Problems In Usual Activities Research Articles

#254 PaCE CKD: examining health status and financial burden in patients with chronic kidney disease: assessing the non-clinical burden of disease

Abstract Background and Aims There is a detrimental effect of chronic kidney disease (CKD) on health states, with many patients worldwide experiencing considerable symptom burden and development of comorbidities, leading to frequent medical appointments and hospitalisations. Patients experience disease-associated financial strain as their ability to work is impaired. The aim of this multinational study was to characterise the non-clinical burden of CKD by quantifying the effect of CKD on health states and productivity in patients versus general population in several regions. Method Patients with early (stages 1-3) to advanced (stages 4-5) of CKD, including those receiving dialysis treatment, in Germany, Mexico, Taiwan, the UK, and the US were enrolled to a cross-sectional non-interventional survey measuring: Scores were compared with a general population cohort, matched 1:1 in sample size against patient cohorts and for demographic characteristics (e.g. age and area of residence). Results Across five countries, an average of 201 (range: 190–212) patients were enrolled, of whom 42% were receiving dialysis in Germany, 57% in Mexico, and 55% in the UK with smaller proportions of patients on dialysis cohorts in the US (32%) and Taiwan (15%). Haemodialysis was the most prevalent mode of dialysis in all countries, with most patients receiving dialysis in a clinic or hospital. Enrolled patients who had received a kidney transplant accounted for 11.5% on average across all countries. Compared with general population, people with CKD experienced a 24% reduction in mean [SD] EQ-5D utility scores, with patients in the US experiencing the greatest disparity in health states (0.64 [0.27] versus 0.95 [0.08]). Patients with CKD reported significantly more problems across all EQ-5D domains in Germany, Mexico, the US, and UK than general population cohorts. The highest percentage of patients reporting problems was in Mexico, with 81.4% reporting problems in usual activities compared with 4.4% in the general population. Patients receiving dialysis reported a mean EQ-VAS value of 70.3 compared with 91.8 in non-dialysis dependent patients, indicating that treatment burden negatively contributes towards patients perception of their health. In addition to impaired health states, patients reported elevated impairment across work and non-work activities in all countries. Patients reported increased rates of absenteeism, presenteeism, work impairment and non-work activity impairment, with the greatest impairment observed in the UK of 46.4% in non-work activity impairment compared with the general population. Conclusion These results indicate that people with CKD experience substantial burden of disease that extends beyond its clinical aspects. Decision makers should consider broader disease effects when addressing the burden of CKD.

Thrombolysis treatment protected impairment of functional ability, quality of life and fatigue seven years after stroke

ObjectivesWe studied quality of life, functional outcome, depression, and fatigue of ischemic stroke patients treated with or without thrombolysis seven years post-stroke. Materials and methodsA total of 204 ischemic stroke patients treated with or without thrombolysis during 2013–2015. After seven years the 136 survivors were assessed with telephone interview, which included questions about subjective quality of life (European Quality of Life-5 Dimensions), depression, fatigue with Fatigue Severity Scale, functional ability assessed with Barthel Index and Modified Rankin Scale, living conditions, need of care, and medical aids. ResultsAt admission patients with thrombolysis had higher National Institutes of Health Stroke Scale scores compared with those not treated with thrombolysis. At seven years post-stroke, 99% of alive patients answered the questionnaires. There were no group differences concerning functional outcome, quality of life, depression, fatigue, or insomnia. The Barthel Index was normal in both groups. The quality of life was good in both groups without group differences in any domains. Of all patients, 68% reported no problems in usual activities, and 61% were without pain. Anxiety or depression were experienced by 19% of all stroke patients, while fatigue was present in 32% of cases. ConclusionsSeven years post-stroke the quality of life was good and functional outcome remained in good level in both study groups. One third experienced fatigue, while every fifth experienced depression. The thrombolysis treatment seems to protect from decreased quality of life, fatigue, and decreased mobility, self-care, and usual activities despite more severe stroke.

Socioeconomic inequality of health-related quality of life in cancer survivors in South Korea.

We investigated the inequalities in health-related quality of life (HRQoL) among cancer survivors in Korea, focusing on income and education levels. The slope index of inequality (SII) and relative index of inequality (RII) were utilized to analyze these disparities. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 2007 and 2021 was analyzed. The HRQoL was assessed using the EQ-5D questionnaire, which included five problem areas: mobility, self-care, usual activity, pain/discomfort, and anxiety/depression. Logistic regression was employed to calculate the odds ratios (ORs) for each education and income level, indicating the probability of reporting problems. Furthermore, the slope index of inequality (SII) and relative index of inequality (RII) were calculated to evaluate the inequalities in HRQoL. Among the 3396 cancer survivors, a considerable proportion reported pain/discomfort (29.6%) and mobility problems (21.1%). The logistic regression results demonstrated a higher likelihood of experiencing problems in all five EQ-5D items among individuals with lower income or education levels. Specifically, compared to the high-income group, the adjusted ORs for mobility problems were 2.19, 1.64, and 1.08 for the low, low-medium, and medium-high-income groups, respectively (p-value < 0.05). Notably, significant income inequalities in HRQoL problems were observed, with the greatest disparities seen in self-care and usual activity problems, as indicated by the SII and RII values. Socioeconomic disparities in HRQoL exist among cancer survivors in Korea, particularly related to income levels. Addressing the financial burdens of cancer treatment for individuals with low-income levels may help improve their HRQoL and mitigate these inequalities.

The association of physical activity and sedentary behaviour on health-related quality of life: a cross-sectional study from the physical activity at work (PAW) trial

IntroductionPhysical inactivity and sedentary behaviour independently increase morbidity and negatively affect quality of life. This study evaluates the associations between physical activity and sedentary behaviour with health-related quality of life, including the five dimensions of quality of life (mobility, self-care, usual activities, pain or discomfort, and anxiety or depression).MethodsThis cross-sectional study analysed baseline data from Thailand's Physical Activity at Work (PAW) trial. Physical activity data were collected using the ActiGraph™ accelerometer, worn on the right hip for a minimum of three ten-hour workdays. Accelerometer data were then used to categorise participants into: (i) not-sedentary and physically active (the Reference Group), (ii) not-sedentary but inactive, (iii) sedentary but active, and (iv) sedentary and inactive. We employed the EuroQol-5 dimensions questionnaire with five scoring levels (EQ-5D-5L) to measure health-related quality of life. The Thai EQ-5D-5D valuation was utilised to convert the EQ-5D profile into utility index scores (EQ-5D values). Tobit regression models were used to analyse EQ-5D value differences. Moreover, the odds of having problems in each EQ-5D dimension were compared between categories.Results277 valid participant data were included. Older age (P = 0.007), higher education (P < 0.001), and higher prevalence of cardiovascular disease (P = 0.032) were observed in participants who were sedentary and physically inactive compared to other groups. We found − 0.0503 (95% CI: − 0.0946–− 0.00597) lower EQ-5D value and 1.39 (95% CI: 1.07–1.79) higher odds of reporting pain or discomfort problems in the sedentary and physically inactive group compared to the Reference Group. We also found 2.12 (95%CI: 1.14–5.40) higher odds of reporting usual activity problems in the not-sedentary but physically inactive group than in the Reference Group.DiscussionWe found further evidence of the potential benefit of higher physical activity levels and lower sedentary time for higher quality of life among healthy office workers in Thailand. Further research with larger cohorts and longitudinal data is needed to establish a stronger foundation for interventions and economic evaluations targeting physical activity promotion to improve quality of life.

Evaluating Risk Factors for Cumulative Life Course Impairment in Psoriasis using Patient-Acceptable Symptom State and European Quality of Life 5 Dimensions (EQ-5D)

Objective: To evaluated the health-utility values and risk factors for cumulative life course impairment (CLCI) using Patient Acceptable Symptom State (PASS) and European Quality of Life 5 Dimensions (EQ-5D). Materials and Methods: This cross-sectional investigation enrolled patients with psoriasis. Patients were asked PASS questions about their overall self-perceived health state, adaptation, and expectations for current, future, and lifelong conditions. The patients also completed EQ-5D. Results: The mean age of 139 enrolled patients was 45.8 ± 14.4 years, and 57.6% were women. Most cases had chronic plaque psoriasis 121 (87.1%). For current PASS, satisfaction was significantly associated with older age, being married, and lower disease severity. The mean health-utility value and visual analog scale of the 139 patients were 0.89 ± 0.12 and 77.0 ± 17.4, respectively. Patients would not accept their disease if they had moderate to extreme problems in usual activities and depression/anxiety for the future and lifelong. Univariate analysis revealed that depression and usual activities were significantly associated with satisfaction for current PASS, future PASS, and lifelong PASS. Conclusion: Disease severity, age, marital status, problems with usual activities, and depression/anxiety were significantly related to CLCI. These findings may allow physicians to identify psychosocial and psychological aspects of psoriatic patients at high risk for developing CLCI. Early and adequate treatment, good coping strategies, and good social support can prevent a negative impact on CLCI and major life-changing decisions.

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.

Interactions between nutrient intake and comorbidities for quality of life in premenopausal and postmenopausal women.

This study aimed to identify the associations between nutrient intake and health-related quality of life (HRQOL) in premenopausal and postmenopausal women. Using data from Korean National Health and Nutrition Examination Surveys (2019-2020), EQ-5D-3L, and multivariate logistic and linear regression models, we analyzed the association and interaction between nutrient intake, comorbidities, and HRQOL among 4,027 Korean women. Nutrient intake levels were lower in postmenopausal women than in premenopausal women. Interactions were observed between numerous nutrient intakes and comorbidities for HRQOL among premenopausal and postmenopausal women. Higher intakes of various nutrients (particularly, folic acid and vitamin A) were related to higher HRQOL scores in premenopausal women with comorbidities (log of inverse HRQOL scores, β = -0.31 [95% confidence interval [CI], -0.58 to -0.05] and β = -0.19 [95% CI, -0.37 to -0.001]) and postmenopausal women with comorbidities (log of inverse HRQOL scores, β = -0.34 [95% CI, -0.61 to -0.07] and β = -0.19 [95% CI, -0.38 to -0.01]), respectively. Regular exercise was associated with a lower risk of mobility problems (odds ratio [OR], 0.59; 95% CI, 0.44-0.81), self-care problems (OR, 0.53; 95% CI, 0.28-0.99), usual activity problems (OR, 0.42; 95% CI, 0.26-0.67), and any problem (OR, 0.71; 95% CI, 0.56-0.90), as well as an increase in HRQOL score (log of inverse HRQOL scores, β = -0.42; 95% CI, -0.68 to -0.16) in postmenopausal women. Smoking was related to a higher prevalence of depression and anxiety problems (OR, 2.51; 95% CI, 1.53-4.13) and any problem (OR, 1.67; 95% CI, 1.11-2.52), as well as a decrease in HRQOL scores (log of inverse HRQOL scores, β = 0.51; 95% CI, 0.14-0.88) in premenopausal women. Given the lower nutrient intake levels in postmenopausal women, it is critical to establish HRQOL-improving approaches for this population, including regular exercise, nutrient intake, and smoking cessation.

The prevalence and correlates of depression in Korean adults with rheumatoid arthritis: Results from the Korea National Health and Nutrition Examination Surveys.

This study aimed to investigate the prevalence and correlates of depression in Korean patients with rheumatoid arthritis (RA). We analyzed the data of the Korean National Health and Nutrition Examination Survey (KNHANES). The sociodemographic, clinical, and psychiatric variables were compared between the RA group (n=277) and the gender- and age-matched non-RA group (n=1068). Participants in the RA group who had a Patient Health Questionnaire-9 (PHQ-9) score of 10 or more were sub-categorized as the depression group (n=52), and the prevalence of depression with RA was determined. Complex samples logistic regression analysis was performed to clarify the associated factors for depression in patients with RA. The prevalence of depression in patients with RA was 17.4%. The RA group experienced more pain, restrictions on usual activities, and stress in their daily lives. RA patients with 3 or more comorbid diseases, extreme pain, problems in usual activities, and moderate to severe perceived stress were more likely to develop depression. Female gender and low income were also associated factors to consider. Depression is significantly prevalent in Korean RA patients. Along with managing pain and daily life functions, interventions to reduce perceived stress are needed for comprehensive RA management.

Health-related QoL and fatality in CHD patients: findings from a national cohort study, Turkey

Abstract Background Although strong association between self-reported health and coronary heart disease (CHD) exists, health related quality of life (HRQOL) has not been conceptualized as a predictor for fatality in CHD patients. We investigated whether HRQOL may predict the risk of death in six years in CHD patients. Methods There were overall, 614 of CHD cases in the national representative Chronic Diseases and Risk Factors Survey in Turkey, 2011. Baseline self-reported health data on EuroQol- 5 Dimension (EQ-5D) and a Visual Analog Scale (VAS) were used from the same survey. The cases were followed-up for all-cause and CHD specific fatality (ICD-10 diagnostic codes: I20- I25) through electronic health records by 2017. Kaplan Meier and Cox regression models were used for data analysis. Age and sex adjusted HRs [aHR 95% CIs] were estimated for having some or extreme problems in EQ5D domains and VAS. Results Median follow-up years (IQR) was 6.46 (6.39-6.47). The number of deaths from all causes and CHD were 103 and 26, respectively. Age and sex adjusted HRs for all causes fatality were statistically significant for some or extreme problems in usual activities [2.48 (95%CI 1.60-3.83)], in pain/comfort [2.28 (95% CI 1.44-3.62)], in self-care [2.25 (95% CI 1.46-3.46)] and in mobility [1.85 (95% CI 1.16-2.96)]. Age and sex adjusted HRs for CHD specific fatality were statistically significant for some or extreme problems in self-care [3.45 (95% CI 1.48-8.07)] and pain/comfort [3.07(95% CI 1.19-7.93)]. VAS was negatively associated with overall fatality. Conclusions In CHD cases, poor self reported health might be a good indicator for overall and CHD specific fatality in 6 years. Especially having some or extreme problems in selfcare and pain/comfort are closely related with overall fatality as well as CHD specific fatality. Key messages There are strong relationships between HRQOL and all causes fatality as well as CHD specific fatality. Poor self- reported health might be a predictor for overall and CHD specific fatality in CHD cases.

Associations of health-related quality of life with sociodemographic characteristics, health, pain, and lifestyle factors, and motivation for changing lifestyle in adults living with chronic pain: a cross-sectional exploratory study.

We investigated the associations between health-related quality of life (HRQoL) and health, pain and lifestyle factors, as well as motivation for lifestyle changes, in adults living with chronic pain referred to a Danish pain centre. A total of 144 outpatients completed a questionnaire on HRQoL (EQ-5D-5L), health, pain, lifestyle factors (Body Mass Index [BMI], physical activity, smoking, alcohol, physical fitness, eating, sleep and stress) and motivation for lifestyle changes. We used multiple linear regression analyses to assess associations between HRQoL and the independent variables. The participants (age mean 50years, 81% females) had≥2 body pain sites (93%), BMI≥25 (64%), sedentary lifestyle (43%) and multiple (n≥2) elevated metabolic risk factors (58%). Most considered lifestyle important for HRQoL (72%) and expressed moderate to very high motivation for changing lifestyle (92%). Poorer HRQoL in the study population was significantly associated with higher pain intensity in the most painful body site (β=-0.316, p=0.001) and very poor sleep quality (β=-0.410, p=0.024). Serious-to-extreme problems in usual activities were associated with significantly poorer health (β=-0.328, p=0.030). Adults living with chronic pain participating in this survey had significantly lower self-evaluated HRQoL than the general population. Lower HRQoL was significantly associated with greater pain intensity and poor sleep quality. Serious-to-extreme problems in usual activities, such as work, study, housework, family and leisure, were associated with poorer self-evaluated health. We observed high frequencies of overweight, obesity, sedentary lifestyle, pain in multiple body sites and multiple lifestyle-related risk factors in the study population. Most participants felt motivated for changing lifestyle. Further interventions addressing pain alleviation, sleep quality, prevention of problems in usual activities and promotion of healthy lifestyle, e.g. physical activity and healthy eating, are needed to estimate the effect of a lifestyle-oriented approach on health and quality of life in people living with chronic pain. The results of this study will inform the research project reg. SJ-703, the Danish the Research Ethics Committee for Region Zealand, Denmark.

PRO76 CAREGIVER-PROXY EQ-5D RATINGS OF CHILDREN WITH GAUCHER DISEASE: A COMPARISON OF 5 DOMAINS BETWEEN GENDERS

Gaucher disease is often associated with high treatment expenses but low health-related quality of life (HRQoL). Yet few studies comprehensively assessed the gender-specific HRQoL among child patients. This study aimed to assess the caregiver-proxy HRQoL on children patients with Gaucher disease, and explore the gender differences in the 5 domains of HRQoL. Participants were recruited from the China Gaucher Disease Association, a national NGO formed by Gaucher patients and their families. People taking care of children aged 5-18 years old were eligible for this study. HRQoL was measured by EuroQoL Five-Dimension Questionnaire (EQ-5D) containing Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression of the patients. Descriptive analyses of each domain were performed with STATA 14.0. Among the 52 male patients and 26 female patients, over 70.5% (55 subjects) were reported as ‘suffering Pain/Discomfort’. 43 subjects (55.1%) reported ‘some or extreme problems’ with the patients’ usual activities. 36 (46.2%) subjects reported ‘moderately or extremely Anxiety/Depression’ of their kids. 35 subjects (44.8%) reported ‘some or extreme problems with the patients’ Self-Care ability’. Although male and female patients on average had similar EQ-5D utility scores, gender differences were observed in Mobility, Self-Care, Usual Activities, and Anxiety/Depression domains. Comparing to female child patients, males had a significantly higher change of having problems in Usual Activities (male: 59.6% vs. female: 46.2%, p<0.05) and Anxiety/Depression conditions (57.7% vs 45.2%, p<0.05), yet better Self-Care Ability (42.2% males had problems vs 49.9% females, p<0.05). The high proportion of child patients with problems in self-care, mobility, usual activities and mental health status implied huge physical and psychological burdens of patients’ caregivers. Comparing the situation between genders, male patients’ usual activities and depression/anxiety conditions, as well as female patients’ self-care ability, need to be further attended.

PRO74 QUALITY OF LIFE AMONG INDIVIDUALS WITH ANGELMAN SYNDROME

Angelman syndrome (AS) is a rare, genetic, neurodevelopmental condition characterized by severe impairments in speech, behavior, motor skills, and sleep. AS is a chronic condition with heterogeneous clinical manifestations. Individuals with AS are fully dependent on families and caregivers, requiring lifelong and continuing care. For this study, we used the baseline data from the STARS Phase 2 study to assess the quality of life (QoL) among individuals with AS. The STARS Phase 2 study was a randomized, double-blind, placebo-controlled trial of gaboxadol (OV101) in adolescents and adults with AS. The EuroQoL 5-Dimension 5-Level (EQ-5D) was used to measure caregiver perceptions of the AS individuals’ QoL at baseline. The EQ-5D utility index at baseline was generated using standard scoring guidelines. EQ-5D baseline data was available on eighty-seven participants (mean age, 22.6 ± 6.9 years). Out of the five domains, 50% of caregivers reported that individuals with Angelman syndrome had (i) extreme problems in self-care activities; (ii) moderate problems in usual activities and mobility; and (iii) only slight depression/anxiety problems. Pain and discomfort were the least impacted by AS. EQ-5D utility index scores will be presented. AS is a heterogeneous condition with highly variable degrees of severity of symptoms and difficulties. This is the first known study to describe the QoL of individuals with AS using EQ-5D. We found that self-care activities were most impacted, which is consistent with the literature. Future research is needed to assess if EQ-5D can accurately represent the quality of life among individuals with AS.

The benefit of Curcuma longa and Boswellia serrata to improve quality of life in osteoarthritis patients: a randomized controlled trial

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Quality of life (QoL) can be affected by chronic pain in osteoarthritis (OA). Previous studies showed that combination of &lt;em&gt;Curcuma longa&lt;/em&gt; (CL) and &lt;em&gt;Boswellia serrata&lt;/em&gt; (BS) extract (CB extract) are promising for alternative treatment for pain in OA. This study aimed to measure the benefit of CB extract to improve QoL in patients with OA.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This was a randomized controlled trial (RCT) in OA patients. Subjects were randomized to 3 different group (Group 1: CB extract (350 mg of CL and 150 mg BS) and NSAID (400 mg ibuprofen or 50 mg diclofenac sodium); group 2: CB extract; group 3: NSAID). Each medication was taken two times per day for 4 weeks. QoL measured using 5Q-5D-5L that include five dimensiones in 5Q-5D: mobility, self-care, usual activities, pain/discomfort, anxiety/depression, with 5 levels of severity.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; There were 105 subjects at baseline. After 4 weeks of study, remained 95 subjects. The most common problem in group 1, 2, and 3 was pain (n=23, n=8, n=15 respectively). The improvement of level of severity in group 1 after 4 weeks of treatment was significant in mobility problems (p=0.002), pain/discomfort (p&amp;lt;0.001), and anxiety/depression (p=0.008). A significant improvement was only seen in usual activity problems (p=0.013) in group 2. The decrease of level of severity in usual activity problems (p=0.034), pain/discomfort (p=0.005), and anxiety/depression (p=0.018) in group 3 were also statistically significant.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; CB extract was beneficial to improve QoL in OA patients with a less side effect compared to NSAID.&lt;/p&gt;

Health-related quality of life in hepatitis C patients who achieve sustained virological response to direct-acting antivirals: a comparison with the general population.

To compare health-related quality of life (HRQoL) between hepatitis C patients who achieve sustained virological response (SVR) to direct-acting antivirals and a sex- and age-paired sample of the general population. HRQoL was evaluated in patients recruited in Navarre, Spain, from May 2016 to April 2017 at baseline and after SVR, using the EQ-5D-5L questionnaire. Both results were compared to those of general population of the same sex and age obtained from the 2011/12 National Health Survey in Spain. Observed/expected (O/E) ratios for health dimensions and differences between O-E in EQ-5D utility and visual analogical scale (VAS) scores were calculated. 206 patients were studied. Before treatment, patients had more problems than the general population in every domain of EQ-5D-5L, except in self-care dimension (O/E = 1.1). After SVR, patients continued having more limitation, especially for usual activities (O/E = 3.1), anxiety/depression (O/E = 2.8) and EQ-5D utility (- 0.086, p < 0.001); however, differences in VAS score between patients and general population disappeared (74.8 vs 76.5, p = 0.210). F0-F1 patients with SVR had minor differences with the general population in EQ-5D-5L dimensions, utility and VAS score. Although cirrhotic patients also reduced that difference, they still had worse HRQoL, especially in usual activities, self-care, EQ-5D utility (- 0.152, p < 0.001) and VAS score (- 8.5, p = 0.005). HRQoL of chronic hepatitis C patients remains lower than that of the general population despite viral clearance, with primary problems in usual activities and anxiety/depression. Knowledge of these on-going problems despite cure serves to guide healthcare interventions and patient's follow-up.

Relationships Between Cognitive Dysfunction and Health-Related Quality of Life Among Older Persons in Taiwan: A Nationwide Population-Based Survey.

To examine the relationships between cognitive dysfunction status and quality of life. Secondary analysis of a nationwide population-based survey (≥65 years) in Taiwan. The 5-dimension EuroQoL questionnaire (EQ-5D) was completed by 10 013 participants. Participants with mild cognitive impairment (MCI; odds ratio = 4.88), very mild dementia (VMD; 7.96), or dementia (32.85) were more likely than those with normal cognition to report self-care problems. Participants with MCI (3.86), VMD (9.26), or dementia (31.61) were more likely to have usual-activity problems, and those with MCI (3.04), VMD (3.82), or dementia (9.23) were more likely to have mobility problems. Participants with MCI (2.10 and 2.14), VMD (2.77 and 2.18), or dementia (3.04 and 3.02) were more likely to report pain/discomfort and anxiety/depression. Dementia was negatively associated with EQ-5D, especially self-care, usual activities, and mobility. Mild cognitive impairment or VMD was also negatively associated, with VMD more negatively associated. Developing interventions for patients with specific cognitive dysfunctions is critical.

PMU92 - CAN THE EQ-5D-3L PREDICT POST-HOSPITALIZATION HEALTHCARE USE AND OUTCOMES?

To examine whether EQ-5D-3L completed at the time of discharge from hospital can predict post-hospitalization healthcare use and outcomes. Data from a longitudinal observational study of adults discharged from hospitals in Alberta, Canada, was used. Each of the EQ-5D-3L dimensions was analyzed as a dichotomous variable. The EQ-5D-3L misery-index, index and VAS scores were also used. Outcomes, including outpatient visits, emergency department (ED) visits, re-hospitalizations, or death at 30-days and 90-days were treated as dichotomous. Logistic regression models adjusted for age, sex, income, Charlson comorbidities score, and frailty were used. Average age of patients (N=495) was 63 years (SD1.0) and 50.5% were female. At discharge, more than half (58.4%) reported problems in mobility, 28.3% in self-care, 62% in usual-activities, 62.4% in pain/discomfort, and 42.2% in anxiety/depression. The average misery index was 7.9 (2.0), index score was 0.70 (0.22), and VAS score was 63.7 (18.4). In adjusted analysis, there were no significant associations between EQ-5D-3L at discharge with any 30-days post-discharge outcomes. For 90-days post-discharge outcomes, mobility, self-care and pain/discomfort were not associated with any outcome. However, patients with problems in usual-activities were 1.7 times (95%CI 1.1,2.6) more likely to have an ED visit and 2.0 times (1.2,3.3) more likely to get re-hospitalized/die than their counterparts. Additionally, patients with moderate-severe anxiety/depression were less likely to have an outpatient visit (OR=0.55,95%CI 0.34,0.90), but 1.7 times (1.1,2.6) more likely to have an ED visit, and 1.7 times (1.1,2.8) more likely to either get re-hospitalized/die within 90 days. The misery-index was associated with all outcomes at 90 days. The index-score was significantly associated with ED visits, and the composite outcome. VAS-score was not associated with any outcomes within 90 days. The EQ-5D-3L, particularly the usual-activities and anxiety/depression dimensions, misery index and index score, could be used to predict patients’ post-hospitalization healthcare use and outcomes.

Relationship between low handgrip strength and quality of life in Korean men and women.

Handgrip strength is strongly related to muscle power in the extremities and is an important index for diagnosing sarcopenia. We evaluated the relationship between handgrip strength and quality of life (QoL) in Korean men and women. We analyzed 4620 participants (2070 men and 2550 women) using data from the Korea National Health and Nutrition Examination Survey VI-3 (2015). Low handgrip strength was defined as the lower quartile of handgrip strength in the study population. QoL was evaluated according to the European Quality of Life Scale-Five Dimensions (EQ-5D). The relationship between handgrip strength and QoL was evaluated by multivariate logistic regression analyses. The odds ratios (ORs) for low handgrip strength significantly increased as age increased for both men and women. The ORs for low handgrip strength increased as body mass index decreased in men. In men with low handgrip strength, the OR for having problems in mobility (OR 1.93, 95% confidence interval (CI) 1.25-2.98) and having pain or discomfort (1.53, 1.04-2.24) significantly increased. In women with low handgrip strength, the OR for having problems in mobility (2.12, 1.02-2.87), problems in usual activities (2.04, 1.46-2.85), and having pain or discomfort (1.48, 1.15-1.90) significantly increased. Men with low handgrip strength had poor QoL on the mobility and pain/discomfort dimensions of EQ-5D, whereas women with low handgrip strength had poor QoL on mobility, usual activities, and pain/discomfort dimensions. Management to improve handgrip strength is necessary for achieving better QoL.

Diabetic retinopathy and health-related quality of life among Chinese with known type 2 diabetes mellitus.

We aim to describe the impact of diabetic retinopathy (DR) on health-related quality of life (HRQOL) among community-dwelling Chinese adults who had been previously diagnosed with type 2 diabetes mellitus (T2DM). A community-based survey including 913 patients with T2DM was conducted in Suzhou, China. Retinopathy lesions were graded according to the Airlie House classification system of the Early Treatment Diabetic Retinopathy Study. The HRQOL was measured by the Chinese version of the EuroQol Group's five-level EuroQol five-dimensional questionnaire (EQ-5D-5L). A Gamma distribution with log link was incorporated into linear regression models to assess the associations between DR and EQ-5D-5L health utility score. The mean EQ-5D-5L index scores were 0.971 ± 0.082 among individuals with unilateral DR and 0.970 ± 0.145 among those with bilateral DR, which were lower compared with those without DR (0.986 ± 0.045, P = 0.02). In multivariate analysis adjusting for confounders, people with bilateral DR reported lower the EQ-5D index scores compared with those without DR. The presence of DR was significantly associated with problems in usual activities (odds ratio [OR] = 0.16, P = 0.02, comparing participants with unilateral vs. no DR; OR = 0.11; P = 0.01, comparing participants with bilateral vs. no DR). No significant variations in EQ-5D-5L index scores as well as different domains of health problems between individuals with unilateral and bilateral DR were observed (P > 0.05). Chinese T2DM patients with bilateral DR tend to report lower HRQOL scores compared with those without DR, especially in health problems associated with usual activities.

Health-related quality of life and related factors in stroke survivors: Data from Korea National Health and Nutrition Examination Survey (KNHANES) 2008 to 2014

As persons with stroke are surviving longer, monitoring and managing their quality of life is becoming important. We reviewed the Korea National Health and Nutrition Examination Survey (KNHANES) in order to evaluate the health-related quality of life (HRQoL) in stroke survivors as measured by the Euro Quality of Life-5D (EQ-5D), and to find out influencing factors. A total of 42,500 subjects were enrolled in the KNHANES, and 575 of them were persons with stroke. The EQ-5D index was lower in persons with stroke than those without stroke, when adjusted for age and sex (with stroke: 0.757±0.012, without stroke: 0.948±0.001, p < .0001). Dimension-specific influencing factors of HRQoL were observed in persons with stroke; mobility problems increased with old age; self-care problems increased with old age and depression; usual activity problems increased with old age, low income, absence of economic activity, and depression; pain/discomfort problems increased with low income. The EQ-5D index was lower in stroke survivors with older age, hypertension, diabetes mellitus, and lack of regular exercise. This is the first study to utilize nationally representative data of the Korean population to investigate the effect of stroke on HRQoL and explore the dimension-specific influencing factors. Further development of rehabilitative interventions for post-stroke depression, vocational rehabilitation, and tailored programs for encouraging physical activity may be needed to improve the HRQoL in Korean stroke survivors.

Health-related quality of life in lower-risk MDS patients compared with age- and sex-matched reference populations: a European LeukemiaNet study

In myelodysplastic syndromes (MDS), health-related quality of life (HRQoL) represents a relevant patient-reported outcome, which is essential in individualized therapy planning. Prospective data on HRQoL in lower-risk MDS remain rare. We assessed HRQOL by EQ-5D questionnaire at initial diagnosis in 1690 consecutive IPSS-Low/Int-1 MDS patients from the European LeukemiaNet Registry. Impairments were compared with age- and sex-matched EuroQol Group norms. A significant proportion of MDS patients reported moderate/severe problems in the dimensions pain/discomfort (49.5%), mobility (41.0%), anxiety/depression (37.9%), and usual activities (36.1%). Limitations in mobility, self-care, usual activities, pain/discomfort, and EQ-VAS were significantly more frequent in the old, in females, and in those with high co-morbidity burden, low haemoglobin levels, or red blood cells transfusion need (p < 0.001). In comparison to age- and sex-matched peers, the proportion of problems in usual activities and anxiety/depression was significantly higher in MDS patients (p < 0.001). MDS-related restrictions in the dimension mobility were most prominent in males, and in older people (p < 0.001); in anxiety/depression in females and in younger people (p < 0.001); and in EQ-VAS in women and in persons older than 75 years (p < 0.05). Patients newly diagnosed with IPSS lower-risk MDS experience a pronounced reduction in HRQoL and a clustering of restrictions in distinct dimensions of HRQoL as compared with reference populations.