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Teni FS, Gerdtham UG, Leidl R, Henriksson M, Åström M, Sun S, Burström K. Inequality and heterogeneity in health-related quality of life: findings based on a large sample of cross-sectional EQ-5D-5L data from the Swedish general population. Qual Life Res 2021; 31:697-712. [PMID: 34628587 PMCID: PMC8921093 DOI: 10.1007/s11136-021-02982-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2021] [Indexed: 11/24/2022]
Abstract
Purpose This study aimed to investigate inequality and heterogeneity in health-related quality of life (HRQoL) and to provide EQ-5D-5L population reference data for Sweden. Methods Based on a large Swedish population-based survey, 25,867 respondents aged 30‒104 years, HRQoL is described by sex, age, education, income, economic activity, health-related behaviours, self-reported diseases and conditions. Results are presented by EQ-5D-5L dimensions, respondents rating of their overall health on the EQ visual analogue scale (EQ VAS), VAS index value and TTO (time trade-off) index value allowing for calculation of quality-adjusted life years (QALYs). Ordinary Least Squares and multivariable logistic regression analyses were used to study inequalities in observed EQ VAS score between socioeconomic groups and the likelihood to report problems on the dimensions, respectively, adjusted for confounders. Results In total, 896 different health states were reported; 24.1% did not report any problems. Most problems were reported with pain/discomfort. Women reported worse HRQoL than men, and health deteriorated with age. The strongest association between diseases and conditions and EQ VAS score was seen for depression and mental health problems. There was a socioeconomic gradient in HRQoL; adjusting for health-related behaviours, diseases and conditions slightly reduced the differences between educational groups and income groups, but socioeconomic inequalities largely remained. Conclusion EQ-5D-5L population reference (norms) data are now available for Sweden, including socioeconomic differentials. Results may be used for comparisons with disease-specific populations and in health economic evaluations. The observed socioeconomic inequality in HRQoL should be of great importance for policy makers concerned with equity aspects. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02982-3.
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Affiliation(s)
- Fitsum Sebsibe Teni
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18a, 171 77, Stockholm, Sweden
| | - Ulf-G Gerdtham
- Department of Economics, Lund University, Lund, Sweden.,Health Economics Unit, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Reiner Leidl
- Institute for Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Munich Center of Health Sciences, Ludwig-Maximilians University, Munich, Germany
| | - Martin Henriksson
- Center for Medical Technology Assessment, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mimmi Åström
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18a, 171 77, Stockholm, Sweden.,Equity and Health Policy Research Group, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Sun Sun
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18a, 171 77, Stockholm, Sweden.,Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Kristina Burström
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18a, 171 77, Stockholm, Sweden. .,Equity and Health Policy Research Group, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
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Kall M, Fresán U, Guy D, Brown G, Burgui C, Castilla J, Grecu VI, Dumitrescu F, Delpech V, Lazarus JV. Quality of life in people living with HIV in Romania and Spain. BMC Infect Dis 2021; 21:898. [PMID: 34517820 PMCID: PMC8436864 DOI: 10.1186/s12879-021-06567-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/12/2021] [Indexed: 01/30/2023] Open
Abstract
Background Health-related quality of life (HRQoL) is a crucial component in assessing and addressing the unmet needs of people, especially those with chronic illnesses such as HIV. The aim of the study was to examine and compare the health-related quality of life of people living with HIV in Romania and Spain, compared to the general populations of each country. Methods A cross-sectional survey was conducted among adults (≥ 18 years) attending for HIV care in Romania and Spain from October 2019 to March 2020. The survey included two validated HRQoL instruments: a generic instrument, EQ-5D-5L, and an HIV-specific instrument, PozQoL, and questions on socio-demographics, HIV-related characteristics, physical and mental health conditions, and substance use. Multivariable linear regression was used to determine factors associated with HRQoL. Results 570 people living with HIV responded (170 in Romania and 400 in Spain). The median age was 31 (18–67) in Romania and 52 (19–83) in Spain. Anxiety/depression symptoms were frequently reported by people with HIV (Romania: 50% vs 30% in the Romanian population; Spain: 38% vs 15% in Spanish population). Spain reported higher mean EQ-5Dutility scores than Romania (0.88 and 0.85, respectively) but identical PozQoL scores (3.5, on a scale of 0–5). In both countries, health concerns were highlighted as a key issue for people with HIV. In multivariable analysis, two factors were consistently associated with worse HRQoL in people with HIV: bad or very bad self-rated health status and presence of a mental health condition. In Romania, being gay/bisexual and being disabled/unemployed were associated with worse HRQoL. Whereas in Spain, older age and financial insecurity were significant predictors. Conclusions Our results indicated a good HRQoL for people living with HIV in Romania and Spain; however, worse HRQoL profiles were characterized by health concerns, poor self-rated health status, and the presence of mental health conditions. This study highlights the importance of monitoring HRQoL in people living with HIV due to the chronic nature of the disease. In this highly-treatment experienced group, disparities were found, particularly highlighting mental health as an area which needs more attention to improve the well-being of people living with HIV.
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Affiliation(s)
- Meaghan Kall
- HIV/STI Department, Public Health England, London, NW9 5EQ, UK.
| | - Ujué Fresán
- Instituto de Salud Pública de Navarra-IdiSNA-CIBERESP, Pamplona, Spain
| | - Danielle Guy
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, S08036, Barcelona, Spain
| | - Graham Brown
- Centre for Social Impact, University of New South Wales, High Street, Sydney, Australia
| | - Cristina Burgui
- Instituto de Salud Pública de Navarra-IdiSNA-CIBERESP, Pamplona, Spain
| | - Jesús Castilla
- Instituto de Salud Pública de Navarra-IdiSNA-CIBERESP, Pamplona, Spain
| | - Victor Ionel Grecu
- Spitalul Clinic de Boli Infectioase si Pneumoftiziologie "Victor Babes" Craiova, 200515, Craiova, Romania
| | - Florentina Dumitrescu
- Spitalul Clinic de Boli Infectioase si Pneumoftiziologie "Victor Babes" Craiova, 200515, Craiova, Romania
| | - Valerie Delpech
- HIV/STI Department, Public Health England, London, NW9 5EQ, UK
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, S08036, Barcelona, Spain
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Arraras JI, Nolte S, Liegl G, Rose M, Manterola A, Illarramendi JJ, Zarandona U, Rico M, Teiejria L, Asin G, Hernandez I, Barrado M, Vera R, Efficace F, Giesinger JM. General Spanish population normative data analysis for the EORTC QLQ-C30 by sex, age, and health condition. Health Qual Life Outcomes 2021; 19:208. [PMID: 34461909 PMCID: PMC8404330 DOI: 10.1186/s12955-021-01820-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/11/2021] [Indexed: 11/19/2022] Open
Abstract
Purpose General population normative data for the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire facilitates interpretation of data assessed from cancer patients. This study aims to present normative data of the general Spanish population. Methods/patients Data were obtained from a prior larger study collecting EORTC QLQ-C30 norm data across 15 countries. Data were stratified by sex and age groups (18–39, 40–49, 50–59, 60–69 and > 70 years). Sex and age distribution were weighted according to population distribution statistics. Sex- and age-specific normative values were analysed separately, as were participants with versus those without health conditions. Multiple linear regression was used to estimate the association of each of the EORTC QLQ-C30 scales with the determinants age, sex, sex-by-age interaction term, and health condition. Results In total, 1,165 Spanish individuals participated in the study. Differences were found by sex and age. The largest sex-related differences were seen in fatigue, emotional functioning, and global QOL (Quality of Life), favouring men. The largest age differences were seen in emotional functioning, insomnia, and pain, with middle-aged groups having the worst scores. Those > 60 years old scored better than those < 60 years old on all scales except for physical functioning. Participants with no health conditions scored better in all QLQ-C30 domains. Conclusions The present study highlights differences in HRQOL between specific sex/age strata and especially between people with and without a health condition in the general Spanish population. These factors must be considered when comparing general population HRQOL data with that of cancer patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01820-x.
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Affiliation(s)
- Juan Ignacio Arraras
- Oncology Departments, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain.
| | - Sandra Nolte
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Medical Clinic, Department of Psychosomatic Medicine, Berlin, Germany
| | - Gregor Liegl
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Medical Clinic, Department of Psychosomatic Medicine, Berlin, Germany
| | - Matthias Rose
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Medical Clinic, Department of Psychosomatic Medicine, Berlin, Germany
| | - Ana Manterola
- Radiotherapeutic Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Jose Juan Illarramendi
- Medical Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Uxue Zarandona
- Oncology Departments, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Mikel Rico
- Radiotherapeutic Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Lucia Teiejria
- Medical Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Gemma Asin
- Radiotherapeutic Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Irene Hernandez
- Medical Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Marta Barrado
- Radiotherapeutic Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Ruth Vera
- Medical Oncology Department, Complejo Hospitalario de Navarra, Irunlarrea 3, 31008, Pamplona, Spain
| | - Fabio Efficace
- Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center, Rome, Italy
| | - Johannes M Giesinger
- University Hospital of Psychiatry II, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
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García-Delgado Y, López-Madrazo-Hernández MJ, Alvarado-Martel D, Miranda-Calderín G, Ugarte-Lopetegui A, González-Medina RA, Hernández-Lázaro A, Zamora G, Pérez-Martín N, Sánchez-Hernández RM, Ibarra-González A, Bengoa-Dolón M, Mendoza-Vega CT, Appelvik-González SM, Caballero-Díaz Y, Hernández-Hernández JR, Wägner AM. Prehabilitation for Bariatric Surgery: A Randomized, Controlled Trial Protocol and Pilot Study. Nutrients 2021; 13:2903. [PMID: 34578781 PMCID: PMC8465022 DOI: 10.3390/nu13092903] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/13/2021] [Accepted: 08/20/2021] [Indexed: 12/15/2022] Open
Abstract
Bariatric surgery is the most efficacious treatment for obesity, though it is not free from complications. Preoperative conditioning has proved beneficial in various clinical contexts, but the evidence is scarce on the role of prehabilitation in bariatric surgery. We describe the protocol and pilot study of a randomized (ratio 1:1), parallel, controlled trial assessing the effect of a physical conditioning and respiratory muscle training programme, added to a standard 8-week group intervention based on therapeutical education and cognitive-behavioural therapy, in patients awaiting bariatric surgery. The primary outcome is preoperative weight-loss. Secondary outcomes include associated comorbidity, eating behaviour, physical activity, quality of life, and short-term postoperative complications. A pilot sample of 15 participants has been randomized to the intervention or control groups and their baseline features and results are described. Only 5 patients completed the group programme and returned for assessment. Measures to improve adherence will be implemented and once the COVID-19 pandemic allows, the clinical trial will start. This is the first randomized, clinical trial assessing the effect of physical and respiratory prehabilitation, added to standard group education and cognitive-behavioural intervention in obese patients on the waiting list for bariatric surgery. Clinical Trial Registration: NCT0404636.
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Affiliation(s)
- Yaiza García-Delgado
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (M.J.L.-M.-H.); (N.P.-M.); (R.M.S.-H.); (A.I.-G.)
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35001 Las Palmas, Spain; (D.A.-M.); (G.Z.)
| | - María José López-Madrazo-Hernández
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (M.J.L.-M.-H.); (N.P.-M.); (R.M.S.-H.); (A.I.-G.)
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35001 Las Palmas, Spain; (D.A.-M.); (G.Z.)
| | - Dácil Alvarado-Martel
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35001 Las Palmas, Spain; (D.A.-M.); (G.Z.)
| | - Guillermo Miranda-Calderín
- Department of Rehabilitation and Physical Medicine, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (G.M.-C.); (A.U.-L.); (C.T.M.-V.); (S.M.A.-G.)
| | - Arantza Ugarte-Lopetegui
- Department of Rehabilitation and Physical Medicine, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (G.M.-C.); (A.U.-L.); (C.T.M.-V.); (S.M.A.-G.)
| | - Raúl Alberto González-Medina
- Internal Medicine Nursing 8th North Wing, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain;
| | - Alba Hernández-Lázaro
- Department of Endocrinology and Nutrition, Hospital Universitario Dr. Negrín, 35010 Gran Canaria, Spain;
| | - Garlene Zamora
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35001 Las Palmas, Spain; (D.A.-M.); (G.Z.)
| | - Nuria Pérez-Martín
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (M.J.L.-M.-H.); (N.P.-M.); (R.M.S.-H.); (A.I.-G.)
| | - Rosa María Sánchez-Hernández
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (M.J.L.-M.-H.); (N.P.-M.); (R.M.S.-H.); (A.I.-G.)
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35001 Las Palmas, Spain; (D.A.-M.); (G.Z.)
| | - Adriana Ibarra-González
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (M.J.L.-M.-H.); (N.P.-M.); (R.M.S.-H.); (A.I.-G.)
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35001 Las Palmas, Spain; (D.A.-M.); (G.Z.)
| | - Mónica Bengoa-Dolón
- Department of Pneumology, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain;
| | - Carmen Teresa Mendoza-Vega
- Department of Rehabilitation and Physical Medicine, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (G.M.-C.); (A.U.-L.); (C.T.M.-V.); (S.M.A.-G.)
| | - Svein Mikael Appelvik-González
- Department of Rehabilitation and Physical Medicine, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (G.M.-C.); (A.U.-L.); (C.T.M.-V.); (S.M.A.-G.)
| | - Yurena Caballero-Díaz
- Department of General and Digestive Surgery, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (Y.C.-D.); (J.R.H.-H.)
| | - Juan Ramón Hernández-Hernández
- Department of General and Digestive Surgery, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (Y.C.-D.); (J.R.H.-H.)
| | - Ana María Wägner
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (M.J.L.-M.-H.); (N.P.-M.); (R.M.S.-H.); (A.I.-G.)
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35001 Las Palmas, Spain; (D.A.-M.); (G.Z.)
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Escriche-Escuder A, Cuesta-Vargas AI, Casaña J. Effect of a common exercise programme with an individualised progression criterion based on the measurement of neuromuscular capacity versus current best practice for lower limb tendinopathies (MaLaGa trial): a protocol for a randomised clinical trial. BMJ Open 2021; 11:e046729. [PMID: 34404699 PMCID: PMC8372811 DOI: 10.1136/bmjopen-2020-046729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION High-load resistance training has shown positive effects in pain and function in lower limb tendinopathies. However, some authors suggest that current exercise programmes produce an increase in tolerance to load and exercise in general but without fixing some existing issues in tendinopathy. This may indicate the need to include training aspects not currently taken into account in the current programmes. The main objective of this study will be to compare the effect of a common exercise protocol for the three predominant lower limb tendinopathies (Achilles, patellar and gluteal), based on an individualised control of the dose and training of specific aspects of the neuromuscular system versus the current best practice for each location. METHODS AND ANALYSIS This study will be conducted among people with mid-portion Achilles, patellar or gluteal tendinopathy. The participants allocated to the experimental group will perform a 14-week innovative common therapeutic exercise programme. Participants allocated to the control group will carry out a 14-week exercise programme based on the best current practice for each of the studied locations. The Victorian Institute of Sports Assessment questionnaire will be considered the primary outcome. Pain, central sensitisation, fear avoidance behaviour, quality of life, treatment satisfaction, lower-limb strength and function, and high-density electromyography profile will be evaluated as secondary outcomes. Outcomes will be assessed at baseline, 7 weeks, after the intervention (week 14), 26 weeks and 52 weeks. ETHICS AND DISSEMINATION The study has been approved by the Portal de Ética de la Investigación Biomédica de Andalucía Ethics Committee (1221-N-19). All participants will be informed about the purpose and content of the study and written informed consent will be completed. The results of this study will be published in a peer-reviewed journal and will be disseminated electronically and in print. TRIAL REGISTRATION NUMBER NCT03853122; Pre-results.
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Affiliation(s)
- Adrian Escriche-Escuder
- Department of Physiotherapy, University of Malaga, Malaga, Spain
- Grupo Clinimetría (F-14), Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
| | - Antonio I Cuesta-Vargas
- Department of Physiotherapy, University of Malaga, Malaga, Spain
- Grupo Clinimetría (F-14), Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
- Health, Queensland University Technology, Brisbane, Queensland, Australia
| | - Jose Casaña
- Department of Physiotherapy, University of Valencia, Valencia, Spain
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Nuño-Solínis R, Urtaran-Laresgoiti M, Lázaro E, Ponce S, Orueta JF, Errea Rodríguez M. Inequalities in Health Care Experience of Patients with Chronic Conditions: Results from a Population-Based Study. Healthcare (Basel) 2021; 9:1005. [PMID: 34442142 PMCID: PMC8394123 DOI: 10.3390/healthcare9081005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 11/17/2022] Open
Abstract
Patients' experience is an acknowledged key factor for the improvement of healthcare delivery quality. This study aims to explore the differences in healthcare experience among patients with chronic conditions according to individual sociodemographic and health-related variables. A population-based and cross-sectional study was conducted. The sample consisted of 3981 respondents of the Basque Health Survey (out of 8036 total respondents to the individual questionnaire), living in the Basque Country, aged 15 or older, self-reporting at least one chronic condition. Patient experience was assessed with the Instrument for Evaluation of the Experience of Chronic Patients questionnaire, which encompasses three major factors: interactions between patients and professionals oriented to improve outcomes (productive interactions); new ways of patient interaction with the health care system (the new relational model); and the ability of individuals to manage their care and improve their wellbeing based on professional-mediated interventions (self-management). We conducted descriptive and regression analyses. We estimated linear regression models with robust variances that allow testing for differences in experience according to sociodemographic characteristics, the number of comorbidities and the condition (for all chronic or for chronic patients' subgroups). Although no unique inequality patterns by these characteristics can be inferred, females reported worse global results than males and older age was related to poorer experience with the new relational model in health care. Individuals with lower education levels tend to report lower experiences. There is not a clear pattern observed for the type of occupation. Multimorbidity and several specific chronic conditions were associated (positive or negatively) with patients' experience. Health care experience was better in patients with greater quality of life. Understanding the relations among the patients' experience and their sociodemographic and health-related characteristics is an essential issue for health care systems to improve quality of assistance.
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Affiliation(s)
| | - Maider Urtaran-Laresgoiti
- Research Group in Social Determinants of Health and Demographic Change (OPIK), University of the Basque Country (EHU-UPV), 48940 Leioa, Spain;
| | - Esther Lázaro
- Faculty of Health Sciences, Valencian International University, 46002 Valencia, Spain;
| | - Sara Ponce
- International Research Projects Office, University of Deusto, 48007 Bilbao, Spain;
| | - Juan F. Orueta
- Primary Health Care Center of Astrabudua, OSI Uribe, Osakidetza Basque Health Service, 48950 Erandio, Spain;
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Shiroiwa T, Noto S, Fukuda T. Japanese Population Norms of EQ-5D-5L and Health Utilities Index Mark 3: Disutility Catalog by Disease and Symptom in Community Settings. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1193-1202. [PMID: 34372985 DOI: 10.1016/j.jval.2021.03.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/03/2021] [Accepted: 03/07/2021] [Indexed: 05/18/2023]
Abstract
OBJECTIVES This study aimed to establish the Japanese population norms of the EQ-5D-5L and Health Utilities Index Mark 3 (HUI3) and estimate the disutility associated with diseases and symptoms. METHODS We performed a door-to-door survey of the general population by random sampling. The planned sample size was 10 000 residents (age ≥16 years) of 334 districts in Japan. In addition to the EQ-5D-5L and HUI3 questionnaires, questions regarding demographic factors and self-reported main diseases and symptoms were asked. The EQ-5D-5L and HUI3 responses were converted to index values on the basis of Japanese value sets. Summary values by age and sex were calculated to obtain Japanese normative values. A multiple linear model was used to examine relationships between these values and diseases and symptoms. RESULTS We collected 10 183 responses from 334 districts. The mean EQ-5D-5L index values were 0.821 (male) and 0.774 (female) in the age group of 80 to 89 years, which were lower compared with 0.978 (male) and 0.967 (female) in the age group of 16 to 19 years. Similar trends were observed for the HUI3 values. Age, sex, household income, and education level had a significant influence on the values of both instruments. When measured with the EQ-5D-5L, Parkinson disease, dementia, and stroke were associated with the largest disutility (>0.2), and the disutility for depression was approximately 0.18. In contrast, the HUI3 disutility values for Parkinson disease and dementia were approximately 0.4. CONCLUSIONS This study established the Japanese population norms of the EQ-5D-5L and HUI3, which can be used in healthcare decision making and contribute to a more reliable analysis of economic evaluations.
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Affiliation(s)
- Takeru Shiroiwa
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Wako, Saitama, Japan.
| | - Shinichi Noto
- Department of Health Sciences, Niigata University of Health and Welfare, Kita-ku, Niigata, Japan
| | - Takashi Fukuda
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Wako, Saitama, Japan
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Brehon K, Carriere J, Churchill K, Loyola-Sanchez A, O'Connell P, Papathanassoglou E, MacIsaac R, Tavakoli M, Ho C, Pohar Manhas K. Evaluating Community-Facing Virtual Modalities to Support Complex Neurological Populations During the COVID-19 Pandemic: Protocol for a Mixed Methods Study. JMIR Res Protoc 2021; 10:e28267. [PMID: 34101610 PMCID: PMC8315160 DOI: 10.2196/28267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/26/2021] [Accepted: 06/04/2021] [Indexed: 01/19/2023] Open
Abstract
Background The COVID-19 pandemic and concomitant governmental responses have created the need for innovative and collaborative approaches to deliver services, especially for populations that have been inequitably affected. In Alberta, Canada, two novel approaches were created in Spring 2020 to remotely support patients with complex neurological conditions and rehabilitation needs. The first approach is a telehealth service that provides wayfinding and self-management advice to Albertans with physical concerns related to existing neurological or musculoskeletal conditions or post-COVID-19 recovery needs. The second approach is a webinar series aimed at supporting self-management and social connectedness of individuals living with spinal cord injury. Objective The study aims to evaluate the short- and long-term impacts and sustainability of two virtual modalities (telehealth initiative called Rehabilitation Advice Line [RAL] and webinar series called Alberta Spinal Cord Injury Community Interactive Learning Seminars [AB-SCILS]) aimed at advancing self-management, connectedness, and rehabilitation needs during the COVID-19 pandemic and beyond. Methods We will use a mixed-methods evaluation approach. Evaluation of the approaches will include one-on-one semistructured interviews and surveys. The evaluation of the telehealth initiative will include secondary data analyses and analysis of call data using artificial intelligence. The evaluation of the webinar series will include analysis of poll questions collected during the webinars and YouTube analytics data. Results The proposed study describes unique pandemic virtual modalities and our approaches to evaluating them to ensure effectiveness and sustainability. Implementing and evaluating these virtual modalities synchronously allows for the building of knowledge on the complementarity of these methods. At the time of submission, we have completed qualitative and quantitative data collection for the telehealth evaluation. For the webinar series, so far, we have distributed the evaluation survey following three webinars and have conducted five attendee interviews. Conclusions Understanding the impact and sustainability of the proposed telehealth modalities is important. The results of the evaluation will provide data that can be actioned and serve to improve other telehealth modalities in the future, since health systems need this information to make decisions on resource allocation, especially in an uncertain pandemic climate. Evaluating the RAL and AB-SCILS to ensure their effectiveness demonstrates that Alberta Health Services and the health system care about ensuring the best practice even after a shift to primarily virtual care. International Registered Report Identifier (IRRID) DERR1-10.2196/28267
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Affiliation(s)
- Katelyn Brehon
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Jay Carriere
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB, Canada
| | - Katie Churchill
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Adalberto Loyola-Sanchez
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - Petra O'Connell
- Obesity Diabetes Nutrition Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada.,Neurosciences, Rehabilitation & Vision Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada
| | - Elisavet Papathanassoglou
- Neurosciences, Rehabilitation & Vision Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada
| | - Rob MacIsaac
- Spinal Cord Injury Alberta, Edmonton, AB, Canada
| | - Mahdi Tavakoli
- Department of Electrical and Computer Engineering, University of Alberta, Edmonton, AB, Canada
| | - Chester Ho
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, AB, Canada.,Neurosciences, Rehabilitation & Vision Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada
| | - Kiran Pohar Manhas
- Neurosciences, Rehabilitation & Vision Strategic Clinical Network, Alberta Health Services, Calgary, AB, Canada
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Health-Related Quality of Life Among Patients With HR+/HER2- Early Breast Cancer. Clin Ther 2021; 43:1228-1244.e4. [PMID: 34256965 DOI: 10.1016/j.clinthera.2021.04.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 03/30/2021] [Accepted: 04/22/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE The goal of this study was to characterize health-related quality of life (HRQOL) among patients diagnosed with early-stage, hormone receptor-positive (HR+)/human epidermal growth factor receptor 2 negative (HER2-) breast cancer. METHODS A multinational (United States, Japan, France, Germany, Italy, Spain, and United Kingdom) study of patients diagnosed with stage I to III HR+/HER2- breast cancer, either receiving adjuvant treatment or under postadjuvant surveillance, was conducted between June and October 2019. Patients were identified by their consulting physician and invited to complete the Functional Assessment of Cancer Therapy-Breast (FACT-B) and the EQ-5D-5L pen and paper questionnaires. EQ-5D-5L index scores were derived by using available country-specific health state value sets, where available, and numerically compared with general population scores derived from published normative and population data. Descriptive summary statistics were reported for FACT-B, Functional Assessment of Cancer Therapy-General (FACT-G) (total and specific subscales), the EQ-5D index scores, and the EQ-VAS scores for each country. Results were stratified according to disease-free treatment status (active adjuvant treatment or postadjuvant surveillance), age (25-44, 45-54, 55-64, or ≥65 years), stage (I, II, or III), and menopausal status at the time of questionnaire completion (pre-/peri-menopausal or postmenopausal). FINDINGS Overall, 1110 patients completed the HRQOL questionnaires (mean age, 59 years; 79% active adjuvant treatment, and 21% under surveillance postadjuvant treatment at time of questionnaire administration; 31% stage I, 48% stage II, and 20% stage III at diagnosis). Of these, 1102 completed the FACT-B and 1083 completed the EQ-5D-5L questionnaires. The mean (SD) FACT-B total score was 99.0 (21.9). The mean FACT-G total score was 72.5 (17.8), which was comparable to the published normative score. The mean EQ-5D index and EQ-VAS scores for each country were similar to corresponding population means; EQ-5D index scores ranged from 0.842 (0.098) in Japan to 0.916 (0.109) in France, and EQ-VAS scores from 68.0 (18.4) in Germany to 78.6 (16.4) in the United States. In addition, mean scores were comparable between the active adjuvant treatment and postadjuvant surveillance groups for the FACT-B total (99.4 [22.5] and 97.7 [19.7], respectively), FACT-G total (72.8 [18.3] and 71.3 [16.0]), EQ-5D index score (0.868 [0.135] and 0.869 [0.142]), and EQ-VAS (74.9 [17.2] and 74.4 [16.1]). IMPLICATIONS Patient-reported HRQOL among patients with HR+/HER2- early breast cancer who were disease-free was high, with reported scores comparable to normative scores. These results improve our understanding of HRQOL among patients with early disease and may facilitate future studies examining the potential impact of adjuvant treatment and disease recurrence, including metastasis.
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Feng YS, Jiang R, Pickard AS, Kohlmann T. Combining EQ-5D-5L items into a level summary score: demonstrating feasibility using non-parametric item response theory using an international dataset. Qual Life Res 2021; 31:11-23. [PMID: 34236579 PMCID: PMC8800896 DOI: 10.1007/s11136-021-02922-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2021] [Indexed: 01/31/2023]
Abstract
Background The EQ-5D-5L is a well-established health questionnaire that estimates health utilities by applying preference-based weights. Limited work has been done to examine alternative scoring approaches when utility weights are unavailable or inapplicable. We examined whether the Mokken scaling approach can elucidate 1) if the level summary score is appropriate for the EQ-5D-5L and 2) an interpretation of such a score. Methods The R package “mokken” was used to assess monotonicity (scaling coefficients H, automated item selection procedure) and manifest invariant item ordering (MIIO: paired item response functions [IRF], HT). We used a rich dataset (the Multiple Instrument Comparison, MIC) which includes EQ-5D-5L data from six Western countries. Results While all EQ-5D-5L items demonstrated monotonicity, the anxiety/depression (AD) item had weak scalability (Hi = 0.377). Without AD, scalability improved from Hs = 0.559 to Hs = 0.714. MIIO revealed that the 5 items can be ordered, and the ordering is moderately accurate in the MIC data (HT = 0.463). Excluding AD, HT improves to 0.743. Results were largely consistent across disease and country subgroups. Discussion The 5 items of the EQ-5D-5L form a moderate to strong Mokken scale, enabling persons to be ordered using the level summary score. Item ordering suggests that the lower range of the score represents mainly problems with pain and anxiety/depression, the mid-range indicates additional problems with mobility and usual activities, and middle to higher range of scores reveals additional limitations with self-care. Scalability and item ordering are even stronger when the anxiety/depression item is not included in the scale. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02922-1.
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Affiliation(s)
- You-Shan Feng
- Institute for Clinical Epidemiology and Applied Biometrics, Medical University of Tübingen, Silcherstraße 5 72076, Tübingen, Germany. .,Institute for Community Medicine, University of Greifswald, Greifswald, Germany.
| | - Ruixuan Jiang
- Center for Observational and Real-World Evidence, Merck & Co, Kenilworth, NJ, USA
| | - A Simon Pickard
- College of Pharmacy, University of Illinois At Chicago, Chicago, IL, USA
| | - Thomas Kohlmann
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
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García-Esquinas E, Ortolá R, Gine-Vázquez I, Carnicero JA, Mañas A, Lara E, Alvarez-Bustos A, Vicente-Rodriguez G, Sotos-Prieto M, Olaya B, Garcia-Garcia FJ, Gusi N, Banegas JR, Rodríguez-Gómez I, Struijk EA, Martínez-Gómez D, Lana A, Haro JM, Ayuso-Mateos JL, Rodríguez-Mañas L, Ara I, Miret M, Rodríguez-Artalejo F. Changes in Health Behaviors, Mental and Physical Health among Older Adults under Severe Lockdown Restrictions during the COVID-19 Pandemic in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137067. [PMID: 34281004 PMCID: PMC8297096 DOI: 10.3390/ijerph18137067] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 12/14/2022]
Abstract
We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.
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Affiliation(s)
- Esther García-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (R.O.); (M.S.-P.); (J.R.B.); (E.A.S.); (D.M.-G.); (F.R.-A.)
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
- Correspondence:
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (R.O.); (M.S.-P.); (J.R.B.); (E.A.S.); (D.M.-G.); (F.R.-A.)
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
| | - Iago Gine-Vázquez
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (I.G.-V.); (B.O.); (J.M.H.)
- CIBERSAM (CIBER of Mental Health), 28029 Madrid, Spain; (E.L.); (J.L.A.-M.); (M.M.)
| | - José A. Carnicero
- Foundation for Biomedical Research, Getafe University Hospital, 28905 Getafe, Spain; (J.A.C.); (A.A.-B.); (L.R.-M.)
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
| | - Asier Mañas
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45004 Toledo, Spain
| | - Elvira Lara
- CIBERSAM (CIBER of Mental Health), 28029 Madrid, Spain; (E.L.); (J.L.A.-M.); (M.M.)
- Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Hospital Universitario de La Princesa, 28006 Madrid, Spain
| | - Alejandro Alvarez-Bustos
- Foundation for Biomedical Research, Getafe University Hospital, 28905 Getafe, Spain; (J.A.C.); (A.A.-B.); (L.R.-M.)
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
| | - German Vicente-Rodriguez
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón IA2, Universidad de Zaragoza, 50013 Zaragoza, Spain;
- CIBEROBN (CIBER of Obesity and Nutrition), 28029 Madrid, Spain
- Faculty of Health and Sport Science, University of Zaragoza, 22001 Huesca, Spain
- Department of Physiatry and Nursing, University of Zaragoza, 22002 Aragón, Spain
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (R.O.); (M.S.-P.); (J.R.B.); (E.A.S.); (D.M.-G.); (F.R.-A.)
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- IMDEA-Food Institute, CEI UAM+CSIC, 28049 Madrid, Spain
| | - Beatriz Olaya
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (I.G.-V.); (B.O.); (J.M.H.)
- CIBERSAM (CIBER of Mental Health), 28029 Madrid, Spain; (E.L.); (J.L.A.-M.); (M.M.)
| | - Francisco José Garcia-Garcia
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
- Hospital Virgen del Valle, Complejo Hospitalario de Toledo, 45071 Toledo, Spain
| | - Narcis Gusi
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
- AFYCAV (Physical Activity, Quality of Life and Health) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Jose R. Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (R.O.); (M.S.-P.); (J.R.B.); (E.A.S.); (D.M.-G.); (F.R.-A.)
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
| | - Irene Rodríguez-Gómez
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45004 Toledo, Spain
| | - Ellen A. Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (R.O.); (M.S.-P.); (J.R.B.); (E.A.S.); (D.M.-G.); (F.R.-A.)
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
| | - David Martínez-Gómez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (R.O.); (M.S.-P.); (J.R.B.); (E.A.S.); (D.M.-G.); (F.R.-A.)
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
| | - Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences, Universidad de Oviedo/ISPA, 33003 Oviedo, Spain;
| | - Josep María Haro
- Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain; (I.G.-V.); (B.O.); (J.M.H.)
- CIBERSAM (CIBER of Mental Health), 28029 Madrid, Spain; (E.L.); (J.L.A.-M.); (M.M.)
| | - José Luis Ayuso-Mateos
- CIBERSAM (CIBER of Mental Health), 28029 Madrid, Spain; (E.L.); (J.L.A.-M.); (M.M.)
- Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Hospital Universitario de La Princesa, 28006 Madrid, Spain
| | - Leocadio Rodríguez-Mañas
- Foundation for Biomedical Research, Getafe University Hospital, 28905 Getafe, Spain; (J.A.C.); (A.A.-B.); (L.R.-M.)
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
| | - Ignacio Ara
- CIBERFES (CIBER of Frailty and Healthy Aging), Instituto de Salud Carlos III, 28029 Madrid, Spain; (A.M.); (F.J.G.-G.); (N.G.); (I.R.-G.); (I.A.)
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45004 Toledo, Spain
| | - Marta Miret
- CIBERSAM (CIBER of Mental Health), 28029 Madrid, Spain; (E.L.); (J.L.A.-M.); (M.M.)
- Department of Psychiatry, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
- Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Hospital Universitario de La Princesa, 28006 Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain; (R.O.); (M.S.-P.); (J.R.B.); (E.A.S.); (D.M.-G.); (F.R.-A.)
- IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), 28029 Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), 28029 Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, 28049 Madrid, Spain
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The Effectiveness of Additional Core Stability Exercises in Improving Dynamic Sitting Balance, Gait and Functional Rehabilitation for Subacute Stroke Patients (CORE-Trial): Study Protocol for a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126615. [PMID: 34205457 PMCID: PMC8296367 DOI: 10.3390/ijerph18126615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/24/2022]
Abstract
Background: Trunk impairment produces disorders of motor control, balance and gait. Core stability exercises (CSE) are a good strategy to improve local strength of trunk, balance and gait. Methods and analysis: This is a single-blind multicenter randomized controlled trial. Two parallel groups are compared, and both perform the same type of therapy. A control group (CG) (n = 110) performs conventional physiotherapy (CP) (1 h per session) focused on improving balance. An experimental group (EG) (n = 110) performs CSE (30 min) in addition to CP (30 min) (1 h/session in total). EG is divided in two subgroups, in which only half of patients (n = 55) perform CSE plus transcutaneous electrical nerve stimulation (TENS). Primary outcome measures are dynamic sitting, assessed by a Spanish version of Trunk Impairment Scale and stepping, assessed by Brunel Balance Assessment. Secondary outcomes are postural control, assessed by Postural Assessment Scale for Stroke patients; standing balance and risk of fall assessed by Berg Balance Scale; gait speed by BTS G-Walk (accelerometer); rate of falls, lower-limb spasticity by Modified Ashworth Scale; activities of daily living by Barthel Index; and quality of life by EQ-5D-5L. These are evaluated at baseline (T0), at three weeks (T1), at five weeks (end of the intervention) (T2), at 17 weeks (T3) and at 29 weeks (T4). Study duration per patient is 29 weeks (a five-week intervention, followed by a 24-week post-intervention).
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Lamu AN, Björkman L, Hamre HJ, Alræk T, Musial F, Robberstad B. Validity and responsiveness of EQ-5D-5L and SF-6D in patients with health complaints attributed to their amalgam fillings: a prospective cohort study of patients undergoing amalgam removal. Health Qual Life Outcomes 2021; 19:125. [PMID: 33865400 PMCID: PMC8052827 DOI: 10.1186/s12955-021-01762-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/03/2021] [Indexed: 02/03/2023] Open
Abstract
Background Evidence of health utility changes in patients who suffer from longstanding health complaints attributed to dental amalgam fillings are limited. The change in health utility outcomes enables calculating quality-adjusted life-year (QALY) and facilitates the comparison with other health conditions. The purpose of this study was to estimate the validity and responsiveness of the EQ-5D-5L and SF-6D utilities following removal of dental amalgam fillings in patients with health complaints attributed to their amalgam fillings, and examine the ability of these instruments to detect minimally important changes over time. Methods Patients with medically unexplained physical symptoms, which they attributed to dental amalgam restorations, were recruited to a prospective cohort study in Norway. Two health state utility instruments, EQ-5D-5L and SF-6D, as well as self-reported general health complaints (GHC-index) and visual analogue scale (EQ-VAS) were administered to all patients (n = 32) at baseline and at follow-up. The last two were used as criteria measures. Concurrent and predictive validities were examined using correlation coefficients. Responsiveness was assessed by the effect size (ES), standardized response mean (SRM), and relative efficiency. Minimally important change (MIC) was examined by distribution and anchor-based approaches. Results Concurrent validity of the EQ-5D-5L was similar to that of SF-6D utility. EQ-5D-5L was more responsive than SF-6D: the ES were 0.73 and 0.58 for EQ-5D-5L and SF-6D, respectively; SRM were 0.76 and 0.67, respectively. EQ-5D-5L was more efficient than SF-6D in detecting changes, but both were less efficient compared to criteria-based measures. The estimated MIC of EQ-5D-5L value set was 0.108 and 0.118 based on distribution and anchor-based approaches, respectively. The corresponding values for SF-6D were 0.048 and 0.064, respectively. Conclusions In patients with health complaints attributed to dental amalgam undergoing amalgam removal, both EQ-5D-5L and SF-6D showed reasonable concurrent and predictive validity and acceptable responsiveness. The EQ-5D-5L utility appears to be more responsive compared to SF-6D. Trial registration The research was registered at ClinicalTrials.gov., NCT01682278. Registered 10 September 2012, https://clinicaltrials.gov/ct2/show/NCT01682278.
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Affiliation(s)
- Admassu N Lamu
- Section for Ethics and Health Economics, Department of Global Public Health and Primary Care, Faculty of Health Sciences, University of Bergen, 5020, Bergen, Norway.
| | - Lars Björkman
- Dental Biomaterials Adverse Reaction Unit, NORCE Norwegian Research Centre AS, Bergen, Norway.,Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Harald J Hamre
- Institute for Applied Epistemology and Medical Methodology, University of Witten/Herdecke, Freiburg, Germany
| | - Terje Alræk
- National Research Center in Complementary and Alternative Medicine, NAFKAM, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Frauke Musial
- National Research Center in Complementary and Alternative Medicine, NAFKAM, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjarne Robberstad
- Section for Ethics and Health Economics, Department of Global Public Health and Primary Care, Faculty of Health Sciences, University of Bergen, 5020, Bergen, Norway
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64
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Martínez Meñaca A, Blanco Vich I, López Meseguer M, López Reyes R, Bedate Díaz P, Elías Hernández T, Fernández-Cuesta Peñafiel I, Fernández G, Álvez Liste A, Escribano Subías P. From Health-Related Quality of Life (HRQoL) of Patients with Pulmonary Hypertension to Patient Experience with the Care Received: Should We Be More Aware of Current Patient Needs? Adv Ther 2021; 38:1860-1875. [PMID: 33675523 DOI: 10.1007/s12325-021-01625-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/13/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Self-perceived health-related quality of life (HRQoL) of patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) and their experience with the care received are important for improving their management. We conducted a study to assess both patient-reported outcomes (PROs) and how they interrelate. METHODS This was a cross-sectional, observational study of consecutive patients with PAH and CTEPH attending pulmonary hypertension (PH)-specialized units at 25 hospitals in Spain. PRO measurements used included CAMPHOR/EQ-5D-5L questionnaires (HRQoL) and IEXPAC (healthcare experience). Patient characteristics were collected. Relationships were analysed with Pearson's correlation coefficient and linear regression analyses. RESULTS A total of 185 patients with PAH and 93 patients with CTEPH aged 54.4 ± 14.4 and 64.8 ± 13.4 years were included: 63.6% and 72% were functional class (FC) I-II; median time from diagnosis was 3 and 2 years, respectively. Most patients with PAH received combination oral therapy. CAMPHOR scores indicated moderate-to-high impairment in the "activity" scale (PAH 21.6 ± 6.8; CTEPH 21.0 ± 6.3). EQ-5D-5L index and visual analogue scale (VAS) score (PAH 0.59 ± 0.15 and 65.55 ± 21.54; CTEPH 0.59 ± 0.13 and 66.95 ± 18.71, respectively) indicated moderate HRQoL impairment. HRQoL was mostly affected by FC. IEXPAC scores (PAH 7.08 ± 1.56 and CTEPH 7.13 ± 1.61) indicated good healthcare experience. In patients with PAH, the CAMPHOR "symptom" and "QoL" domains inversely correlated with the IEXPAC "patient self-management" factor. CONCLUSION In patients with long-standing PAH and CTEPH with good disease control, functional limitations greatly impact HRQoL while symptoms and generic QoL were less affected. Healthcare received was perceived as good; however, use of information and communication technologies, patient associations and promotion of self-management should improve for enhanced patient experience.
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Affiliation(s)
- Amaya Martínez Meñaca
- Pneumology Division, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
| | - Isabel Blanco Vich
- Pneumology Division, Hospital Universitario Clinic de Barcelona, Barcelona, Spain
| | | | - Raquel López Reyes
- Pneumology Division, Hospital Universitario Politécnico la Fe, Valencia, Spain
| | - Pedro Bedate Díaz
- Pneumology Division, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | | | - Ana Álvez Liste
- Global Medical and Scientific Affairs, MSD Spain, Madrid, Spain
| | - Pilar Escribano Subías
- Cardiology Division, Hospital Universitario 12 de Octubre, Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
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Raya-Tena A, Fernández-San-Martin MI, Martin-Royo J, Casañas R, Sauch-Valmaña G, Cols-Sagarra C, Navas-Mendez E, Masa-Font R, Casajuana-Closas M, Foguet-Boreu Q, Fernández-Linares EM, Mendioroz-Peña J, González-Tejón S, Martín-López LM, Jiménez-Herrera MF. Effectiveness of a Psychoeducational Group Intervention Carried Out by Nurses for Patients with Depression and Physical Comorbidity in Primary Care: Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062948. [PMID: 33805664 PMCID: PMC7998350 DOI: 10.3390/ijerph18062948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/05/2021] [Accepted: 03/07/2021] [Indexed: 11/18/2022]
Abstract
The association between physical illness and depression implies a poorer management of chronic disease and a lower response to antidepressant treatments. Our study evaluates the effectiveness of a psychoeducational group intervention led by Primary Care (PC) nurses, aimed at patients of this kind. It is a randomized, multicenter clinical trial with intervention (IG) and control groups (CG), blind response variables, and a one year follow-up. The study included 380 patients ≥50 years of age from 18 PC teams. The participants presented depression (BDI-II > 12) and a physical comorbidity: diabetes mellitus type 2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma. The IG (n = 204) received the psychoeducational intervention (12 weekly sessions of 90 min), and the CG (n = 176) had standard care. The patients were evaluated at baseline, and at 4 and 12 months. The main outcome measures were clinical remission of depressive symptoms (BDI-II ≤ 13) and therapeutic response (reduction of depressive symptoms by 50%). Remission was not significant at four months. At 12 months it was 53.9% in the IG and 41.5% in the CG. (OR = 0.61, 95% CI, 0.49–0.76). At 4 months the response in the IG (OR = 0.59, 95% CI, 0.44–0.78) was significant, but not at 12 months. The psychoeducational group intervention led by PC nurses for individuals with depression and physical comorbidity has been shown to be effective for remission at long-term and for therapeutic response at short-term.
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Affiliation(s)
- Antonia Raya-Tena
- Centre d’Atenció Primària Raval Nord, Institut Català de la Salut, 08001 Barcelona, Spain
- Nursing Department, Faculty of Nursing, Rovira and Virgili University, 43002 Tarragona, Spain;
- Correspondence: ; Tel.: +34-687-503-647
| | - María Isabel Fernández-San-Martin
- Unitat de Suport a la Recerca Barcelona ciutat, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPGol), 08001 Barcelona, Spain; (M.I.F.-S.-M.); (J.M.-R.); (E.N.-M.)
- Unitat Docent Multiprofesional Gerència Territorial Barcelona, Institut Català de la Salut, 08001 Barcelona, Spain
| | - Jaume Martin-Royo
- Unitat de Suport a la Recerca Barcelona ciutat, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPGol), 08001 Barcelona, Spain; (M.I.F.-S.-M.); (J.M.-R.); (E.N.-M.)
- Unitat Básica de Prevenció, Gerència Territorial de Barcelona, Institut Català de la Salut, 08001 Barcelona, Spain
| | - Rocío Casañas
- Research Departament, Associació Higiene Mental Les Corts, 08001 Barcelona, Spain;
| | - Glòria Sauch-Valmaña
- Unitat de Suport a la Recerca Catalunya Central, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPGol), 08001 Barcelona, Spain; (G.S.-V.); (J.M.-P.)
| | - Cèlia Cols-Sagarra
- Centre d’Atenció Primària Martorell Rural, Institut Català de la Salut, 08001 Barcelona, Spain;
| | - Elena Navas-Mendez
- Unitat de Suport a la Recerca Barcelona ciutat, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPGol), 08001 Barcelona, Spain; (M.I.F.-S.-M.); (J.M.-R.); (E.N.-M.)
| | - Roser Masa-Font
- Centre d’Atenció Primària Besos, Institut Català de la Salut, 08001 Barcelona, Spain;
| | - Marc Casajuana-Closas
- Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPGol), 08001 Barcelona, Spain;
| | - Quintí Foguet-Boreu
- Department of Psychiatry, Vic University Hospital. Francesc Pla el Vigatà, 1, 08500 Vic, 08001 Barcelona, Spain;
- Faculty of Medicine, University of Vic-Central University of Catalonia (UVic-UCC), 08500 Barcelona, Spain
| | | | - Jacobo Mendioroz-Peña
- Unitat de Suport a la Recerca Catalunya Central, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPGol), 08001 Barcelona, Spain; (G.S.-V.); (J.M.-P.)
- Health Promotion in Rural Areas Research Group (PRoSaARu), Gerència Territorial de la Catalunya Central, Catalan Health Institute, Sant Fruitós del Bages, 08001 Barcelona, Spain
| | - Susana González-Tejón
- Centre d’Atenció Primària Raval Sud, Institut Català de la Salut, 08001 Barcelona, Spain;
| | - Luis Miguel Martín-López
- Instituto de Neuropsiquiatria y Adicciones del Parc de Salut del Mar (INAD), Consorci Parc de Salut Mar, 08001 Barcelona, Spain;
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, 08290 Cerdanyola del Valles, Spain
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Buendía-Martínez J, Barreda-Sánchez M, Rodríguez-Peña L, Ballesta-Martínez MJ, López-González V, Sánchez-Soler MJ, Serrano-Antón AT, Pérez-Tomás ME, Gil-Ferrer R, Avilés-Plaza F, Glover-López G, Carazo-Díaz C, Guillén-Navarro E. Health impact of acute intermittent porphyria in latent and non-recurrent attacks patients. Orphanet J Rare Dis 2021; 16:106. [PMID: 33639982 PMCID: PMC7913433 DOI: 10.1186/s13023-021-01742-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/11/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Acute intermittent porphyria (AIP) is a genetic disease characterized by acute neurovisceral attacks. Long-term clinical conditions, chronic symptoms and impaired health related quality of life (HRQoL) have been reported during non-attack periods but mainly in patients with recurrent attacks. Our aim was to investigate these aspects in sporadic AIP (SA-AIP) and latent AIP (L-AIP) patients. Fifty-five participants, 27 SA-AIP (< 4 attacks/year) and 28 L-AIP patients with a prevalent founder mutation from Spain were included. Medical records were reviewed, and individual interviews, physical examinations, biochemical analyses, and abdominal ultrasound scans were conducted. HRQoL was assessed through an EQ-5D-5L questionnaire. A comparative study was made between SA-AIP and L-AIP patients. RESULTS The earliest long-term clinical condition associated with SA-AIP was chronic kidney disease. Chronic symptoms were reported in 85.2 % of SA-AIP and 46.4 % of L-AIP patients. Unspecific abdominal pain, fatigue, muscle pain and insomnia were significantly more frequent in SA-AIP than in L-AIP patients. The EQ-5D-5L index was lower in SA-AIP (0.809 vs. 0.926, p = 0.0497), and the impact of "pain", "anxiety-depression" and "mobility" was more intense in the EQ-5D-5L domains in SA-AIP than in L-AIP subjects and the general Spanish population. CONCLUSIONS AIP remains a chronically symptomatic disease that adversely affects health and quality of life, even in patients with low rate of acute attacks. We suggest a regular monitoring of patients with symptomatic AIP regardless of their attack rate or the time since their last attack, with proper pain management and careful attention to kidney function.
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Affiliation(s)
- Juan Buendía-Martínez
- Servicio de Neurología, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008, Murcia, Spain. .,Facultad de Ciencias de la Salud, Universidad Católica de Murcia (UCAM), Murcia, Spain.
| | - María Barreda-Sánchez
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain.,Facultad de Ciencias de la Salud, Universidad Católica de Murcia (UCAM), Murcia, Spain
| | - Lidya Rodríguez-Peña
- Sección Genética Médica, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), Ctra. Madrid-Cartagena s/n., CP 30120, El Palmar (Murcia), Spain
| | - María Juliana Ballesta-Martínez
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain.,Facultad de Ciencias de la Salud, Universidad Católica de Murcia (UCAM), Murcia, Spain.,Sección Genética Médica, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), Ctra. Madrid-Cartagena s/n., CP 30120, El Palmar (Murcia), Spain.,CIBERER-ISCIII, Madrid, Spain
| | - Vanesa López-González
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain.,Sección Genética Médica, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), Ctra. Madrid-Cartagena s/n., CP 30120, El Palmar (Murcia), Spain.,CIBERER-ISCIII, Madrid, Spain.,Departamento de Cirugía, Pediatría y Obstetricia y Ginecología, Facultad de Medicina, Universidad de Murcia (UMU), Murcia, Spain
| | - María José Sánchez-Soler
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain.,Facultad de Ciencias de la Salud, Universidad Católica de Murcia (UCAM), Murcia, Spain.,Sección Genética Médica, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), Ctra. Madrid-Cartagena s/n., CP 30120, El Palmar (Murcia), Spain.,CIBERER-ISCIII, Madrid, Spain
| | - Ana Teresa Serrano-Antón
- Sección Genética Médica, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), Ctra. Madrid-Cartagena s/n., CP 30120, El Palmar (Murcia), Spain.,Departamento de Cirugía, Pediatría y Obstetricia y Ginecología, Facultad de Medicina, Universidad de Murcia (UMU), Murcia, Spain
| | - María Elena Pérez-Tomás
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Remedios Gil-Ferrer
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain.,Sección Genética Médica, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), Ctra. Madrid-Cartagena s/n., CP 30120, El Palmar (Murcia), Spain
| | | | - Guillermo Glover-López
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain.,CIBERER-ISCIII, Madrid, Spain.,Centro de Bioquímica y Genética Clínica, HCUVA, Murcia, Spain
| | - Carmen Carazo-Díaz
- Applied Statistical Methods in Medical Research Group, UCAM, Murcia, Spain
| | - Encarna Guillén-Navarro
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain. .,Sección Genética Médica, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA), Ctra. Madrid-Cartagena s/n., CP 30120, El Palmar (Murcia), Spain. .,CIBERER-ISCIII, Madrid, Spain. .,Departamento de Cirugía, Pediatría y Obstetricia y Ginecología, Facultad de Medicina, Universidad de Murcia (UMU), Murcia, Spain.
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Hurtado-Ruzza R, Iglesias ÓÁC, Becerro-de-Bengoa-Vallejo R, Calvo-Lobo C, San-Antolín M, Losa-Iglesias ME, Romero-Morales C, López-López D. Self-Perceived Handicap Associated With Dysphonia and Health-Related Quality of Life of Asthma and Chronic Obstructive Pulmonary Disease Patients: A Case-Control Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:433-443. [PMID: 33465320 DOI: 10.1044/2020_jslhr-20-00473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The association between voice alterations, health-related quality of life (HRQL), and chronic respiratory diseases, such as asthma and chronic obstructive pulmonary disease (COPD), has previously been reported. The aim of this study was to test the hypothesis that HRQL and dysphonia-associated handicap of patients diagnosed with asthma or COPD are worse than healthy controls. Method A case-control study in which participants were recruited by a consecutive sampling method from a single institution was conducted. Three groups were created: (a) asthma (51 patients), (b) COPD (52 patients), and (c) 50 healthy controls. Self-reported handicap associated with dysphonia was assessed using the 30-item Voice Handicap Index (VHI-30); meanwhile, HRQL was tested via the European Quality of Life (EQ) Questionnaire and the EQ-visual analog scale. Also, aerodynamic assessment applied to phonation was assessed, and maximum phonation time and s/e index were registered. Results VHI scores were higher for asthma and COPD (7.19 ± 8.31 and 11.80 ± 15.18, respectively) than in the control group (3.72 ± 6.78). The EQ index was lower in asthma and COPD patients than in controls. The EQ-visual analog scale showed lower scores in asthma and COPD than in the controls. Conclusions HRQL was worse in COPD patients than in asthma patients. Even though the patient groups showed worse VHI and HRQL scores than the healthy controls, the scores fell within the normal variation range. No significant variations in the maximum phonation time index between groups were noted.
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Affiliation(s)
- Rafael Hurtado-Ruzza
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain
- ENT Department, Complexo Hospitalario Universitario de Ourense, Spain
| | - Óscar Álvarez-Calderón Iglesias
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain
- ENT Department, Complexo Hospitalario Universitario de Ourense, Spain
| | | | - César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Spain
| | - Marta San-Antolín
- Department of Psychology, Universidad Europea de Madrid, Villaviciosa de Odón, Spain
| | | | - Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Spain
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain
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Terradas-Monllor M, Navarro-Fernández G, Ruiz MA, Beltran-Alacreu H, Fernández-Carnero J, Salinas-Chesa J, Ochandorena-Acha M. Postoperative Psychosocial Factors in Health Functioning and Health-Related Quality of Life After Knee Arthroplasty: A 6-Month Follow up Prospective Observational Study. PAIN MEDICINE 2021; 22:1905-1915. [PMID: 33538821 DOI: 10.1093/pm/pnab025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Knee arthroplasty (KA) is an effective and cost-effective treatment for end-stage knee osteoarthritis. Despite high surgical success rates, as many as 25% of patients report compromised postoperative functioning, persistent pain, and reduced quality of life. The purpose of this study was to assess the predictive value of psychological factors in health functioning and quality of life, during a 6-month period after KA. DESIGN A prospective observational study. SETTING Surgery at two hospitals and follow-up was carried out through the domiciliary rehabilitation service. SUBJECTS In total, 89 patients (age 70.27 ± 7.99 years) met the inclusion criteria. METHOD A test battery composed of Health functioning associated with osteoarthritis (WOMAC), Health-related quality of life (EQ-5D-5L), Anxiety and Depression (HADS), Pain attitudes (SOPA-B), Pain catastrophizing (PCS), and Fear of Movement (TSK-11) was assessed at 1 week, and 1, 3, and 6 months after surgery. A mixed effects linear model was used to estimate the effect of time and covariates. An exploratory factor analysis was used to identify the number of dimensions underlying the group of psychological measurements. RESULTS In WOMAC model, anxiety level (F = 120.8), PCS (F = 103.9), depression level (F = 93.6) and pain score (F = 72.8) were the most influential variables. Regarding EQ-5D-5L model, anxiety level (F = 98.5), PCS (F = 79.8), depression level (F = 78.3) and pain score (F = 45) were the most influential variables. Pain score and the psychosocial variables of PCS, TSK, HADS-A, HADS-D, SOPA-B Emotion, SOPA-B Harm and SOPA-B Disability loaded in one single dimension. CONCLUSIONS Postoperative acute pain and psychosocial factors of pain catastrophizing, anxiety, depression, and pain attitudes might influence health functioning and quality of life during KA rehabilitation. Such factors could be gathered into one single dimension defined as pain-related psychologic distress.
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Affiliation(s)
- Marc Terradas-Monllor
- Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia, Vic, Spain.,Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain.,Institut de Rehabilitació i Terapèutica Biofísica (IRITEB), Badalona, Spain.,Programa de Doctorat en Medicina i Recerca Translacional, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Gonzalo Navarro-Fernández
- Physiotherapy Department, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid Madrid, Spain
| | - Miguel A Ruiz
- Faculty of Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Hector Beltran-Alacreu
- Toledo Physiotherapy Research Group (GIFTO), Faculty of Physical Therapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Josué Fernández-Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain.,Unit of Physiotherapy, Hospital La Paz Institute for Health Research, IdiPAZ, Madrid, Spain.,Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, Madrid, Spain
| | | | - Mirari Ochandorena-Acha
- Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia, Vic, Spain.,Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
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Bilbao A, Martín-Fernández J, García-Pérez L, Mendezona JI, Arrasate M, Candela R, Acosta FJ, Estebanez S, Retolaza A. Psychometric properties of the EQ-5D-5L in patients with major depression: factor analysis and Rasch analysis. J Ment Health 2021; 31:506-516. [PMID: 33522336 DOI: 10.1080/09638237.2021.1875422] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The EQ-5D is one of the most recommended questionnaires for cost-effectiveness studies. AIMS To study the psychometric properties of the EQ-5D-5L in patients with major depression. METHODS This prospective observational study included 433 patients with major depression who completed the EQ-5D-5L and Patient Health Questionnaire-9 (PHQ-9) questionnaires at baseline, of whom 310 also did six months later. The structural validity was assessed by confirmatory factor analysis, the item functioning by item response analysis, and reliability by Cronbach's alpha. Convergent validity and known-groups validity was studied using the PHQ-9 and a general health question. To assess responsiveness effect sizes were calculated. RESULTS The results supported the unidimensionality and showed adequate item functioning, with somewhat age-related item differential functioning for the mobility dimension. Cronbach's alpha was 0.77. The EQ-5D-5L showed a high correlation with the PHQ-9 and general health. The more severe the depression level and the poorer the general health, the lower the EQ-5D-5L scores (p < 0.001). Responsiveness parameters showed moderate changes among "improved" patients. CONCLUSIONS These findings support the adequate psychometric properties of the EQ-5D-5L in patients with major depression. It could be very useful for clinicians and researchers as an outcome measure and for use in economic evaluation.
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Affiliation(s)
- Amaia Bilbao
- Osakidetza Basque Health Service, Basurto University Hospital, Research Unit, Bilbao, Spain.,Health Service Research Network on Chronic Diseases (REDISSEC), Spain.,Kronikgune Institute for Health Services Research, Barakaldo, Spain
| | - Jesús Martín-Fernández
- Health Service Research Network on Chronic Diseases (REDISSEC), Spain.,Oeste Multiprofessional Teaching Unit of Primary and Community Care, Primary Healthcare Management, Madrid Health Service, Madrid, Spain.,Health Sciences Faculty, Rey Juan Carlos University, Madrid, Spain
| | - Lidia García-Pérez
- Health Service Research Network on Chronic Diseases (REDISSEC), Spain.,Fundación Canaria de Investigación Sanitaria (FUNCANIS), Santa Cruz de Tenerife, Spain
| | - José Ignacio Mendezona
- Osakidetza Basque Health Service, Bizkaia Mental Health Network, Derio Mental Health Centre, Derio, Spain
| | - Marta Arrasate
- Osakidetza Basque Health Service, Bizkaia Mental Health Network, Derio Mental Health Centre, Derio, Spain.,Osakidetza Basque Health Service, Bizkaia Mental Health Network, Uribe Mental Health Centre, Getxo, Spain
| | - Ruth Candela
- Psychiatry Department, Fuenlabrada University Hospital, Madrid, Spain
| | - Francisco Javier Acosta
- Health Service Research Network on Chronic Diseases (REDISSEC), Spain.,Service of Mental Health, General Management of Healthcare Programs, Canary Islands Health Service, Canary Islands, Spain.,Insular University Hospital of Gran Canaria, Canary Islands, Spain
| | - Soraya Estebanez
- Osakidetza Basque Health Service, Basurto University Hospital, Research Unit, Bilbao, Spain
| | - Ander Retolaza
- Health Service Research Network on Chronic Diseases (REDISSEC), Spain.,Osakidetza Basque Health Service, Bizkaia Mental Health Network, Basauri Mental Health Centre, Basauri, Spain.,Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
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[Quality of life in people with depression and physical comorbidity from a gender perspective]. Aten Primaria 2021; 53:101946. [PMID: 33431241 PMCID: PMC7910680 DOI: 10.1016/j.aprim.2020.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/09/2020] [Accepted: 07/20/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE The aim of the study is to describe from a gender perspective how people with depression and physical comorbidity perceive their quality of life. The study included 380 people over 49 years of age with at least one of the following pathologies: diabetes, chronic obstructive pulmonary disease and ischemic heart disease. Participants were recruited from 31 teams the primary care of in Catalonia. Quality of life was measured using the EuroQol Scale. In addition, sociodemographic variables were collected, as well as the severity of depression, the index of economic deprivation and area of residence. The adjusted relationship between sex and dimensions of quality of life was assessed by means of multivariate logistic regression. RESULTS 81.3% were women; the mean age was 68.4 years (SD: 8.8). The mean on the Visual Analogue Scale was 57.8 (SD: 17.4) in men and 55.8 (SD: 18.6) in women. The mean of the EQ-Health Index was 0.74 (SD: 0.17) in men and 0.65 (SD: 0.2) in women (p = 0.001). The probability of having problems of the EQ-5D showed sex as the most important factor (woman = 1/man = 0) in: self-care OR: 2.29 (95% CI 1.04-5.07) and daily activities OR: 3.09 (95% CI 1.67-5.71). Mobility was associated with age OR: 1.87 (95% CI 1.22-2.86), pain with area of residence OR: 2.51 (95% CI 1.18-5,34) and the BDI with anxiety/depression OR: 4,77 (95% CI 1.77-12,88). CONCLUSION The perception quality of life of women with depression and physical comorbidity is lower than that of men and, in both cases, it is lower than that of the general population.
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Fernández-Martínez E, Onieva-Zafra MDMD, Abreu-Sánchez A, González-Sanz JD, Iglesias-López MT, Fernández-Muñoz JJ, Parra-Fernández MLML. Menstrual Migraine Among Spanish University Students. J Pediatr Nurs 2021; 56:e1-e6. [PMID: 32651034 DOI: 10.1016/j.pedn.2020.06.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 11/15/2022]
Abstract
PURPOSE This study sought to determine the prevalence of menstrual migraine among female university students at the Nursing Faculty of Ciudad Real and to determine possible risk factors. DESIGN AND METHODS A cross-sectional observational study was performed using a self-report questionnaire. Two hundred and ninety-nine female university students participated in the study; all were enrolled in the 2017/2018 academic year at the Faculty of Nursing. Participants were over the age of 18 years and without any diagnosed gynecological pathology. The main measurement tools were menstrual migraine between days -2 and +3 of the menstrual cycle, over the previous six cycles. RESULTS The prevalence of menstrual migraine was 45.15%, identifying the following possible risk factors: dysmenorrhea (OR 9.19; 1.62-6.28% CI), use of hormonal contraceptive methods (OR 2.60; 95% CI 1.30-5.20), menstrual irritability (OR 2.34; 95% CI 1.25-4.40), menstrual dizziness (OR 2.05; 95% CI % 1.12-3.75) and daily consumption of cola beverages (OR 1.85; 95% CI % 1.04-3.32). CONCLUSIONS The prevalence of this problem is high among our population and the approach is complex. PRACTICE IMPLICATIONS It is necessary to continue to research the pharmacological measures and methods of pharmacological pain relief as well as interventions directed at lifestyle modifications considering the potential risk factors involved in menstrual migraine.
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Feng YS, Kohlmann T, Janssen MF, Buchholz I. Psychometric properties of the EQ-5D-5L: a systematic review of the literature. Qual Life Res 2020; 30:647-673. [PMID: 33284428 PMCID: PMC7952346 DOI: 10.1007/s11136-020-02688-y] [Citation(s) in RCA: 258] [Impact Index Per Article: 64.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Although the EQ-5D has a long history of use in a wide range of populations, the newer five-level version (EQ-5D-5L) has not yet had such extensive experience. This systematic review summarizes the available published scientific evidence on the psychometric properties of the EQ-5D-5L. METHODS Pre-determined key words and exclusion criteria were used to systematically search publications from 2011 to 2019. Information on study characteristics and psychometric properties were extracted: specifically, EQ-5D-5L distribution (including ceiling and floor), missing values, reliability (test-retest), validity (convergent, known-groups, discriminate) and responsiveness (distribution, anchor-based). EQ-5D-5L index value means, ceiling and correlation coefficients (convergent validity) were pooled across the studies using random-effects models. RESULTS Of the 889 identified publications, 99 were included for review, representing 32 countries. Musculoskeletal/orthopedic problems and cancer (n = 8 each) were most often studied. Most papers found missing values (17 of 17 papers) and floor effects (43 of 48 papers) to be unproblematic. While the index was found to be reliable (9 of 9 papers), individual dimensions exhibited instability over time. Index values and dimensions demonstrated moderate to strong correlations with global health measures, other multi-attribute utility instruments, physical/functional health, pain, activities of daily living, and clinical/biological measures. The instrument was not correlated with life satisfaction and cognition/communication measures. Responsiveness was addressed by 15 studies, finding moderate effect sizes when confined to studied subgroups with improvements in health. CONCLUSIONS The EQ-5D-5L exhibits excellent psychometric properties across a broad range of populations, conditions and settings. Rigorous exploration of its responsiveness is needed.
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Affiliation(s)
- You-Shan Feng
- Institute for Community Medicine, Medical University Greifswald, Greifswald, Germany. .,Institute for Clinical Epidemiology and Applied Biometrics, Medical University of Tübingen, Silcherstraße 5, 72076, Tübingen, Germany.
| | - Thomas Kohlmann
- Institute for Community Medicine, Medical University Greifswald, Greifswald, Germany
| | - Mathieu F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Erasmus University, Rotterdam, The Netherlands
| | - Ines Buchholz
- Institute for Community Medicine, Medical University Greifswald, Greifswald, Germany
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Martínez-Santamaría L, Cárcamo C, García-Pardo L, García-Arranz M, Melen G, Guerrero-Aspizua S, Llanos L, Río MD, García-Olmo D, Escámez MJ. Combined adipose mesenchymal stromal cell advanced therapy resolved a recalcitrant leg ulcer in an 85-year-old patient. Regen Med 2020; 15:2053-2065. [PMID: 33245008 DOI: 10.2217/rme-2020-0139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Venous leg ulcers (VLU) represent an uphill economic, health and social burden, aggravated in the elderly. Best-practice care interventions are often insufficient and alternative therapies need to be explored. Herein, we have treated for the first time a chronic VLU in an elderly patient by combining cell therapy and tissue engineering in the context of a compassionate use. The administration of allogeneic adipose-derived mesenchymal stromal cells (MSCs) embedded in a plasma-based bioengineered dermis covering the ulcer bed and also injected into the ulcer margins led to the complete closure of a 10-year recalcitrant VLU in an 85-year-old patient. Regenerative properties of MSCs might be boosted by the use of bioengineered matrices for their delivery.
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Affiliation(s)
- Lucía Martínez-Santamaría
- Department of Bioengineering, Carlos III University (UC3M). Avda. Universidad, 30. 28911. Leganés, Madrid, Spain.,Centre for Biomedical Network Research on Rare Diseases (CIBERER), U714. C/ Monforte de Lemos 3-5. 28029 Madrid, Spain.,Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain.,Centre for Energy, Environment & Technology Research (CIEMAT). Avda. Complutense, 40, 28040 Madrid, Spain
| | - Carmen Cárcamo
- Plastic & Reconstructive Surgery Department, Hospital Universitario Fundación Jiménez Díaz. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain
| | - Lourdes García-Pardo
- Plastic & Reconstructive Surgery Department, Hospital Universitario Fundación Jiménez Díaz. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain
| | - Mariano García-Arranz
- New Therapy Unit, Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz & Universidad Autónoma de Madrid. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain.,Department of Surgery, Medicine School, Universidad Autónoma de Madrid. C/ Arzobispo Morcillo, 4, 28029 Madrid, Spain
| | - Gustavo Melen
- Production Unit of Advanced Therapies Medicines, Fundación para la Investigación Biomédica del Hospital Infantil Universitario Niño Jesús. Avda. de Menéndez Pelayo,65, 28009 Madrid, Spain
| | - Sara Guerrero-Aspizua
- Department of Bioengineering, Carlos III University (UC3M). Avda. Universidad, 30. 28911. Leganés, Madrid, Spain.,Centre for Biomedical Network Research on Rare Diseases (CIBERER), U714. C/ Monforte de Lemos 3-5. 28029 Madrid, Spain.,Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain.,Centre for Energy, Environment & Technology Research (CIEMAT). Avda. Complutense, 40, 28040 Madrid, Spain
| | - Lucía Llanos
- Clinical Research Unit, Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain
| | - Marcela Del Río
- Department of Bioengineering, Carlos III University (UC3M). Avda. Universidad, 30. 28911. Leganés, Madrid, Spain.,Centre for Biomedical Network Research on Rare Diseases (CIBERER), U714. C/ Monforte de Lemos 3-5. 28029 Madrid, Spain.,Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain.,Centre for Energy, Environment & Technology Research (CIEMAT). Avda. Complutense, 40, 28040 Madrid, Spain
| | - Damián García-Olmo
- New Therapy Unit, Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz & Universidad Autónoma de Madrid. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain.,Department of Surgery, Medicine School, Universidad Autónoma de Madrid. C/ Arzobispo Morcillo, 4, 28029 Madrid, Spain
| | - María-José Escámez
- Department of Bioengineering, Carlos III University (UC3M). Avda. Universidad, 30. 28911. Leganés, Madrid, Spain.,Centre for Biomedical Network Research on Rare Diseases (CIBERER), U714. C/ Monforte de Lemos 3-5. 28029 Madrid, Spain.,Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz. Avda. de los Reyes Católicos, 2, 28040 Madrid, Spain.,Centre for Energy, Environment & Technology Research (CIEMAT). Avda. Complutense, 40, 28040 Madrid, Spain
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Maseda R, Martínez-Santamaría L, Sacedón R, Butta N, de Arriba MDC, García-Barcenilla S, García M, Illera N, Pérez-Conde I, Carretero M, Jiménez E, Melen G, Borobia AM, Jiménez-Yuste V, Vicente Á, del Río M, de Lucas R, Escámez MJ. Beneficial Effect of Systemic Allogeneic Adipose Derived Mesenchymal Cells on the Clinical, Inflammatory and Immunologic Status of a Patient With Recessive Dystrophic Epidermolysis Bullosa: A Case Report. Front Med (Lausanne) 2020; 7:576558. [PMID: 33324660 PMCID: PMC7726418 DOI: 10.3389/fmed.2020.576558] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 11/02/2020] [Indexed: 12/22/2022] Open
Abstract
Recessive dystrophic epidermolysis bullosa (RDEB) is an incurable inherited mucocutaneous fragility disorder characterized by recurrent blisters, erosions, and wounds. Continuous blistering triggers overlapping cycles of never-ending healing and scarring commonly evolving to chronic systemic inflammation and fibrosis. The systemic treatment with allogeneic mesenchymal cells (MSC) from bone marrow has previously shown benefits in RDEB. MSC from adipose tissue (ADMSC) are easier to isolate. This is the first report on the use of systemic allogeneic ADMSC, correlating the clinical, inflammatory, and immunologic outcomes in RDEB indicating long-lasting benefits. We present the case of an RDEB patient harboring heterozygous biallelic COL7A1 gene mutations and with a diminished expression of C7. The patient presented with long-lasting refractory and painful oral ulcers distressing her quality of life. Histamine receptor antagonists, opioid analgesics, proton-pump inhibitors, and low-dose tricyclic antidepressants barely improved gastric symptoms, pain, and pruritus. Concomitantly, allogeneic ADMSC were provided as three separate intravenous injections of 106 cells/kg every 21 days. ADMSC treatment was well-tolerated. Improvements in wound healing, itch, pain and quality of life were observed, maximally at 6-9 months post-treatment, with the relief of symptoms still noticeable for up to 2 years. Remarkably, significant modifications in PBL participating in both the innate and adaptive responses, alongside regulation of levels of profibrotic factors, MCP-1/CCL2 and TGF-β, correlated with the health improvement. This treatment might represent an alternative for non-responding patients to conventional management. It seems critical to elucidate the paracrine modulation of the immune system by MSC for their rational use in regenerative/immunoregulatory therapies.
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Affiliation(s)
- Rocío Maseda
- Department of Dermatology, La Paz University Hospital, Madrid, Spain
| | - Lucía Martínez-Santamaría
- Department of Bioengineering, Carlos III University (UC3M), Madrid, Spain
- Rare Diseases Networking Biomedical Research Centre (CIBERER) U714, Madrid, Spain
- Regenerative Medicine and Tissue Engineering Group, Health Research Institute Foundation of the Jiménez Díaz Foundation, Madrid, Spain
- Centre for Energy, Environment and Technology Research (CIEMAT), Madrid, Spain
| | - Rosa Sacedón
- Department of Cell Biology, Faculty of Medicine, Complutense University, Madrid, Spain
| | - Nora Butta
- Hematology Unit, La Paz University Hospital-IdiPAZ, Madrid, Spain
| | - María del Carmen de Arriba
- Department of Bioengineering, Carlos III University (UC3M), Madrid, Spain
- Regenerative Medicine and Tissue Engineering Group, Health Research Institute Foundation of the Jiménez Díaz Foundation, Madrid, Spain
- Centre for Energy, Environment and Technology Research (CIEMAT), Madrid, Spain
| | | | - Marta García
- Department of Bioengineering, Carlos III University (UC3M), Madrid, Spain
- Rare Diseases Networking Biomedical Research Centre (CIBERER) U714, Madrid, Spain
- Regenerative Medicine and Tissue Engineering Group, Health Research Institute Foundation of the Jiménez Díaz Foundation, Madrid, Spain
- Centre for Energy, Environment and Technology Research (CIEMAT), Madrid, Spain
| | - Nuria Illera
- Rare Diseases Networking Biomedical Research Centre (CIBERER) U714, Madrid, Spain
- Regenerative Medicine and Tissue Engineering Group, Health Research Institute Foundation of the Jiménez Díaz Foundation, Madrid, Spain
- Centre for Energy, Environment and Technology Research (CIEMAT), Madrid, Spain
| | | | - Marta Carretero
- Rare Diseases Networking Biomedical Research Centre (CIBERER) U714, Madrid, Spain
- Regenerative Medicine and Tissue Engineering Group, Health Research Institute Foundation of the Jiménez Díaz Foundation, Madrid, Spain
- Centre for Energy, Environment and Technology Research (CIEMAT), Madrid, Spain
| | - Eva Jiménez
- Department of Cell Biology, Faculty of Medicine, Complutense University, Madrid, Spain
| | - Gustavo Melen
- Cell & Gene Therapies Laboratory, Niño Jesus University Hospital, Madrid, Spain
| | - Alberto M. Borobia
- Clinical Pharmacology Department, School of Medicine, La Paz University Hospital, IdiPAZ, Autonomous University of Madrid, Madrid, Spain
| | | | - Ángeles Vicente
- Department of Cell Biology, Faculty of Medicine, Complutense University, Madrid, Spain
| | - Marcela del Río
- Department of Bioengineering, Carlos III University (UC3M), Madrid, Spain
- Rare Diseases Networking Biomedical Research Centre (CIBERER) U714, Madrid, Spain
- Regenerative Medicine and Tissue Engineering Group, Health Research Institute Foundation of the Jiménez Díaz Foundation, Madrid, Spain
- Centre for Energy, Environment and Technology Research (CIEMAT), Madrid, Spain
| | - Raúl de Lucas
- Department of Dermatology, La Paz University Hospital, Madrid, Spain
| | - María José Escámez
- Department of Bioengineering, Carlos III University (UC3M), Madrid, Spain
- Rare Diseases Networking Biomedical Research Centre (CIBERER) U714, Madrid, Spain
- Regenerative Medicine and Tissue Engineering Group, Health Research Institute Foundation of the Jiménez Díaz Foundation, Madrid, Spain
- Centre for Energy, Environment and Technology Research (CIEMAT), Madrid, Spain
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Population norms of health-related quality of life in Moscow, Russia: the EQ-5D-5L-based survey. Qual Life Res 2020; 30:831-840. [PMID: 33237551 PMCID: PMC7952340 DOI: 10.1007/s11136-020-02705-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 01/28/2023]
Abstract
Purpose To develop population norms for the EQ-5D-5L questionnaire based on a representative sample of Moscow citizens. Methods We used quota sampling accounting for sex, age group and administrative district of residence. Respondents in randomly selected outdoor and indoor locations were surveyed with the official Russian paper-and-pencil version of the EQ-5D-5L questionnaire and a set of socio-demographic questions. We estimated four types of EQ-5D results: the distribution of limitations according to EQ-5D-5L dimensions, the perception of the health-related quality of life (HRQoL) with a visual analogue scale (EQ VAS), the unweighted score for a respondent’s health state (Level Sum Score, LSS) and the Russian health preferences-based weighted score (EQ index). In order to estimate the EQ-5D-5L index, we used a newly developed Russian EQ-5D-3L value set, together with EuroQol Group cross-over methodology. Results A total of 1020 respondents (18–93 years old) from the general Moscow adult population completed the EQ-5D-5L questionnaire. HRQoL domains with the largest number of identified health limitations were pain/discomfort (48.6%) and anxiety/depression (44.1%). Two hundred seventy-nine respondents (27.0%) did not report any health restrictions. The mean EQ VAS and EQ-5D-5L index were 74.1 (SD 17.3) and 0.907 (0.106) respectively. Multivariate analysis showed that female sex, advanced age and lack of access to the Internet had a negative influence on HRQoL, whereas residence in certain districts had a positive impact. Conclusions The study provides population norms of health-related quality of life in Moscow, measured according to the EQ-5D-5L questionnaire. These reference values can be used to optimise the effectiveness of resource allocation in healthcare. Electronic supplementary material The online version of this article (10.1007/s11136-020-02705-0) contains supplementary material, which is available to authorised users.
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Han K, Yang S, Jia W, Wang S, Song Y, Cao W, Wang J, Liu M, He Y. Health-Related Quality of Life and Its Correlation With Depression Among Chinese Centenarians. Front Public Health 2020; 8:580757. [PMID: 33194985 PMCID: PMC7661682 DOI: 10.3389/fpubh.2020.580757] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/12/2020] [Indexed: 12/27/2022] Open
Abstract
Background: As evidence on depression and health-related quality of life (HRQoL) among the oldest-old is currently limited, this study aimed to re-examine the association between depression and HRQoL among centenarians. Methods: We analyzed cross-sectional data from the China Hainan Centenarian Cohort Study (CHCCS). The 15-item Geriatric Depression Scale (GDS-15) and three-level EuroQol five-dimensions (EQ-5D-3L) were used to evaluate depression and HRQoL, respectively. Poor health states were defined as EQ-5D index <0.665. Based on their GDS-15 score, individuals were categorized into three stages of depression: major depressive disorder (MDD; score ≥10), minor depressive disorder (MnDD; score between 6 and 9), and normal (score ≤ 5). Based on sex and comorbidity stratification, multivariable logistic regression was used to calculate the risk of poor health state in different levels of depression. We also used restricted cubic splines with a knot at 5 points (GDS-15) to flexibly model the association of GDS-15 scores with poor health states. Results: Totally, 1,002 participants were included in this study for analysis. Participants' median age was 102 years, and 82.04% were female. The median EQ-5D index was 0.68 (range: −0.149–1), and the mean VAS and GDS-15 scores were 61.60 (range: 0–100), and 5.23 (range: 0–15), respectively. Centenarians with MnDD and MDD accounted for 38.12 and 9.98%, respectively. While those with poor health states accounted for 45.11%. For every 1-point increase in GDS-15, the risk of poor health state increased by 20% (P < 0.001) after an adjustment for age, gender, ethnicity, marital status, education, residence type, smoking, drinking, weekly exercise, body mass index category, serum albumin, 25-hydroxyvitamin D, C-reactive protein, and comorbidities. MnDD and MDD were independent risk factors for poor health state (MnDD, OR = 2.76, P < 0.001; MDD, OR = 3.14, P < 0.001). The association was more prominent in centenarians without comorbidity. Conclusions: This study demonstrated a negative association between depression and HRQoL in Chinese centenarians, especially in centenarians without comorbidity. Large-scale prospective studies are needed to corroborate our findings and provide more information about the causal inference and internal mechanisms of this association.
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Affiliation(s)
- Ke Han
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shanshan Yang
- Department of Disease Prevention and Control, The 1st Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wangping Jia
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shengshu Wang
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yang Song
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wenzhe Cao
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jianwei Wang
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Miao Liu
- Department of Statistics and Epidemiology, Graduate School, Chinese PLA General Hospital, Beijing, China
| | - Yao He
- State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Institute of Geriatrics, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
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Encheva M, Djambazov S, Vekov T, Golicki D. EQ-5D-5L Bulgarian population norms. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2020; 21:1169-1178. [PMID: 32813084 DOI: 10.1007/s10198-020-01225-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 08/11/2020] [Indexed: 05/18/2023]
Abstract
OBJECTIVES The present study aimed to provide normative data for the EQ-5D-5L questionnaire in Bulgaria, based on a nationally representative sample. METHODS Random sampling was used. In September 2018, a total of 1005 respondents (aged 18-89 years) completed the self-administered paper-based EQ-5D-5L questionnaire, including a visual analogue scale (EQ VAS). Health state utility index scores were derived using the directly measured Polish value set. RESULTS The study sample was representative of the general Bulgarian population in terms of age, sex, geographical region, educational level, social and professional status. Mean EQ-5D-5L and EQ VAS values decreased from 0.986 and 89.7 (age group 18-24 years) to 0.789 and 53.6 (age group ≥ 75 years), respectively. Perfect health (the "11,111" health state) was reported by half of the population (50.1%), more often by men than women (55.8% vs 44.9%). The most frequently reported complaints characterised pain/discomfort dimension (39.1%), followed by anxiety/depression (34.5%). Although the least commonly reported health limitations concerned the self-care dimension, their frequency (13.6%) was the highest among the seventeen identified EQ-5D-5L population norm studies. The mean severity index score for the whole study sample was 6.96. EQ-5D-5L index was higher in respondents from lower age groups and with a higher average income per household member. CONCLUSIONS Bulgarian population norms, which were developed for the descriptive part of the EQ-5D-5L and EQ VAS, can be used as reference values. The availability of such normative data should encourage the use of the EQ-5D-5L questionnaire in health-related quality-of-life studies in Bulgaria.
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Affiliation(s)
- Marta Encheva
- HTA Ltd., Vertigo Business Tower, Bulgaria Blvd. 109, 14 Floor, Sofia, 1404, Bulgaria.
| | - Slaveyko Djambazov
- HTA Ltd., Vertigo Business Tower, Bulgaria Blvd. 109, 14 Floor, Sofia, 1404, Bulgaria
| | - Toni Vekov
- Faculty of Pharmacy, Medical University of Pleven, 1, Sv. Kliment Ohridski Str., Pleven, Bulgaria
| | - Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Banacha 1b St, 02-097, Warsaw, Poland
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Młyńczak K, Golicki D. Validity of the EQ-5D-5L questionnaire among the general population of Poland. Qual Life Res 2020; 30:817-829. [PMID: 33099710 PMCID: PMC7952292 DOI: 10.1007/s11136-020-02667-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2020] [Indexed: 01/13/2023]
Abstract
Purpose We aim to compare the psychometric properties of the EQ-5D-5L questionnaire with the EQ-5D-3L version and EQ VAS, based on a survey conducted in a sample representing the general adult population of Poland. Methods The survey comprised health-related quality of life (HRQoL) questionnaires: EQ-5D-5L, EQ VAS, SF-12 and EQ-5D-3L, together with demographic and socio-economic characteristics items. The EQ-5D index values were estimated based on a directly measured value set for Poland. The following psychometric properties were analysed: feasibility, distribution of responses, redistribution from EQ-5D-3L to EQ-5D-5L, inconsistencies, ceiling effects, informativity power and construct validity. We proposed a novel approach to the construct validity assessment, based on the use of a machine learning technique known as the random forest algorithm. Results From March to June 2014, 3978 subjects (aged 18–87, 53.2% female) were surveyed. The EQ-5D-5L questionnaire had a lower ceiling effect compared to EQ-5D-3L (38.0% vs 46.6%). Redistribution from EQ-5D-3L to EQ-5D-5L was similar for each dimension, and the mean inconsistency did not exceed 5%. The results of known-groups validation confirmed the hypothesis concerning the relationship between the EQ-5D index values and age, sex and occurrence of diabetes. Conclusions The EQ-5D-5L, in comparison with its EQ-5D-3L equivalent, showed similar or better psychometric properties within the general population of a country. We assessed the construct validity of the questionnaire with a novel approach that was based on a machine learning technique known as the random forest algorithm.
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Affiliation(s)
- Katarzyna Młyńczak
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 1b Banacha St, 02-097, Warsaw, Poland. .,HealthQuest spółka z ograniczoną odpowiedzialnością Sp. K, Warsaw, Poland.
| | - Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 1b Banacha St, 02-097, Warsaw, Poland.,HealthQuest spółka z ograniczoną odpowiedzialnością Sp. K, Warsaw, Poland
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79
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Jiang R, Janssen MFB, Pickard AS. US population norms for the EQ-5D-5L and comparison of norms from face-to-face and online samples. Qual Life Res 2020; 30:803-816. [PMID: 33025373 PMCID: PMC7952367 DOI: 10.1007/s11136-020-02650-y] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2020] [Indexed: 11/25/2022]
Abstract
Purpose Normative scores (norms) allow for comparisons between population(s) of interest and the general population, which is useful for burden of disease studies and cost-effectiveness analysis. The primary aim of this study was to estimate US visual analogue scale (EQ VAS) and utility-based norms for the EQ-5D-5L using the face-to-face sample. The secondary aim was to compare norms estimated in the face-to-face and online populations. Methods This study estimated population norms from two general population surveys: (a) face-to-face and (b) online. In these surveys, respondents provided their health state using the EQ-5D-5L health classifier and the EQ VAS. Descriptive statistics, including mean, standard deviation (SD), 95% confidence interval, and median for the 5L utility and EQ VAS were estimated for each sample and across relevant respondent characteristics to serve as the basis for US EQ-5D-5L norms Results Face-to-face sample respondents (n = 1134) were representative of the US adult general population. In this sample, mean (SD) utility decreased with increasing age until age 45 or greater (age 45–54: 0.816 (0.249) age 55–64: 0.815 (0.243) age 65–74: 0.824 (0.217) age 75 + : 0.811 (0.218)). With increasing age, more problems were reported on all dimensions except anxiety/depression; a smaller proportion of respondents age 65 and older reported problems with anxiety/depression (23.8%) as compared to the youngest respondents (42.1%). Online (n = 2018) mean utility and EQ VAS values were consistently lower than the face-to-face sample. Conclusions The availability of US EQ-5D-5L norms facilitates interpretation and understanding of general population and patient health. Electronic supplementary material The online version of this article (10.1007/s11136-020-02650-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ruixuan Jiang
- Center for Observational and Real-World Evidence, Merck, Kenilworth, NJ, USA
| | - M F Bas Janssen
- EuroQol Group, Rotterdam, The Netherlands
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - A Simon Pickard
- Department of Pharmacy Systems, Outcomes, and Policy, University of Illinois At Chicago College of Pharmacy, 833 S Wood St, Chicago, IL, 60612, USA.
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80
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García-Agua Soler N, Gómez-Bermúdez E, Baixauli-Fernández VJ, Bellver-Beltrán S, Velasco-Martínez J, García Ruiz AJ, Jódar-Sánchez F. Medicines use review service in community pharmacies in Spain: REVISA project. Int J Clin Pharm 2020; 43:524-531. [PMID: 32996076 PMCID: PMC8214585 DOI: 10.1007/s11096-020-01158-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 09/17/2020] [Indexed: 11/26/2022]
Abstract
Background Community pharmacy services play an important role in controlling some factors related to medicine use and patients can benefit from these services to improve the adherence and knowledge of their medications, besides to reduce medicine-related problems. Objective The aim of the REVISA project is to carry out a study on preliminary implementation of the medicines use review service in Spanish community pharmacies. Setting Sixty-four community pharmacies from all regions of Spain. Method A preliminary implementation, cross-sectional multicentre study was conducted using a convenience sample of voluntary community pharmacies. A structured interview enabled to pharmacists to obtain a better understanding of patient's medicines use. Main outcome measure Medicines use review-related time and cost, satisfaction and willingness to pay. Results A total of 495 patients were enrolled. The mean age of the patients was 66.1 years, with the majority females (56.4%) and a mean consumption of 5.7 medicines. A total of 2811 medicines were evaluated and 550 referral recommendations were made (29.8% to Primary Care). The mean time employed by the pharmacists in the medicines use review service was 52.8 min (medicines use review-related cost of €17.27). Most patients expressed a high level of satisfaction with this service (98.5%) and a willingness to pay for it (84%). Conclusion Medicines use review service in community pharmacies in Spain can be delivered, that it appears to be acceptable to patients and that most patients said they would be willing to pay for it. This service may offer an opportunity to promote inter-professional collaboration between pharmacists and general practitioners.
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Affiliation(s)
- Nuria García-Agua Soler
- Chair of Health Economics and Rational Use of Drugs, Department of Pharmacology. University of Málaga, Boulevard Louis Pasteur, 32, 29071, Málaga, Spain.
- Pharmacoeconomics: Clinical and Economic Evaluation of Pharmaceutical Drugs and Palliative Care, Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain.
- Illustrious in the Official College of Pharmacists of Málaga, Málaga, Spain.
- Subcommittee Medicines Use Review, Spanish Society of Family and Community Pharmacy (SEFAC-Sociedad Española de Farmacia Familiar y Comunitaria), Madrid, Spain.
| | - Eugenia Gómez-Bermúdez
- Subcommittee Medicines Use Review, Spanish Society of Family and Community Pharmacy (SEFAC-Sociedad Española de Farmacia Familiar y Comunitaria), Madrid, Spain
| | - Vicente J Baixauli-Fernández
- Subcommittee Medicines Use Review, Spanish Society of Family and Community Pharmacy (SEFAC-Sociedad Española de Farmacia Familiar y Comunitaria), Madrid, Spain
| | - Sara Bellver-Beltrán
- Subcommittee Medicines Use Review, Spanish Society of Family and Community Pharmacy (SEFAC-Sociedad Española de Farmacia Familiar y Comunitaria), Madrid, Spain
| | - Javier Velasco-Martínez
- Subcommittee Medicines Use Review, Spanish Society of Family and Community Pharmacy (SEFAC-Sociedad Española de Farmacia Familiar y Comunitaria), Madrid, Spain
| | - Antonio J García Ruiz
- Chair of Health Economics and Rational Use of Drugs, Department of Pharmacology. University of Málaga, Boulevard Louis Pasteur, 32, 29071, Málaga, Spain
- Pharmacoeconomics: Clinical and Economic Evaluation of Pharmaceutical Drugs and Palliative Care, Institute of Biomedical Research in Malaga (IBIMA), Málaga, Spain
| | - Francisco Jódar-Sánchez
- Group in Biomedical Informatics, Biomedical Engineering and Health Economy, Institute of Biomedicine of Seville, IBiS/Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain
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81
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Terradas-Monllor M, Ochandorena-Acha M, Salinas-Chesa J, Ramírez S, Beltran-Alacreu H. Assessment of postoperative health functioning after knee arthroplasty in relation to pain catastrophizing: a 6-month follow-up cohort study. PeerJ 2020; 8:e9903. [PMID: 32974103 PMCID: PMC7486825 DOI: 10.7717/peerj.9903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/18/2020] [Indexed: 11/25/2022] Open
Abstract
Background Knee arthroplasty (KA) is a typically successful surgical procedure commonly performed to alleviate painin participants with end-stage knee osteoarthritis. Despite its beneficial effects, a significant proportion of individuals with KA continue experiencing persistent pain and functional limitations. The purpose of this study was to assess the postoperative outcomes after KA in relation to postoperative pain catastrophizing. Methods Participants were recruited at a domiciliary physiotherapy service, using a prospective, observational, hypothesis-generating cohort design. Participants were divided into two groups based on their Pain Catastrophizing Scale (PCS) total score (50th percentile), which resulted in high and low PCS groups. The primary outcome measure was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). In addition, quality of life, walking speed, physical performance, range of motion, and pain were measured. Outcome measures were collected at baseline (1 week postoperatively) and at follow-up (1, 3, and 6 months postoperatively). Results A total of 60 participants (21 total KA and 39 unicompartmental KA) were recruited. Individuals with a higher degree of pain catastrophizing showed significantly higher WOMAC total scores at every follow-up, indicating poorer health functioning (p < 0.01). Similarly, the high PCS group showed higher WOMAC pain, stiffness and disability subscale scores (p < 0.05), poorer quality of life (p < 0.01), and poorer physical performance (p < 0.05) at every follow-up. In addition, the high PCS group achieved a slower walking speed at baseline and at 3 months follow-up (p < 0.05), and a higher degree of pain at rest, on walking and on knee flexion at every follow-up (p < 0.01, p < 0.05 and p < 0.05, respectively) except for walking pain at 3 months follow-up. No significant differences were observed between groups in range of motion, except for active knee extension at the 6-month follow-up (p < 0.05). Effect size was large at 1 month follow-up in WOMAC total score (r = 0.578) and pain intensity during knee flexion (r = 0.529). Longitudinal analyses revealed different improvement trends during the rehabilitation process between groups, with a lack of significant improvements in the high PCS group between the 3- and 6-month follow-up in WOMAC total score, WOMAC pain, WOMAC disability, quality of life, physical performance, active knee extension and resting pain (p > 0.05). Conclusion The results of the present study suggest that participants with high postoperative pain catastrophizing might have poorer outcomes during the rehabilitation process after KA. Future work should seek to clarify if this relationship is causal.
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Affiliation(s)
- Marc Terradas-Monllor
- Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia, Vic, Spain.,Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain.,Institut de Rehabilitació i Terapèutica Biofísica (IRITEB), Badalona, Spain.,Programa de Doctorat en Medicina i Recerca Translacional, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Mirari Ochandorena-Acha
- Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia, Vic, Spain.,Research Group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Center for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
| | | | - Sergi Ramírez
- Institut de Rehabilitació i Terapèutica Biofísica (IRITEB), Badalona, Spain
| | - Hector Beltran-Alacreu
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain.,Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
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82
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Interference and Impact of Dysmenorrhea on the Life of Spanish Nursing Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186473. [PMID: 32899505 PMCID: PMC7559731 DOI: 10.3390/ijerph17186473] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 08/30/2020] [Accepted: 09/03/2020] [Indexed: 12/14/2022]
Abstract
Dysmenorrhea is a cause of absenteeism in universities which, in the context of nursing studies, may affect mandatory attendance. Moreover, presenteeism is associated with medication errors, patient falls, and a reduced quality of patient care. This study sought to identify the degree of interference of dysmenorrhea on daily life and its impact on academic performance among Spanish nursing students, and to explore the reasons for presenteeism. A cross-sectional descriptive study was conducted on 261 nursing students. Data were collected using a self-administered questionnaire. The chi square tests, chi-square linear trend, Student's t-test, one-way analysis of variance of polynomial contrasts, and post hoc tests for the bi-variate analysis were used to compare the participants' responses regarding their type of dysmenorrhea and pain intensity. In addition, a multivariate regression was performed to predict absenteeism. The answers to the open questions were analyzed using thematic content analysis techniques. We observed 62.8% of absenteeism and 92.7% of presenteeism due to dysmenorrhea. Absenteeism was observed to be 3.079 (confidence interval (CI): 95%1.724-5.499; p < 0.001) times more likely among women with severe menstrual pain, 2.513 (CI 95%1.314-4.807; p = 0.005) times more in those suffering from menstrual nausea and 1.936 (CI 95%1.098-3.411; p = 0.022) times more frequent in those suffering from diarrhea. The reasons for presenteeism were grouped into five categories: the pain was bearable, it is not a reason to be absent, others don't consider it a reason to be absent, responsibility and guilt, and academic consequences. Dysmenorrhea can have a significant impact on academic performance. The concern among students about the academic repercussions and even feelings of guilt and incomprehension from others leads to high rates of presenteeism with potentially negative consequences for patient care.
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83
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Guzman-Esquivel J, Mendoza-Hernandez MA, Tiburcio-Jimenez D, Avila-Zamora ON, Delgado-Enciso J, De-Leon-Zaragoza L, Casarez-Price JC, Rodriguez-Sanchez IP, Martinez-Fierro ML, Meza-Robles C, Barocio-Acosta A, Baltazar-Rodriguez LM, Zaizar-Fregoso SA, Plata-Florenzano JE, Delgado-Enciso I. Decreased biochemical progression in patients with castration-resistant prostate cancer using a novel mefenamic acid anti-inflammatory therapy: A randomized controlled trial. Oncol Lett 2020; 19:4151-4160. [PMID: 32391109 DOI: 10.3892/ol.2020.11509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/13/2019] [Indexed: 12/19/2022] Open
Abstract
Prostate cancer (PCa) is the second most common non-dermatological cancer in men and is a growing public health problem. Castration-resistant disease (CRD) is the most advanced stage of the disease and is difficult to control. Patients with CRD may no longer accept conventional therapies as they are not in appropriate clinical conditions or they refuse to receive it. Given that inflammation is an essential component of CRD origin and progression, anti-inflammatory agents could be a therapeutic option with fenamates as one of the proposed choices. A prospective, randomized, double-blinded, 2-arm, parallel group, phase II-III clinical trial was performed involving 20 patients with CRD-PCa (with a prostate specific antigen level <100 ng/ml) that were undergoing androgen deprivation therapy (ADT) and did not accept any established treatment for that disease stage. In addition to ADT, 10 patients received placebo and 10 received mefenamic acid (500 mg orally every 12 h) for 6 months. The primary endpoint was the change in serum prostate-specific antigen (PSA) at 6 months. The PSA levels decreased significantly with mefenamic acid (an average 42% decrease), whereas there was an average 55% increase in the placebo group (P=0.024). In the patients treated with the placebo, 70% had biochemical disease progression (an increase of ≥25% in PSA levels), which did not occur in any of the patients treated with mefenamic acid (relative risk=0.12; 95% confidence interval, 0.01-0.85; P=0.033). There was a significant increase in quality of life (EQ-5D-5L score) and body mass index (BMI) with the experimental treatment. In conclusion, mefenamic acid administration decreased biochemical progression in patients with castration resistant PCa, improved their quality of life and increased their BMI. Future studies are required in order to strengthen the findings of the present clinical trial. Trial registration, Cuban Public Registry of Clinical Trials Database RPCEC00000248, August 2017.
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Affiliation(s)
- José Guzman-Esquivel
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico.,Department of Research, General Hospital of Zone No. 1 IMSS, Villa de Alvarez, Colima 28983, Mexico
| | | | - Daniel Tiburcio-Jimenez
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico
| | - Oscar N Avila-Zamora
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Josuel Delgado-Enciso
- Department of Research, Foundation for Cancer Ethics, Education and Research of The Cancerology State Institute, Colima 28085, Mexico
| | - Luis De-Leon-Zaragoza
- Department of Research, General Hospital of Zone No. 1 IMSS, Villa de Alvarez, Colima 28983, Mexico.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Juan C Casarez-Price
- Department of Research, General Hospital of Zone No. 1 IMSS, Villa de Alvarez, Colima 28983, Mexico.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Iram P Rodriguez-Sanchez
- Molecular and Structural Physiology Laboratory, School of Biological Sciences, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico
| | - Margarita L Martinez-Fierro
- Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Autonomous University of Zacatecas, Zacatecas, Zacatecas 98160, Mexico
| | - Carmen Meza-Robles
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Alejandro Barocio-Acosta
- Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Luz M Baltazar-Rodriguez
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico
| | - Sergio A Zaizar-Fregoso
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico
| | - Jorge E Plata-Florenzano
- Department of Research, General Hospital of Zone No. 1 IMSS, Villa de Alvarez, Colima 28983, Mexico.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
| | - Iván Delgado-Enciso
- Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico.,Department of Research, Cancerology State Institute, Colima State Health Services, Colima 28085, Mexico
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84
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Rivas-Ruiz F, Machón M, Mateo-Abad M, Contreras-Fernández E, Güell C, Baro-Rodríguez L, Vrotsou K, Quirós-López R, Vergara I. Tackling frailty at primary care: evaluation of the effectiveness of a multicomponent intervention through a randomised controlled trial: study protocol. BMJ Open 2020; 10:e034591. [PMID: 32086358 PMCID: PMC7045273 DOI: 10.1136/bmjopen-2019-034591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION This project focuses on how frailty is addressed in primary healthcare (PHC) and will evaluate the effectiveness of a multifactorial intervention (considering the appropriateness of the pharmaceutical prescription, the nutritional care provided and the exercise intervention) for persons with frailty, in terms of improving their functional capacity and reducing the incidence of adverse events related to frailty. The final evaluation will be made at 12 months' follow-up. METHODS AND ANALYSIS Pragmatic multicentre cluster randomised controlled clinical trial, single blind with two arms: multifactorial intervention in PHC versus usual follow-up. The randomisation unit is the patient list and the analysis unit is the patient. In addition, a cost-effectiveness study and a qualitative study will be carried out, the latter based on semistructured interviews and focus groups. Two hundred persons (100 per study branch) all aged ≥70 years, presenting frailty, but functionally independent and resident in the community, will be recruited. A baseline evaluation will be carried out prior to the intervention, with follow-up at 6 and 12 months. The main study variables considered will be functional capacity and incidence of adverse events; the secondary variables considered will be the patients' sociodemographic characteristics, nutritional status, level of physical activity and drug consumption, together with data on comorbidity, cognitive and affective status and health-related quality of life. Data will be analysed according to the intention-to-treat principle using a 5% significance level. ETHICS AND DISSEMINATION The study will at all times be conducted in strict accordance with the provisions of the Declaration of Helsinki and with the national legislation regulating patients' autonomy. All patients recruited will be asked to provide written informed consent before taking part in the clinical trial. On completion of the study, the principal investigator expects to publish the results of this research in a peer-reviewed open access scientific journal. TRIAL REGISTRATION NUMBER ISRCTN17143761.
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Affiliation(s)
- Francisco Rivas-Ruiz
- Unidad de Investigación, Agencia Sanitaria Costa del Sol, Marbella, Málaga, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
| | - Mónica Machón
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, San Sebastián, Spain
- Instituto de Investigación en Servicios de Salud Kronikgune, Baracaldo, Spain
| | - Maider Mateo-Abad
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Instituto de Investigación en Servicios de Salud Kronikgune, Baracaldo, Spain
| | - Eugenio Contreras-Fernández
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Unidad Gestión Clínica de Prevención, Promoción y Vigilancia de la Salud, Distrito Sanitario de Atención Primaria Costa del Sol, Mijas, Málaga, Spain
| | - Carolina Güell
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, San Sebastián, Spain
- Osakidetza, Centro de salud de Altza, San Sebastián, Spain
| | - Luis Baro-Rodríguez
- Área del Medicamento, Distrito Sanitario de Atencion Primaria Costa del Sol, Mijas, Spain
| | - Kalliopi Vrotsou
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, San Sebastián, Spain
- Instituto de Investigación en Servicios de Salud Kronikgune, Baracaldo, Spain
| | - Raúl Quirós-López
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Servicio de Medicina Interna, Agencia Sanitaria Costa del Sol, Marbella, Spain
| | - Itziar Vergara
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain
- Instituto de Investigación Sanitaria Biodonostia, Grupo de Atención Primaria, San Sebastián, Spain
- Instituto de Investigación en Servicios de Salud Kronikgune, Baracaldo, Spain
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85
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Valiente-Gómez A, Pujol N, Moreno-Alcázar A, Radua J, Monteagudo-Gimeno E, Gardoki-Souto I, Hogg B, Álvarez MJ, Safont G, Lupo W, Pérez V, Amann BL. A Multicenter Phase II RCT to Compare the Effectiveness of EMDR Versus TAU in Patients With a First-Episode Psychosis and Psychological Trauma: A Protocol Design. Front Psychiatry 2020; 10:1023. [PMID: 32116827 PMCID: PMC7014965 DOI: 10.3389/fpsyt.2019.01023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 12/24/2019] [Indexed: 11/13/2022] Open
Abstract
Background Patients with a first episode psychosis (FEP) who are admitted for the first time to a psychiatric hospital frequently have experienced prior psychological trauma. Additionally, 40-80% develop posttraumatic stress symptoms, which are summarized as a post-psychotic post-traumatic syndrome (PPS). Eye Movement Desensitization and reprocessing (EMDR) therapy could be an effective psychotherapy to treat a PPS and prior psychological traumas in this population. Objectives To assess if EMDR therapy leads to: 1) a reduction of relapses after intervention, 2) an improvement of trauma-related, psychotic and affective symptoms, 3) an improvement of overall functioning, and 4) an improvement in quality of life. Methods This is a multicenter phase II rater-blinded randomized controlled trial in which 80 FEP patients with a history of psychological trauma will be randomly assigned to EMDR (n = 40) or to TAU (n = 40). Traumatic events will be measured by the Global Assessment of Posttraumatic Stress Questionnaire, the Cumulative Trauma Screening, the Impact of Event Scale-Revised, the Dissociative Experiences Scale, the Childhood Trauma Scale, the Holmes-Rahe Life Stress Inventory, and the Dissociative Experiences Questionnaire. Clinical symptomatology will be evaluated using the Suicide and Drug Consumption module of the International Neuropsychiatric Interview, Structured Clinical Interview for Positive and Negative Syndrome Scale, Young's Scale for Mania Evaluation, and Beck Depression II Questionnaire. Functionality will be assessed with the Global Assessment of Functioning and the Quality of Life with the Standardized Instrument developed by the EuroQol Group. The cognitive insight and adherence to the treatment will be assessed with the Beck Cognitive Insight Scale and the Drug Attitude Inventory. All variables will be measured at baseline, post-treatment and at 12-month follow-up. Conclusion This study will provide evidence of whether EMDR therapy is effective in reducing trauma and clinical symptoms, reducing relapses and in improving functionality and quality of life in patients with FEP and a history of trauma. Clinical Trial Registration www.ClinicalTrials.gov, identifier: NCT03991377.
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Affiliation(s)
- Alicia Valiente-Gómez
- Centre Forum Research Unit, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBERSAM, Madrid, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Nuria Pujol
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBERSAM, Madrid, Spain
- Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, Barcelona, Spain
| | - Ana Moreno-Alcázar
- Centre Forum Research Unit, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBERSAM, Madrid, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joaquim Radua
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Eila Monteagudo-Gimeno
- Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain
- Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, Barcelona, Spain
| | - Itxaso Gardoki-Souto
- Centre Forum Research Unit, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Bridget Hogg
- Centre Forum Research Unit, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Gemma Safont
- CIBERSAM, Madrid, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain
- University Hospital Mutua Terrassa, Barcelona, Spain
| | - Walter Lupo
- Centre Forum Research Unit, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Victor Pérez
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBERSAM, Madrid, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain
- Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, Barcelona, Spain
| | - Benedikt L. Amann
- Centre Forum Research Unit, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBERSAM, Madrid, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain
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Verde Z, Giaquinta A, Moreno Sainz C, Díaz Ondina M, Fernández Araque A. Bone Mineral Metabolism Status, Quality of Life, and Muscle Strength in Older People. Nutrients 2019; 11:E2748. [PMID: 31726780 PMCID: PMC6893588 DOI: 10.3390/nu11112748] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 11/06/2019] [Accepted: 11/08/2019] [Indexed: 02/07/2023] Open
Abstract
As the relationship between vitamin D and various diseases or health conditions has become known, interest in the contribution of vitamin D to overall health-related quality of life (QoL) has increased. We examined the relationship between vitamin D status and QoL in 273 participants aged 65 years and older. Serum levels of total calcium, phosphorus, intact parathyroid hormone, albumin, and 25-hydroxyvitaminD3 were analyzed. We also recruited data for QoL, physical activity, nutritional impairment, and muscular strength. Ninety percent of the subjects were classified as vitamin D deficient or insufficient. Participants with higher serum 25(OH)D3, calcium, phosphorous, and Alb levels were significantly less likely to self-report depression or anxiety after adjustment (p = 0.009, p = 0.005, p = 0.003, and p = 0.005, respectively). Additionally, we found an association between lower levels of albumin and self-reported problems with mobility or usual activities (p = 0.01). We also found associations between better muscle strength and higher levels of vitamin D, calcium, phosphorous, and albumin (p = 0.006, p = 0.003, p = 0.004 and p = 0.002, respectively). Overall, our data provide evidence that serum vitamin D and Alb levels are negatively related to self-reported anxiety or depression, usual activities, mobility, and three dimensions of QoL in older adults. Furthermore, vitamin D levels are positively related to hand grip strength in adults over 65 years old.
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Affiliation(s)
- Zoraida Verde
- Department of Biochemistry, Molecular Biology and Physiology, Universidad de Valladolid, Campus Duques de Soria, 42002 Soria, Spain
| | - Andrea Giaquinta
- Department of Nursery, Universidad de Valladolid, Campus Duques de Soria, 42002 Soria, Spain; (A.G.); (A.F.A.)
| | - Carmelo Moreno Sainz
- Department of Clinic Biochemistry, Hospital Santa Bárbara, 42002 Soria, Spain; (C.M.S.); (M.D.O.)
| | - Marta Díaz Ondina
- Department of Clinic Biochemistry, Hospital Santa Bárbara, 42002 Soria, Spain; (C.M.S.); (M.D.O.)
| | - Ana Fernández Araque
- Department of Nursery, Universidad de Valladolid, Campus Duques de Soria, 42002 Soria, Spain; (A.G.); (A.F.A.)
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87
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Feng YS, Jiang R, Kohlmann T, Pickard AS. Exploring the Internal Structure of the EQ-5D Using Non-Preference-Based Methods. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:527-536. [PMID: 31104730 DOI: 10.1016/j.jval.2019.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 02/16/2019] [Accepted: 02/20/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND When the EuroQol EQ-5D is applied in settings other than resource allocation, a non-preference-based score may be more appropriate than societal, preference-weighted utility. To develop a psychometric score for the EQ-5D, its structural relationship, ie, how the 5 items/dimensions interrelate, must be understood to inform appropriate methods of summarizing the instrument. OBJECTIVES To explore psychometrically derived approaches of elucidating the 5-level EQ-5D (EQ-5D-5L) item structure. METHODS Three measurement models were assessed. All 5 items were modeled as reflective indicators using confirmatory factor analysis. EQ-5D-5L items were conceptualized as formative indicators, and other health scales (eg, the short form 36 health survey) were conceptualized as reflective indicators in Multiple Indicators Multiple Causes models (external MIMIC). The EQ-5D-5L items were modeled as a combination of formative and reflective indicators in internal MIMIC models. Results across 9 data sets from various countries and patient groups were examined to determine their robustness. RESULTS All items loaded well (0.63-0.96) in the confirmatory factor analysis except for anxiety/depression (0.20-0.66, excluding 1 outlier). The model fit statistics of the external MIMIC models were poor, and the coefficients of the Self-Care dimension were small. The internal MIMIC model with Mobility, Pain/Discomfort, and Anxiety/Depression as formative indicators and Self-Care and Usual Activities as reflective indicators fit best. The model results of the Spanish valuation data set were outliers. CONCLUSIONS Although there were some variations in results across subgroups, the relationship between the items remained robust. The evidence calls for testing of formative/reflective combination approaches to summarize the EQ-5D-5L.
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Affiliation(s)
- You-Shan Feng
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany.
| | - Ruixuan Jiang
- University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | - Thomas Kohlmann
- Institute for Community Medicine, University of Greifswald, Greifswald, Germany
| | - A Simon Pickard
- University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
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Arrospide A, Machón M, Ramos-Goñi JM, Ibarrondo O, Mar J. Inequalities in health-related quality of life according to age, gender, educational level, social class, body mass index and chronic diseases using the Spanish value set for Euroquol 5D-5L questionnaire. Health Qual Life Outcomes 2019; 17:69. [PMID: 30999899 PMCID: PMC6472013 DOI: 10.1186/s12955-019-1134-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 04/01/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reducing health inequalities on the basis of social factors has been a key driver in the development of Public Health policies. Health-related quality of life is a global indicator useful to assess health inequalities within a society. The objective of this study was to identify inequalities on health by analysing the interactive effects of gender, age, educational level, social class, body mass index and chronic diseases on health-related quality of life in a Spanish population sample. METHODS We used data from the Spanish National Health Survey 2011-2012. Health-related quality of life was measured by the EQ-5D-5L instrument applying the Spanish value set. Probability of being in perfect health was ascertained by logistic regression models including gender, age, educational level, body mass index and social class and the corresponding terms of interaction. A two-part model combining logistic regression analysis and generalized linear models was applied to calculate the adjusted utility loss associated with chronic conditions (disutility values). RESULTS The sample used for analysis contained 18,450 individuals. The mean age was 50 years, 51.3% were women, 55% were overweight or obese and 46.7% had low social status. The mean utility was 0.94 in men and 0.89 in women. Elderly women, obese people, those of low social class and those with chronic conditions had significant lower utility values. Within the regression analysis, interaction assessment revealed that the detrimental effect of obesity disappeared in higher social classes. Utility values for all chronic conditions considered were lower in women than in men and were on a gradient within social class, the lowest for individuals declaring stroke. The greatest decrease on health-related quality of life was determined by declaration of stroke (17.6%) or mental diseases (18.6%). CONCLUSIONS The interactive effects of gender, age, educational level, social class, body mass index and chronic diseases on health-related quality of life in the Spanish population revealed important inequalities in health. Social class acted as a modulator of the stigma associated with obesity. Chronic conditions producing loss of autonomy had the greatest impact on reduction of health-related quality of life. This is the first study using the Spanish EQ-5D-5L value set to estimate utilities.
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Affiliation(s)
- Arantzazu Arrospide
- Unidad de Investigación AP-OSIs Gipuzkoa, Hospital Alto Deba, Avda Navarra 16, Arrasate-Mondragón, 20500 Gipuzkoa Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain
- Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain
| | - Mónica Machón
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain
- Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain
- Unidad de Investigación AP-OSIs Gipuzkoa, Osakidetza, San Sebastián, Spain
- Centro de Investigación en Cronicidad Kronikgune, Barakaldo, Spain
| | - Juan M. Ramos-Goñi
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain
- Axentiva Solutions, Tacoronte, Spain
| | - Oliver Ibarrondo
- Unidad de Investigación AP-OSIs Gipuzkoa, Hospital Alto Deba, Avda Navarra 16, Arrasate-Mondragón, 20500 Gipuzkoa Spain
- Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain
| | - Javier Mar
- Unidad de Investigación AP-OSIs Gipuzkoa, Hospital Alto Deba, Avda Navarra 16, Arrasate-Mondragón, 20500 Gipuzkoa Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain
- Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain
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The Impact of Dysmenorrhea on Quality of Life Among Spanish Female University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050713. [PMID: 30818861 PMCID: PMC6427338 DOI: 10.3390/ijerph16050713] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/22/2019] [Accepted: 02/24/2019] [Indexed: 12/19/2022]
Abstract
(1) Background: Primary dysmenorrhea, which is characterized by menstrual pain in the absence of a pelvic pathology, is one of the main reasons for gynecological consultation. This study aimed to assess the prevalence of dysmenorrhea in a sample of university students, as well as their quality of life, and to examine the most common methods used for alleviating symptoms. (2) Methods: The participants comprised 305 female university students with a mean age of 20.32 ± 3.19 years who completed a self-report survey comprising sociodemographic, gynecological and lifestyle questions. EuroQol-5 dimensions-5 levels (EQ-5D-5L) was used to measure quality of life. (3) Results: In total, 76% of the sample suffered from dysmenorrhea. Among the students who did not suffer from dysmenorrhea, a significantly greater proportion participated in activities such as jogging or Pilates on a regular basis (several times per week). Concerning quality of life, patients with dysmenorrhea showed significant differences on the pain/discomfort scale and on the total score for perceived quality of life. However, this perception showed no correlation with the VAS (visual analogue scale) pain scale. Additionally, 90.5% of students with dysmenorrhea used pharmacological treatment, and 80% self-medicated. (4) Conclusions: Dysmenorrhea represents a major problem among youth today and the impact on the quality of life (QoL) of patients is evident. Physical activity may alleviate symptoms of dysmenorrhea and this and other complementary treatments should be promoted within health services.
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