children completed 4 questionnaires at four timepoints (day 0, 7, 14 and 30) after diagnosis.Results 117 children were enrolled in the study and 86 (73.5%) were RSV + . Median (interquartile range; IQR) scores were 0.52 (0.42–0.68), 0.65 (0.49–0.79), 0.82 (0.68–0.97) and 0.94 (0.81–1), for days 0, 7, 14 and 30, respectively. Compared to total recovery (Q30), HRQoL loss was 37.5%, 31.5% and 8.9% on days 0, 7 and 14 since diagnosis of the disease. The total median cost per patient (including treatments) was €598.8 (IQR: 359.63–2425.85).Conclusions RSV had almost 40% impact on HRQoL during the first week since onset of symptoms and the median cost per episode and patient was about €600. These results represent a substantial input for health-economic evaluations of future RSV-related interventions such as vaccination.

Estimation of Health-Related Quality of Life Losses Owing to a Technological Disaster in Brazil Using EQ-5D-3L: A Cross-Sectional Study

ObjectivesIn 2015, a dam collapsed at Samarco iron ore mine in the municipality of Mariana, Brazil, and contaminated more than 600 km of watercourses and destroyed almost 1600 acres of vegetation. Nineteen people died and more than 600 families lost their homes. This study aimed to estimate health-related quality of life (HRQoL) losses owing to this disaster. MethodsWe collected data from a probabilistic sample of 459 individuals aged 15 years or older. Household face-to-face interviews were conducted in December 2018. Pre-event data were not available for this population, so respondents were asked to evaluate at present and in retrospect their health status using EQ-5D-3L. The Minas Gerais societal value sets for EQ-5D-3L health preferences, estimated in 2011, were used to calculate utility losses. The health loss estimation from EQ-5D will form the basis for the calculation of compensation payments for the victims. ResultsApproximately 74% of the study population suffered some HRQoL loss. On average, EQ-5D index values decreased from 0.95 to 0.76. The greatest effects were observed for the anxiety/depression dimension, followed by pain/discomfort. Before the tragedy, the proportion of individuals with severe anxiety/depression and pain/discomfort was equal to 1% rising to 23% and 11%, respectively. ConclusionsCatastrophic losses owing to the Samarco disaster were found. The EQ-5D-3L instrument showed feasibility and sensitiveness to measure HRQoL losses owing to a negative health shock in a low-income Brazilian population.

Epidemiology of Peer Victimization and its Impact on Health-Related Quality of Life in Adolescents: a Longitudinal Study

Numerous cross-sectional studies have linked health-related quality of life (HRQoL) with peer victimization, but evidence of how this relationship may change over time is lacking. The main objectives of this study were to analyze the prevalence, incidence, and stability of peer victimization and to longitudinally relate peer victimization to HRQoL. A longitudinal study was designed and implemented at three separate time points over a 13-month period. The study involved 1,155 adolescents (43.5% boys; n = 503) aged between 11 and 18 years. The prevalence of victimization for each wave was, respectively, 32.4%, 25.9%, and 23.7%, with a period prevalence of 48.5% and a cumulative incidence of 25%. Eight percent of the victims were stable victims across the three waves. The most frequent type of victimization was direct verbal victimization. Peer victimization correlated significantly across the three waves (r > .40; p .50; p < .001). Stable victims showed the lowest HRQoL scores. There were no statistically significant differences in HRQoL among new victims, ceased victims, and intermittent victims, but all of them presented lower HRQoLs than non-victims (p < .001). In conclusion, this manuscript presents a unique approach to peer victimization through an epidemiological perspective and provides evidence that stable victims experience the greatest loss of HRQoL.

Quality of life and disease burden in patients with MCI and dementia

AbstractBackgroundUnderstanding of Health Related Quality of Life (HRQoL) and disease burden from Mild Cognitive Impairment (MCI) and dementia is critical to properly manage growing clinical and social burden of cognitive disorder. While each type of cognitive disorders requires different management strategy, studies separately evaluating HRQoL and disease burden of different types of dementia are sparse. Particularly, there is no study estimating disease burden from MCI. Therefore, we investigated 1) the loss of HRQoL from each of MCI, Alzheimer’s Dementia (AD), Vascular Dementia (VD), and dementia total, 2) the disease burden of each disorder in Disability Adjusted Life Year (DALY) with population representative cohort data.MethodEuro‐QoL‐5D index scores and clinical data of 6,520 elderlies are derived from Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD) cohort. We built a multiple linear regression model to estimate the adjusted impact of cognitive disorder on HRQoL. For calculation of DALY, disease specific prevalence, mortality, remission rate are obtained from Korean Longitudinal Study on Health and Aging (KLOSHA) and KLOSCAD cohort. The current and future DALY from MCI, AD, VD and total dementia is calculated by standardized method according to the World Health Organization’s guideline.ResultAfter adjustment of covariates, VD causes the most substantial HRQoL loss of ‐0.309, followed by AD (‐0.143) and MCI (‐0.017). Patients with CDR ≥2 experience significantly higher loss of HRQoL (‐0.498) than patient with CDR 1 (‐0.151) or CDR &lt;1 (‐0.096). In 2015, DALY per 100,000 attributed to AD, VD and dementia total is 417, 237, and 931 respectively. The DALY from MCI (412 per 100,000) is almost same with that of AD. The projected DALY from MCI and dementia in 2065 (9,543 per 100,000) is more than seven times bigger than 2015 (1,343 per 100,000).ConclusionCognitive disorders, especially VD, cause significant loss of HRQoL in elderlies. The disease burden from MCI as well as dementia is substantial at present and rapidly grows. From MCI stage, the early efforts should be made to prevent HRQoL loss and to manage increasing disease burden. (Supported by Korean Health Technology R&amp;D Project, Ministry of Health and Welfare, grant number HI15C3206.)

Prenusinersen economic and health-related quality of life burden of spinal muscular atrophy.

To quantify the economic and health-related quality of life (HRQoL) burden incurred by households with a child affected by spinal muscular atrophy (SMA). Hospital records, insurance claims, and detailed resource use questionnaires completed by caregivers were used to capture the direct and indirect costs to households of 40 children affected by SMA I, II, and III in Australia between 2016 and 2017. Prevalence costing methods were used and reported in 2017 US dollar (USD) purchasing power parity (PPP). The HRQoL for patients and primary caregivers was quantified with the youth version of the EQ-5D and CareQoL multiattribute utility instruments and Australian utility weights. The average total annual cost of SMA per household was $143,705 USD PPP for all SMA types (SMA I $229,346, SMA II $150,909, SMA III $94,948). Direct costs accounted for 56% of total costs. The average total indirect health care costs for all SMA types were $63,145 per annum and were highest in families affected by SMA II. Loss of income and unpaid informal care made up 24.2% and 19.8% respectively, of annual SMA costs. Three of 4 (78%) caregivers stated that they experienced financial problems because of care tasks. The loss in HRQoL of children affected by SMA and caregivers was substantial, with average caregiver and patient scores of 0.708 and 0.115, respectively (reference range 0 = death and 1 = full health). Our results demonstrate the substantial and far-ranging economic and quality of life burden on households and society of SMA and are essential to fully understanding the health benefits and cost-effectiveness associated with emerging disease-modifying therapies for SMA.

Adult Obesity and Health-Related Quality of Life, Patient Activation, Work Productivity, and Weight Loss Behaviors in the United States.

IntroductionWhile it is generally believed that people living with more severe obesity experience greater negative impacts on health-related quality of life (HRQoL), their experience may be impacted by other factors such as age, gender, and type 2 diabetes mellitus (T2DM).MethodsThe 36-Item Short Form Health Survey physical component score and mental component score, Work Productivity and Activity Impairment, and Patient Activation Measure® data from the 2018 National Health and Wellness Survey were analyzed in adults by body mass index (BMI) categories (normal weight: ≥18.5–<25kg/m2, overweight: ≥25–<30kg/m2, class 1 obesity: ≥30–<35kg/m2, class 2 obesity: ≥35–<40kg/m2, class 3 obesity: ≥40kg/m2, combined class 2/3 obesity: ≥35kg/m2). Findings were further stratified across age groups (young: 18–35y, middle-aged: 36–64y, older: ≥65y), by gender, and by T2DM status.ResultsOverall, as BMI increased people had greater negative effects on HRQoL, felt less involved with and in control of their healthcare, and had greater work productivity and activity impairments. The largest declines were generally observed between class 2 and 3 obesity categories. Young adults with obesity were more likely to feel less engaged with their health care than middle-aged/older adults with obesity. The effects of obesity on HRQoL and patient activation were generally consistent by gender. People with T2DM and obesity tended to have greater declines in physical functioning and more work and activity impairments than people with obesity without T2DM. The proportion of people trying to lose weight increased with increasing BMI category, and people with T2DM were less likely to exercise and more likely to diet than those without T2DM.ConclusionIncreasing levels of obesity tended to have a greater negative impact on HRQoL, patient activation, work productivity, and weight loss behaviors, but some differences in effects by age, gender, and T2DM status were observed.

Childhood maltreatment among university students in Turkey: prevalence, demographic factors, and health-related quality of life consequences

ABSTRACT Childhood maltreatment (CM) is a global problem with serious life-long consequences. The purpose of the present study was to determine the prevalence of CM among university students and to assess the associations between CM and the health-related quality of life (HRQOL) in adulthood. The present descriptive cross-sectional study involved 626 students who had been selected by means of a cluster sampling method from among all the students studying in Giresun University. CM was assessed with the Childhood Trauma Questionnaire at interview and HRQOL was assessed using the Duke Health Profile. Data were analyzed using descriptive statistics, Pearson chi-square tests, independent samples t-test, and binary logistic regression. About half (43.5%) of the students reported exposure to some form of CM. Logistic regression analysis showed that male gender, parental separation or divorce, poorer familial relationships, lower socioeconomic status, smoking and alcohol consumption were significantly associated with CM. A significant correlation emerged between CM and physical health, general health, perceived health, self-esteem, anxiety, pain and disability. CM is common among university students in Turkey. Students who had experienced CM had significant and sustained losses in HRQOL in adulthood relative to students who had not experienced maltreatment.