Health-related Quality Of Life Scores Research Articles

Socio-demographic disparities in health-related quality of life in hypertensive patients in Bangladesh: a comprehensive survey analysis.

Hypertension is a major health concern in Bangladesh. Assessing the health-related quality of life (HRQoL) among hypertensive patients in Bangladesh can highlight the broad impacts of the condition on morbidity and mortality. Such insights are essential for developing targeted healthcare and prevention strategies to reduce complications, including heart disease, stroke, and kidney failure. In this cross-sectional study, 5,086 hypertensive patients aged between 18 and 80 were recruited from 75 pharmacies in Bangladesh. We assessed the participants' health using the EQ-5D-5L descriptive system and the EQ-VAS. Utility scores were calculated using the Indian EQ-5D-5L value set. Regression models were employed to identify factors associated with overall HRQoL and individual health dimensions. Study participants were mean aged 52 years old, with average systolic and diastolic blood pressures of 140.79 mmHg and 85.98 mmHg, respectively. The average EQ-index and EQ-VAS score were 0.83 and 67.47, respectively. 39% reported difficulties with self-care, 43.5% had mobility problems, 80.6% had pain, and 61.2% had anxiety. HRQoL scores decreased significantly with age, according to the multilevel model. Higher education levels, however, were associated with better HRQoL scores. Male respondents reported fewer problems with mobility, self-care, activity, pain, and anxiety. A decrease in HRQoL scores was observed among older individuals, those without formal education, those in lower quintiles, those unemployed, and those with poor blood pressure control, obesity, or fasting glucose. Study findings indicate disparities in HRQoL based on age, gender, education, and socioeconomic status, highlighting the need for targeted policy interventions.

Quality-of-Life Assessment and Pharmacokinetic Study in Hemophilia A Patients Undergoing Prophylactic Treatment

This study evaluates the health-related quality of life (HRQoL) among patients with hemophilia A currently undergoing prophylactic treatment at the Hemophilia Center of Northern Greece. Using the Haem-A-QoL questionnaire, we assessed various HRQoL dimensions in a cohort of 29 adult male patients, analyzing the impact of age, disease severity, and treatment regimens. The results revealed that younger patients (18–30 years old) exhibited significantly better overall HRQoL scores (total score of 25.36) compared to older age groups (37.81 for the 31–45 group and 43.71 in the 45+ group), particularly in the physical health (29.16 vs. 48.43 vs. 58.57) and mental well-being domains (25 vs. 37.11 vs. 41.07). Interestingly, moderate hemophilia patients reported lower HRQoL (42.31) than those with severe form (34.85), suggesting unique challenges in managing their condition. The ’Sports/Free Time’ domain had the highest scores (65.81), indicating significant limitations in physical activities in the everyday lives of affected individuals. However, better outcomes were observed in the mental dimension (36.09), work/study (34.88), family planning (10.68), and relationships aspects (16.67), where our cohort reported very low scores compared to similar studies, indicating a significantly better quality of life in these domains. These findings highlight the importance of personalized psychosocial support and targeted interventions to address the specific needs of hemophilia patients, particularly in enhancing physical activity opportunities and managing the psychological burden of moderate hemophilia. The study contributes valuable insights into the HRQoL of hemophilia patients and underscores the necessity for tailored approaches to improve patient outcomes across all dimensions of life.

Interactive 3D visualisation technique used in pulmonary rehabilitation in chronic obstructive pulmonary disease: A randomised controlled study evaluating quality of life, compliance and use of health care.

A pulmonary rehabilitation (PR) programme, including exercise training, education, and behaviour change, is highly recommended in treatment guidelines for chronic obstructive pulmonary disease (COPD). A new PR educational material for PR using an interactive three-dimensional (3D) visualisation technique was developed. There is little known regarding using 3D in this setting. The aim was to evaluate, within a PR programme setting, differences between outcomes of education through interactive 3D compared with education by means of 2D visualisation in patients with COPD regarding health-related quality of life (HRQL), physical capacity, exercise self-efficacy, compliance to exercise training, compliance to medication, and the use of health care and to describe learning styles. Patients were cluster randomised to PR at the University Hospital clinic, including exercise training, for 10 weeks with education by 3D (n = 27) or education by traditional 2D technique (n = 17). At follow-ups, HRQL, physical capacity, self-efficacy, handgrip strength, compliance to exercise training, compliance to medication and health care utilisation were assessed. No significant differences were observed in HRQL in relation to COPD between the groups after 10 weeks. Differences were found in handgrip strength at baseline and at 10 weeks (p < 0.01). The 3D group had improved scores in HRQL assessed with the Leicester Cough Questionnaire (LCQ-S) psychological domain (p = 0.022). In the 2D group, the LCQ-S social domain (p = 0.028), psychological domain (p = 0.021) and the St George's Respiratory Questionnaire total (p = 0.050) were increased. The most common learning mode and learning style in both groups was reflective observation and divergent style. An interactive education in 3D technique used in a PR programme for patients with COPD yielded no significant differences compared to conventional techniques. Three-dimensional techniques can be used in PR for COPD as an alternative to conventional techniques. ClinicalTrials.gov (identifier:NCT02802618).

Health-related quality of life and symptom concordance between patients and physicians in pulmonary arterial hypertension in the United States, Europe, and Japan

This study involved analyses of a real world, cross-sectional survey of physicians and their patients with pulmonary arterial hypertension (PAH). Physician and patient symptom concordance was assessed, and patients self-reported Health-Related Quality of Life (HRQoL). Data were drawn from the Adelphi PAH Disease Specific Programme (DSP)™ in the United States, France, Germany, Italy, Spain, United Kingdom, and Japan, between March and August 2022. EQ-5D 5L utility, EQ-5D Visual Analogue Scale (VAS) scores, and emPHasis-10 (e10) HRQoL scores were reported by patients. Physician-patient symptom concordance was analyzed with Cohen's Weighted Kappa (κ) analysis. Of 628 PAH patients, the mean (SD) EQ-5D VAS and e10 scores were 66 (17) and 23 (11). Data was stratified by World Health Organization Functional Class (WHO-FC). As WHO-FC increased, EQ-5D utility and VAS scores decreased and e10 scores increased, indicating poorer patient-reported HRQoL. Symptom concordance varied, ranging from κ=0.11-0.57 (slight-moderate agreement), and physicians frequently underestimated the presence and severity of patient-reported symptoms. Future research should aim to bridge this gap between patient and physician understanding of HRQoL and the symptom burden associated with PAH.

Etiology remains king: health-related quality of life outcome at 5years following growth friendly instrumentation for EOS.

The etiology of early-onset scoliosis (EOS) has been shown to significantly influence baseline parent-reported health-related quality of life (HRQoL) measures as assessed by the Early Onset Scoliosis Questionnaire (EOSQ). However, it remains unclear how etiology influences mid-term outcomes following growth friendly instrumentation (GFI) for EOS. A retrospective review of a multi-center prospective spinal database was performed. Children undergoing primary distraction-based, GFI for EOS with complete baseline, 2-year, and 5-year post-surgical EOSQ were included. The identified children were subdivided by etiology as classified by the C-EOS system. EOSQ scores were compared over time according to etiology cohorts and between instrumentation types. Minimal clinically important difference (MCID) was defined as ≥ 20% change in domain score and compared across etiologies. Dominance analysis was used to assess for drivers of treatment satisfaction. A total of 178 children (mean 7.3 ± 2.1years, 51.1% female) were included. The most common etiology was neuromuscular (NM: 36.5%), with the majority of children treated with MCGR (N = 125). Significant differences between etiology groups were present with congenital and idiopathic cohorts demonstrating similar EOSQ domain scores that were significantly higher than neuromuscular and syndromic cohorts. In assessing clinically important changes in EOSQ scores over the 5-year follow-up period, neuromuscular and syndromic patients demonstrated the greatest capacity for improved outcomes. Instrumentation type had no influence on HRQoL scores at 5-year follow-up. Etiology was a driver of satisfaction with syndromic etiology and transfer domain score at 2years follow-up associated with dissatisfaction. Curve etiology remains a significant driver of HRQoL domains following growth-friendly instrumentation for EOS. Neuromuscular and syndromic patient have significantly lower domain scores. Despite this, or perhaps because of it, they also demonstrate the greatest capacity for clinically important improvement in HRQoL measures 5years following intervention.

Second-line therapy with Nal-IRI/5-FU/FA after failure of gemcitabine/nab-paclitaxel in advanced pancreatic cancer (PC): Predictive role of 1st-line therapy (PREDICT) and impact of quality of life (QoL).

707 Background: Metastatic PC has the lowest survival rate of all malignant diseases and is the fourth most common cancer. QoL remains an unresolved issue in PC for patients (pts) after treatment failure of 1 st -line CTx (TTF1). Nanoliposomal irinotecan (Nal-IRI) with 5-FU/folinic acid (FA) increased survival of PC pts from 4.2 months (mo) to 6.1 mo as compared to 5-FU/FA alone, with a rate of toxicities that may impact QoL. PREDICT is an open label, single arm, multicenter Phase IIIb trial (NCT03468335) and examined 2 nd -line Nal/IRI/5-FU/FA for PC. Here we report on QoL during 2 nd -line Nal-IRI after failure of 1 st -line gemcitabine/nab-Paclitaxel (gem/nab-Pac). Methods: In this prospective trial, 151 patients with locally advanced or metastatic PC were treated with biweekly Nal-IRI/5-FU/FA (70 mg/m², 2400 mg/m², 400 mg/m²) after failure of gem/nab-pac (TTF1). Primary end point (EP) was the time to treatment failure of 2 nd -line therapy (TTF2) and has been reported elsewhere. Secondary EP were QoL and Health related quality of life (HR-QoL) which were evaluated using questionnaires (EORTC QLQC30, QLQ-PAN26, EQ-5D-5L). Evaluation of time to definitive deterioration of QoL (TDD) during 2 nd -line therapy, defined as the time from screening/baseline until loss of ≥10 points in the EORTC QLQ-C30 was compared to baseline. Results: QoL analyses were performed with all QoL evaluable subjects set (QAS). The QAS included 143 pts, of which 48 pts were included in TTF1 high (TTF of 1 st -line ≥213 d) and 49 pts in the TTF1 low (TTF ≤119 d) cohort, with 79 (54.1%) female and 67 (45.9%) male pts. Mean age was 68.2±8.9 years. Overall, a low global health status / QoL mean score was observed at baseline for TTF1 high and low cohorts (about 48 points), which slightly improved during the study for TTF1 high (3.5±23.7) and slightly worsened for TTF1 low cohort (-0.7±22.5). Substantial improvements were observed for both cohorts in emotional functioning scale at certain study time points (TTF1 high: up to 9.1±25.7, TTF1 low: up to 6.6±17.0). A relatively high mean score was observed for cognitive function scale for both cohorts at baseline (TTF1 high: 70.1±30.2; TTF1 low: 72.5±21.4). Pts in the TTF1 low vs. high cohort showed more pronounced worsening of cognitive function. Median TDD was numerically longer (about one month) for TTF1 high (5,3 mo) compared to TTF1 low cohort (3,9 mo). The probability to maintain QoL after six months was similar between the two cohorts. Conclusions: QoL showed similar global and HR-QoL scores with only slight changes during the study. Median TDD was numerically longer for high TTF1 pts, but similar after six months between pts still on 2 nd line Nal/IRI/5-FU regardless of duration of TTF in 1 st -line. Clinical trial information: NCT03468335 .

Health-related Quality of Life and Exercise Capacity in Double Lung Transplant Recipients With Baseline Lung Allograft Dysfunction.

Baseline lung allograft dysfunction (BLAD) after lung transplant is associated with an increased risk of dying, but the association with health-related quality of life (HRQL) and exercise capacity is not known. We hypothesized that BLAD would be associated with reduced HRQL and 6-min walk distance (6MWD) at 1 y post-lung transplant. We analyzed patients who underwent lung transplants in our program from 2004 to 2018 who completed 1-y 36-item Short Form (SF-36) questionnaire and 6MWD testing. We secondarily analyzed the Beck Depression Inventory and Borg dyspnea scores in patients using the available data. We defined BLAD as a failure of both forced expiratory volume in 1 s and forced vital capacity to reach ≥80% predicted of a healthy reference population's lung function on 2 consecutive tests ≥3 wk apart at any time point posttransplant. We tested the relationship between BLAD status and SF-36 physical component summaries and 6MWD using least squares regression, adjusting for age at transplant, sex at birth, and primary lung disease. Two hundred sixty-four patients were included, 96 (36%) of whom met the criteria for BLAD. Patients with interstitial lung disease as an indication for transplant and those who received older, female, and heavy smoking donors were at increased risk of BLAD. SF-36 physical component summary scores were lower in patients with BLAD (75 versus 85; P = 0.0076), as were 6MWD values (528 versus 572 m; P = 0.0053). BLAD was associated with lower SF-36 scores (P = 0.0025) and 6MWD (P = 0.0008) in adjusted regression models at 1 y posttransplant. We did not observe differences in Beck Depression Inventory or Borg scores. BLAD was associated with reduced HRQL and 6MWD scores at 1 y posttransplant in adjusted models. This suggests that poor posttransplant lung function could contribute to lower HRQL and exercise capacity in lung recipients and is worthy of further exploration in terms of causes, prevention, and treatment.

Coprophenomena Associated With Worse Individual and Family Function for Youth With Tourette Syndrome: A Cross-Sectional Study.

Tourette syndrome (TS) is defined by multiple motor tics and one or more phonic tics with a symptom duration of >1 year. Coprophenomena are uncommon tics characterized by obscene sounds, words, or gestures. Youth with TS commonly have psychiatric co-occurring conditions such as attention-deficit hyperactivity disorder or obsessive-compulsive disorder and have reported lower scores on measures of individual and family functioning than youth without TS. This study aimed to determine associations among co-occurring condition symptoms, tic severity, and function in youth with TS and coprophenomena compared with those with TS without coprophenomena. Data were collected through a multicenter, cross-sectional study. Youth with TS were recruited from 2 referral centers, and data were collected from youth and their parents or caregivers. Tic severity was assessed using the Yale Global Tic Severity Scale, and individual function was measured with the Children's Global Assessment Scale. Family impact was measured using the Family Impact Module in domains of parent health-related quality of life (HRQOL), family functioning, and total family impact. We compared individual and family function in youth with TS with coprophenomena (TS+copro) and without coprophenomena (TS-copro). Wilcoxon rank-sum tests were used to compare scores on individual function and family function measures. Of 169 participants, 17 (10.1%) reported coprophenomena. Participants with TS and coprophenomena had higher tic severity scores than those without coprophenomena (TS+copro mean = 36.9, TS-copro = 20.8). Youth with coprophenomena had lower scores for global function (TS+copro median = 51, TS-copro = 60), family functioning (TS+copro = 43.8, TS-copro = 59.4), parent HRQOL (TS+copro = 57, TS-copro = 72), and total family QOL (TS+copro = 50.7, TS-copro = 65.3). Youth with TS and coprophenomena had lower individual function, family function, and parent HRQOL than youth without coprophenomena. Coprophenomena presence may indicate that youth have a more severe phenotype of TS, and youth with copropheneomena may benefit from additional caregiver or family supports.

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

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

Changes in physical activity since cancer diagnosis and associations with health-related quality of life: a study of adults living with advanced cancer.

Physical activity (PA) is associated with better quality of life for cancer survivors; however, less is known about this association among individuals with advanced cancer. This study assesses whether changes in PA following an advanced cancer diagnosis are associated with health-related quality of life (HRQoL) outcomes. Data were collected from 247 participants in a survey of adults with advanced cancer who visited the University of Wisconsin Carbone Cancer Center (January 2021-2023). PA since cancer diagnosis was assessed using a validated, self-reported tool. HRQoL was assessed using the Functional Assessment of Cancer Therapy - General and Patient-Reported Outcomes Measurement Information System measures of physical function, fatigue, and pain interference. We used generalized linear models to assess relationships between PA and HRQoL. Most adults with advanced cancer were insufficiently active (53%), and reported a lot less activity (41%) after diagnosis, followed by a little less activity (33%), and the same/more activity (26%). Compared to the other activity groups, those who reported a lot less activity had the worst HRQoL scores, including lower HRQoL (x̄ = 70.3 vs. x̄ = 82.6, 90.7) and physical function (x̄ = 40.3 vs. x̄ = 47.3, 52.5), and higher fatigue (x̄ = 59.3 vs. x̄ = 51.4, 42.3) and pain interference (x̄ = 55.5 vs. x̄ = 48.8, 45.6). Adults with advanced cancer who report PA reductions have worse HRQoL, higher pain and fatigue, and lower physical function than those engaging in the same/more PA since their diagnosis. Future interventions focused on improving HRQoL among adults with advanced cancer should incorporate light-intensity PA to reduce declines following diagnosis.

Correlations between spinopelvic parameters and health-related quality of life in degenerative lumbar scoliosis patients before and after long -level fusion surgery

BackgroundFor degenerative lumbar scoliosis (DLS), prior studies mainly focused on the preoperative relationship between spinopelvic parameters and health-related quality of life (HRQoL), lacking an exhaustive evaluation of the postoperative situation. Therefore, the postoperative parameters most closely bonded with clinical outcomes has not yet been well-defined in DLS patients. The objective of this study was to comprehensively assess the correlation between radiographic parameters and HRQoL before and after surgery, and to identified the most valuable spinopelvic parameters for postoperative curative effect.MethodsThis study retrospectively reviewed 130 consecutive patients who underwent long-level fusion with at least 1 year follow-up. Standing whole-spine radiographs and HRQoL measurements were examined preoperatively and at final follow-up. Spinopelvic parameters included thoracic kyphosis (TK), thoracolumbar kyphosis (TLK), lumbar lordosis (LL), pelvic incidence minus lumbar lordosis (PI-LL), pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), sagittal vertical axis (SVA), T1 pelvic angle (TPA), Global tilt (GT), Cobb angle (CA), apical vertebral translation (AVT) and coronal vertical axis (CVA). HRQoL was evaluated using the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Chinese version of Lumbar Stiffness Disability Index (C-LSDI), Japanese Orthopedic Association-29 (JOA-29), Scoliosis Research Society-22 (SRS-22),and the 36-item Short Form Health Survey (SF-36) total and subscale scores. Pearson’s correlation analysis was performed to determine relationships between them.ResultsThe study population included 104 women and 26 men with an average age of 62.9 years. Both coronal and sagittal parameters showed significant correlations with HRQoL scores pre- and post-operatively. Among the coronal parameters, only CA showed correlations with SRS-22 subscale scores, and its correlation with Self-image scores were observed both before and after surgery. Among sagittal parameters, PT, PI-LL, LL, SVA, TPA, and GT showed significant correlations with HRQoL before surgery, including ODI, JOA-29, and SF-36 PCS. At final follow-up, except for AVT, CVA, and LL, all other sagittal parameters were significantly correlated with HRQoL.ConclusionsHRQoL scores not only correlated with radiological parameters before surgery, but also after long-term follow-up. Besides, sagittal parameters, especially postoperative PI-LL, SVA, TPA, GT, were more closely correlated with clinical outcome measurements.

Prevalence of lymphedema symptoms across cancer diagnoses and association with depression, pain interference and health-related quality of life.

Lymphedema is a debilitating late effect of cancer treatments, yet its prevalence beyond breast cancer remains understudied. This study examined the prevalence of lymphedema symptoms across cancer diagnoses and their association with depression, pain interference, and health-related quality of life (HRQoL). This cross-sectional study was conducted at the Department of Oncology, Copenhagen University Hospital, from February to April 2021, as part of a broader investigation into cancer-related late effects. Here, we present data from patients in follow-up who received online lymphedema symptom assesments (swelling, heaviness, or tightness). Utilized questionnaires were the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, the Major Depression Inventory, and the Brief Pain Inventory. Associations between lymphedema symptoms and depression, pain interference, and HRQoL were examined via multiple linear regression. Of 1,901 patients in follow-up who received the lymphedema symptom items, 1,296 responded. Most participants had breast cancer (48%), followed by testicular (17%), gynecological (16%), and head/neck cancer (11%). One-third (n = 397) reported lymphedema symptoms, with 38% (n = 152) reporting moderate/severe symptoms. The highest symptom prevalence was seen in gynecological cancer (59%), followed by head/neck (41%), breast (21%), and testicular cancer (19%). Participants with moderate/severe lymphedema symptoms were significantly more likely to report higher depression and pain interference scores and lower HRQoL scores compared to those with no/mild symptoms. Lymphedema symptoms are highly prevalent among patients who have completed treatment for diverse cancers and associated with higher scores for depression and pain interference, and lower HRQoL.

A comparison of health-related quality of life between continuous ambulatory peritoneal dialysis and automated peritoneal dialysis in children with stage 5 chronic kidney disease in Thailand: a randomized controlled trial.

Improving health-related quality of life (HRQoL) is one of the main goals in managing stage 5 chronic kidney disease (CKD). However, limited evidence compares HRQoL between continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD) in children. This open-label randomized controlled trial (RCT) aimed to compare HRQoL in pediatric patients with stage 5 CKD receiving CAPD vs. APD in Thailand. Children with stage 5 CKD were randomized 1:1 to receive APD or CAPD. The primary outcome was HRQoL, measured by EQ-5D-5L, EQ-5D-3L, and PedsQL at baseline, week 16 and week 48. Outcomes were analyzed using linear mixed models. A total of 60 patients were recruited: 30 with CAPD and 30 with APD. General characteristics, utility scores measured by EQ-5D and HRQoL score measured by PedsQL were comparable between both groups at baseline. During follow-up, no significant differences in terms of utility and HRQoL scores could be identified at week 16 and week 48. Although the children in the APD group seemed to have more favorable changes in some PedsQL domains of PedsQL (school and social domain), as compared to the CAPD group, it was not found that the improvement from baseline was significantly different between both groups. No significant benefit of APD was found over CAPD in terms of HRQoL improvement. However, larger studies are warranted along with qualitative studies to examine the complete impacts of APD on HRQoL among pediatric patients with stage 5 CKD and their families.

An Assessment of Erectile Dysfunction and Health-Related Quality of Life Among Men Attending the General Outpatient Clinic in a Tertiary Hospital in North Central, Nigeria

Background: Erectile dysfunction is a distressing condition that impacts negatively a man’s well-being. Health-related quality of life (HRQOL) is a useful indicator of overall health that has gained wide acceptance as the patient-centred approach to assessing overall health. Objectives: This survey assessed the prevalence and pattern of erectile dysfunctions and their association with health-related quality of life. Methods: We conducted a hospital-based cross-sectional study and interviewed 392 sexually active adult male patients with the aid of interviewer-administered structured and semi-structured questionnaires at the general outpatient clinic of the University of Ilorin Teaching Hospital. The HRQOL was assessed with the World Health Organization Quality of Life abridged version (WHOQOL-BREF), while ED was assessed with the International Index for Erectile Function 5 (IIEF-5). Result: A total of 235 (59.9%) had ED: of those, 67 (28.5%) had mild ED, 77 (32.8%) had mild to moderate ED, 57 (24.3%) had moderate ED, and 34 (14.4%) had severe ED. Respondents with ED had lower mean HRQOL scores across all domains, (psychological f=94.700 p=0.001, Physical f=68.582 p=0.001, environmental f=30.314 p=0.0001, social f=8.346 p=0.004). Conclusion: The prevalence of ED was high among the study population. Although ED negatively impacted all HRQOL domains, the psychological domain had the most profound impairment.

Adverse health outcomes and health-related quality of life (HRQoL) among long-term adolescent and young adult (AYA) brain tumour survivors: results from the population-based SURVAYA study

PurposeAdolescent and young adult (AYA) malignant brain tumour (BT) survivors are at risk of adverse health outcomes, which may impact their health-related quality of life (HRQoL). This study aimed to investigate the (1) prevalence of physical and psychological adverse health outcomes, (2) the HRQoL, and (3) the association of adverse health outcomes and HRQoL among long-term AYA-BT survivors. Adverse health outcomes and HRQoL were compared to other AYA cancer (AYAC) survivors.MethodsA cross-sectional secondary data analysis of the SURVAYA study among 133 AYA-BT and 3877 AYAC survivors was conducted. Participant self-reported adverse health outcomes and HRQoL scores were analysed and compared between the two populations. Associations with HRQoL were assessed using linear regression modelling with AIC-based backward elimination.ResultsAYA-BT survivors faced significant issues of fatigue (47.6%), future uncertainty (45.2%), and medical conditions like vision (34.4%), speech, taste, or smell (26.2%) impairments, cancer recurrence, and metastasis (25.4%). Neurocognitive symptoms were identified as BT-specific issues (13.6–33.6%). Compared to AYAC survivors, AYA-BT survivors reported significantly (p < 0.05) lower functioning scores on the role, cognitive, emotional, and social HRQoL, with cognitive (56.0%) and emotional (40.0%) domains being the most affected. Adverse health outcomes were negatively associated with HRQoL, ranging from small to large clinical relevance.ConclusionLong-term AYA-BT survivors were identified as a highly burdened population, affected by multifaceted issues and multidimensional detriments in HRQoL years beyond their cancer diagnosis. This study highlights the necessity of long-term follow-up and a holistic, multidisciplinary approach to survivorship care to ultimately improve the quality of AYA-BT survivorship.

One is not like the other: health quality of life scores vary in neuromuscular EOS by diagnosis.

The etiology of early-onset scoliosis (EOS) has been shown to significantly influence baseline parent-reported health-related quality of life (HrQOL). In combining these etiology groups, we obligatorily lump together many disparate diagnoses, particularly true in the neuromuscular (NM) cohort. We sought to evaluate the influence of underlying neuromuscular diagnosis on the HrQOL at 5years following surgery for EOS. A retrospective review of a multi-center EOS database was performed. Children treated with primary distraction-based, growth-friendly instrumentation (GFI) for EOS with complete baseline, 2-year, and 5-year post-surgical EOSQs were included. Neuromuscular scoliosis patients, as classified by the C-EOS system, were isolated and subdivided by underlying diagnosis into 5 groups. EOSQ domains and composite HrQOL score at presentation, 2-year, and 5-year follow-up were compared across underlying diagnosis. A total of 65 neuromuscular EOS patients were identified (mean 7.6 ± 1.99years of age, 50% female). Cerebral palsy was the most common underlying diagnosis (30%, N = 18), followed by spinal muscular atrophy (SMA, N = 16). There were differences in EOSQ domains with CP, SMA, and MD having significantly lower scores than Chiari/Syrinx patients at 2-year follow-up. Chiari/Syrinx patients demonstrated EOSQ scores statistically similar to idiopathic EOS patients at all time points (P > 0.05). CP patients were most likely to experience improvement in HrQOL at 5-year follow-up. Underlying NM diagnosis has direct implications on treatment response following GFI for EOS. Cerebral palsy patients demonstrate the best improvement in HrQOL at 5years following surgery while others actually deteriorate over time. Children with EOS related to Chiari and Syringomyelia had similar HrQOL scores to idiopathic EOS and may not be best suited for inclusion in NM cohorts when assessing HrQOL scores following treatment. Increasing population-based HrQOL data may allow further refinement and prognostication of neuromuscular diagnoses over time.

Back pain disability and PROMIS scores in children with hyperkyphosis are worse than children with idiopathic scoliosis.

To compare health-related quality-of-life (HRQOL) between children with hyperkyphosis and idiopathic scoliosis using 9-item Oswestry Disability Index (ODI-9) and Patient Reported Outcome Measurement Information System (PROMIS) Pain Interference, Mobility, and Anxiety. Children with hyperkyphosis, idiopathic scoliosis, and controls with no structural diagnosis ages 10-18years who completed the PROMIS Pediatric Pain Interference, Mobility, and Anxiety domains were retrospectively evaluated from April 2021 to June 2023. Comparisons were made between hyperkyphosis, idiopathic scoliosis, and control groups. Within the hyperkyphosis group, comparisons were made between Scheuermann kyphosis and postural kyphosis subgroups. 304 children with hyperkyphosis, 1134 with idiopathic scoliosis, and 1493 controls were included. Children with hyperkyphosis had increased age, male sex, BMI percentile, Spanish than English speakers, and public insurance type. They also had worse ODI-9, PROMIS Pain Interference and Mobility scores which remained significant after multivariate regression analysis included age, sex, BMI percentile, language, insurance type, and race/ethnicity (p < 0.01). The Scheuermann kyphosis (n = 67) subgroup had increased age, male sex, area deprivation index (ADI), BMI percentile, concern by their appearance, and worse PROMIS Pain Interference and Mobility scores than the postural kyphosis (n = 237) subgroup. However, Scheuermann kyphosis subgroup score differences did not remain significant after considering age, sex, ADI, and BMI percentile. Children with hyperkyphosis (both Scheuermann and postural kyphosis subtypes) have worse HRQOL scores than their peers with idiopathic scoliosis. Worse ODI-9, PROMIS Pain Interference and Mobility scores remained significant only in the hyperkyphosis group as a whole after adjusting for confounding variables, but not between hyperkyphosis subgroups.

Quality of life in early breast cancer patients after adjuvant accelerated partial-breast irradiation (APBI) in randomized trial

Accelerated partial breast irradiation (APBI) represents a valid option for adjuvant therapy of selected early breast cancer (BC). This single-institution prospective randomized study compares the health-related quality of life (HRQoL) between women treated with the highly conformal-external beam APBI technique and those with the more commonly used moderately hypofractionated whole breast irradiation (hypo-WBI). Eligible patients were women over 50 years with early BC (G1/2 DCIS ≤ 25 mm or G1/2 invasive non-lobular luminal-like HER2 negative carcinoma ≤ 20 mm) after breast-conserving surgery with negative margins. APBI arm consisted of 30 Gy in 5 consecutive daily fractions and WBI arm of 40 Gy in 15 fractions plus 10 Gy in 5 fractions boost to the tumor bed. Patients were requested to complete the official Czech translation of the EORTC QoL questionnaires, including QLQ-C30 and QLQ-BR45, before radiation (baseline), at the end of radiation (M0) and 1 (M1), 3 (M3), 6 (M6), 12 (M12), and 24 (M24) months after radiation. Linear regression models were used to analyze differences in HRQoL between the arms. The 85 enrolled patients exhibited no differences in HRQoL scores between the two arms at baseline. Patients in the APBI arm reported more favorable global health status at M6 (p = 0.055). Other functional scales showed a decrease in the WBI arm at M0 (p = 0.027 for physical functioning). During radiation, symptoms scores increased. Significant between-group differences were observed for the pain (p = 0.002), systemic therapy side effects (p = 0.004), and breast symptoms (p < 0.001) scales at M0, with higher scores in the WBI arm. During follow-up, scores on symptoms scales returned to at least the baseline values. Early BC patients treated with APBI showed non-inferior short-term and late HRQoL outcomes compared to hypo-WBI. In addition to previous findings regarding toxicity, promising pain and breast symptoms results, suggest that APBI should be strongly considered as a treatment option for selected low-risk patients.Trial registration NCT06007118, August 23, 2023 (retrospectively registered).

Activity impairment, work productivity, health-related quality-of-life, and costs associated with uncomplicated urinary tract infection among females in Germany.

Uncomplicated urinary tract infections (uUTIs) represent a sizable healthcare burden with a substantial negative impact on patients' health-related quality-of-life (HRQoL). However, the HRQoL impact of uUTI from the patient perspective is under-represented in research. A cross-sectional online survey assessed activity impairment and work productivity, HRQoL, costs, and treatment satisfaction of female patients with uUTIs in the US; the current study applies this earlier methodology to Germany to provide a European perspective. We examined: activity impairment and work productivity using Activity Impairment Assessment (AIA), and Work Productivity and Activity Impairment (WPAI) questionnaires, respectively; HRQoL using a modified Short Form-36, and participants completed the treatment satisfaction questionnaire for medication. Participants (≥ 12 years) self-reported a uUTI treated with oral antibiotics in the last 60 days, had no evidence of complicated UTI, and were recruited via a consumer panel. In the patient (N = 200) survey, bladder pain (70%), dysuria (69%), and frequent urination (66%) were the most common uUTI symptoms reported. Activities frequently affected by uUTI were sexual activity (56%) and exercise (48%), resulting in an overall AIA score of 8.2 indicating that activities among patients were impaired 'most of the time' during their recent uUTI. Absenteeism was 29% (of a 40-hour work week); presenteeism, 34%; and overall work impairment, 41%. Indirect costs due to impact of uUTI were €7.62/hour/participant, representing a loss for the employer. The lowest HRQoL scores were for mental (44%) and physical components (43%); emotional and physical functioning scores were 71% and 70%, respectively. Mean direct costs of €20.10 for medical treatments and €11.30 for other treatment costs were reported. Overall, most participants were satisfied with the uUTI treatment (76% satisfaction score). Results demonstrate the patient-reported burden of uUTI for patients and employers, with activities and ability to work impacted, resulting in a notable indirect burden in Europe.

Long-Term Outcomes and Quality of Life of High-Risk Neuroblastoma Patients Treated with a Multimodal Treatment Including Anti-GD2 Immunotherapy: A Retrospective Cohort Study.

The incorporation of anti-GD2 antibodies such as ch14.18/SP2/0 into the multimodal treatment of high-risk neuroblastoma (HR-NB) patients has improved their outcomes. As studies assessing the long-term outcomes, long-term sequelae, and health-related quality of life (HRQoL) of this treatment are limited, this retrospective analysis aimed to explore these. Between 1991 and 2002, 65 children received a multimodal treatment, including ch14.18/SP2/0, for primary HR-NB. All received chemotherapy according to the NB90/NB97 trial, 51 received high-dose chemotherapy, and all received ch14.18/SP2/0 treatment. We analyzed the long-term sequelae and HRQoL (EORTC QLQ-C30), and evaluated overall and event-free survival (OS/EFS). Twenty-five survivors were evaluated for HRQoL and long-term effects. All reported long-term sequelae, including ototoxicity in 16/25 (64%), cardiac toxicity in 6/25 (24%), and endocrine toxicity in 19/25 (76%) patients. Chronic diarrhea was reported in 20% of female patients. Seven patients developed autoimmune diseases. HRQoL scores were better across multiple scales than those of the matched German general population. Twenty-five-year OS and EFS were 50.8% (95% confidence interval: 31-55) and 43% (30.1-55.3), with 33 (50.8%) long-term survivors. Thirty-two patients died: 28 (43.1%) because of progression/relapse and 4 (6.2%) because of secondary neoplasms. Multimodal treatment, including ch14.18/SP2/0, can achieve long-term survival in HR-NB patients, with a substantial proportion of survivors reporting better HRQoL compared to the general population. All patients reported long-term side effects mostly attributable to chemotherapy and radiotherapy. The relatively high prevalence of autoimmune diseases and persistent diarrhea warrants additional longitudinal research on individuals treated with anti-GD2 antibodies.