Health-related Quality Of Life Loss Research Articles

Health-related quality of life in patients with pain related to depression (Results from UK subsample of the European Finder study)

Objectives: To estimate the health-related quality of life (HRQOL) and impact of concurrent pain on HRQOL in patients seeking treatment for depression in a 6 month observational study in the United Kingdom (subsample results from pan-European study). Methodology: HRQOL was measured using two generic quality of life instruments: the Short Form 36 Health Status Survey (SF-36) and the EuroQol (EQ-5D). Pain was assessed using a visual analogue scale (range 0-100, no/mild pain [NMP] 0-29, clinically significant pain ?30). Results: 608 eligible patients were enrolled, mean age 42.8 years (SD 14.7) and 61.2% were female. 49.4% of patients reported NMP; 10.8% had significant pain from a co-morbid medical condition known to cause pain (PMC) and 39.8% had significant pain associated with a medical disorder not known to cause pain or without further co-morbidity (PD). SF-36 physical component scores were lowest in the PMC group, 36.7 (SD 9.7); with improving scores in the PD group, 44.4 (SD 10.0) and the NMP group, 54.5 (SD 8.3). There was no marked variation in mental component summary scores between the groups; 23.0 (SD 8.5), 20.4 (SD 9.1) and 21.7 (SD 10.8) respectively. A similar trend in HRQOL loss was observed for the EQ-5D health state index, where scores of 0.30 (SD 0.32), 0.41 (SD 0.30) and 0.60 (SD 0.25) were observed respectively. Conclusions: A high proportion of patients presented with pain presumably related to depression. The presence of concurrent pain appears to be associated with reductions in SF-36 physical component scores and overall HRQOL (EQ-5D).

The Impact of 29 Chronic Conditions on Health-related Quality of Life: A General Population Survey in Finland Using 15D and EQ-5D

Health-related quality of life (HRQoL) is an essential outcome of health care, but there is no gold standard of HRQoL measurement. We investigated the impact of major chronic conditions on HRQoL using 15D and EQ-5D in a representative sample of Finns. Information on chronic somatic conditions was obtained by interviews. Psychiatric disorders were diagnosed using a structured interview (M-CIDI). Tobit and CLAD regression analysis was used to estimate the impact of conditions on HRQoL at the individual and population level. Adjusted for other conditions and sociodemographic variables, Parkinson's disease had the largest negative impact on HRQoL at the individual level, followed by anxiety disorders, depressive disorders and arthrosis of the hip and knee. Based on prevalence, arthrosis of the hip or knee, depression, back problems and urinary incontinence caused the greatest loss of HRQoL at the population level. The results obtained with the two HRQoL measures differed markedly for some conditions and the EQ-5D results also varied with the regression method used. Musculoskeletal disorders are associated with largest losses of HRQoL in the Finnish population, followed by psychiatric conditions. Different HRQoL measures may systematically emphasize different conditions.

An integrated method to determine meaningful changes in health-related quality of life

Objective We describe an integrated method for determining meaningful change in health-related quality of life (HRQOL) that combines information from anchor-based and distribution-based methods and illustrate this method using data aggregated from weight loss studies. Study design and setting A total of 1476 participants in weight loss studies were evaluated at baseline and at 6 months using the Impact of Weight on Quality of Life-Lite (IWQOL-Lite). Severity of baseline impairment was determined by comparing scores with those obtained from a normative sample of 534 normal/overweight individuals. The precision of the IWQOL-Lite was evaluated using standard error of measurement corrected for regression to the mean. Weight loss was used as an anchor for evaluating changes in IWQOL-Lite scores. Results Change in HRQOL varied as a function of weight loss and baseline severity of HRQOL. Using this integrated method, an improvement of 7.7 to 12 points (depending on baseline severity) on IWQOL-Lite total score is considered meaningful. Conclusion Meaningful change in HRQOL can be determined using an integrated method that (1) combines information from anchor-based and distribution-based methods, (2) reconciles discrepancies between these two methods, and (3) adjusts for baseline severity and regression to the mean. This method may be applied to other types of HRQOL measures and conditions.