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Assessing the engagement of children and families in selecting patient-reported outcomes (PROs) and developing their measures: a systematic review. Qual Life Res 2020; 30:983-995. [DOI: 10.1007/s11136-020-02690-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 01/14/2023]
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Kall M, Marcellin F, Harding R, Lazarus JV, Carrieri P. Patient-reported outcomes to enhance person-centred HIV care. Lancet HIV 2019; 7:e59-e68. [PMID: 31776101 DOI: 10.1016/s2352-3018(19)30345-5] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 12/19/2022]
Abstract
Quality of life has been proposed as the fourth 90 to complement the UNAIDS 90-90-90 targets to monitor the global HIV response, highlighting a need to address the holistic needs of people living with HIV beyond viral suppression. This proposal has instigated a wider discussion about the use of patient-reported outcomes (PROs) to improve the treatment and care of an ageing HIV population with increasing comorbidities and a disproportionate burden of social problems. PROs can provide a first-hand assessment of the impact of HIV treatment and care on patients' quality of life, including symptoms. The field of PRO measures is rapidly expanding but still no gold standard exists, raising concerns about tool selection. Challenges also remain in the collection, interpretation, and use of PRO data to improve the performance of the health system. An emerging concern is how to adapt PROs to different sociocultural and geographical settings.
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Affiliation(s)
- Meaghan Kall
- HIV/STI Department, National Infection Service, Public Health England, London, UK.
| | - Fabienne Marcellin
- Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Richard Harding
- Florence Nightingale Faculty of Nursing, Midwifery, and Palliative Care, Cicely Saunders Institute, Kings College London, London, UK
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Patrizia Carrieri
- Aix Marseille University, Institut National de la Santé et de la Recherche Médicale, Institution Française Publique de Recherche, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale, Marseille, France; Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
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Health-related quality of life (HRQoL) and its correlates among community-recruited children living with HIV and uninfected children born to HIV-infected parents in West Bengal, India. Qual Life Res 2017; 26:2171-2180. [PMID: 28343351 DOI: 10.1007/s11136-017-1557-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Helping children living with HIV (CLH) to attain an optimum quality of life is an important goal for HIV programs around the world. Our principal objectives were to determine the association of HIV infection with different domains of health-related quality of life (HRQoL) among 8- to 15-year-old CLH in India and to compare the HRQoL parameters between CLH and HIV-negative children born to HIV-infected parents ("HIV-affected"). We also assessed whether antiretroviral therapy (ART) and CD4 lymphocyte counts were associated with HRQoL among CLH. METHODS Using the "Quality of Life (health-related) of Children Living with HIV/AIDS in India" instrument, we interviewed 199 CLH and 194 HIV-affected children from three districts of West Bengal, India. Participants were asked to quantify the difficulties faced by them in six HRQoL domains: physical, emotional, social, school functioning, symptoms, and discrimination. RESULTS The mean age of the participants was 11.6 (SD ± 2.5) years. CLH, compared to HIV-affected children, had poorer scores on all HRQoL domains except 'discrimination.' Among CLH, there were no significant differences in HRQoL domain scores (except in the 'discrimination' domain) between ART-treated and -untreated groups. CD4 lymphocyte count was found to be a significant positive predictor of the 'symptom' scale score. CONCLUSIONS In India, interventions for CLH mostly focus on biological disease. However, the current study revealed that HRQoL among CLH was much poorer than that of a socio-demographically comparable group. Culturally and developmentally appropriate psychosocial support measures for Indian CLH are urgently needed.
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Das A, Detels R, Afifi AA, Javanbakht M, Sorvillo F, Panda S. Formation and psychometric evaluation of a health-related quality of life instrument for children living with HIV in India. J Health Psychol 2016; 23:577-587. [PMID: 27703079 DOI: 10.1177/1359105316671022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In-depth interviews and focus group discussions were conducted to inform the development of an instrument to measure the health-related quality of life of children living with HIV. The QOL-CHAI instrument consists of four generic core scales of the "Pediatric Quality of Life Inventory" and two HIV-targeted scales-"symptoms" and "discrimination." A piloting exercise involving groups of children living with HIV and HIV-negative children born to HIV-infected parents provided evidence for the acceptable psychometric properties and usability of the instrument. It is expected that the QOL-CHAI can serve well as a brief, standardized, and culturally appropriate instrument for assessing health-related quality of life of Indian children living with HIV.
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Affiliation(s)
- Aritra Das
- 1 Fielding School of Public Health, University of California, Los Angeles, USA
| | - Roger Detels
- 1 Fielding School of Public Health, University of California, Los Angeles, USA
| | - Abdelmonem A Afifi
- 1 Fielding School of Public Health, University of California, Los Angeles, USA
| | - Marjan Javanbakht
- 1 Fielding School of Public Health, University of California, Los Angeles, USA
| | - Frank Sorvillo
- 1 Fielding School of Public Health, University of California, Los Angeles, USA
| | - Samiran Panda
- 2 National Institute of Cholera and Enteric Diseases, India
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Cohen S, ter Stege JA, Weijsenfeld AM, van der Plas A, Kuijpers TW, Reiss P, Scherpbier HJ, Haverman L, Pajkrt D. Health-related quality of life in perinatally HIV-infected children in the Netherlands. AIDS Care 2015; 27:1279-88. [PMID: 26272357 DOI: 10.1080/09540121.2015.1050986] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Combination antiretroviral therapy (cART) can alter HIV infection in children into a chronic condition. Studies investigating health-related quality of life (HRQoL) in HIV-infected children are scarce, and lacking from Western Europe. This study aimed to compare the HRQoL of clinically stable perinatally HIV-infected children to healthy, socioeconomically (SES)-matched controls as well as the Dutch norm population, and to explore associations between HIV and cART-related factors with HRQoL. HIV-infected and healthy children aged 8-18 years completed the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™). We determined differences between groups on PedsQL™ mean scores, and the proportion of children with an impaired HRQoL per group (≥1 SD lower than the Dutch norm population). Logistic regression models were used to explore associations between disease-related factors and HRQoL impairment. In total, 33 HIV-infected and 37 healthy children were included. There were no differences in the mean PedsQL™ subscales between HIV-infected children and both control groups. The proportion of children with an impaired HRQoL was higher in the HIV-infected group (27%) as compared to the healthy control group (22%) and the Dutch norm (14%) on the school functioning subscale (HIV vs. Dutch norm: P = .045). Mean scores of HRQoL of perinatally HIV-infected children in the Netherlands were not different from a SES-matched control group, or from the Dutch norm population. However, the HIV-infected group did contain more children with HRQoL impairment, suggesting that HIV-infected children in the Netherlands are still more vulnerable to a compromised HRQoL.
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Affiliation(s)
- Sophie Cohen
- a Department of Paediatric Hematology, Immunology, and Infectious Diseases , Emma Children's Hospital, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - Jacqueline A ter Stege
- a Department of Paediatric Hematology, Immunology, and Infectious Diseases , Emma Children's Hospital, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands.,b Psychosocial Department , Emma Children's Hospital, Academic Medical Center , The Netherlands
| | - Annouschka M Weijsenfeld
- a Department of Paediatric Hematology, Immunology, and Infectious Diseases , Emma Children's Hospital, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - Atie van der Plas
- a Department of Paediatric Hematology, Immunology, and Infectious Diseases , Emma Children's Hospital, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - Taco W Kuijpers
- a Department of Paediatric Hematology, Immunology, and Infectious Diseases , Emma Children's Hospital, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - Peter Reiss
- c Department of Internal Medicine, Division of Infectious Diseases , Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center , Amsterdam , The Netherlands.,d Department of Global Health , Academic Medical Center, University of Amsterdam, and Amsterdam Institute of Global Health and Development , Amsterdam , The Netherlands.,e Amsterdam Institute of Global Health and Development , Amsterdam , The Netherlands.,f HIV Monitoring Foundation , Amsterdam , The Netherlands
| | - Henriette J Scherpbier
- a Department of Paediatric Hematology, Immunology, and Infectious Diseases , Emma Children's Hospital, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
| | - Lotte Haverman
- b Psychosocial Department , Emma Children's Hospital, Academic Medical Center , The Netherlands
| | - Dasja Pajkrt
- a Department of Paediatric Hematology, Immunology, and Infectious Diseases , Emma Children's Hospital, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
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Tulloch O, Theobald S, Ananworanich J, Chasombat S, Kosalaraksa P, Jirawattanapisal T, Lakonphon S, Lumbiganon P, Taegtmeyer M. From transmission to transition: lessons learnt from the Thai paediatric antiretroviral programme. PLoS One 2014; 9:e99061. [PMID: 24893160 PMCID: PMC4043947 DOI: 10.1371/journal.pone.0099061] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 04/28/2014] [Indexed: 12/04/2022] Open
Abstract
Background The Thai HIV programme is a leader in the public health approach to HIV treatment. Starting at transmission of HIV and ending with transition to adult services this paper assesses the paediatric HIV treatment continuum from three perspectives: service-user, provider and policy maker, to understand what works well and why. Methods A qualitative research design was used to assess and triangulate the stakeholder perspectives. Semi-structured interviews were conducted with ART service-users (n = 35), policy actors (n = 20); telephone interviews with prior caregivers of orphans (n = 10); and three focus group discussions with service-providers (hospital staff and volunteers) from a district, provincial and a university hospital. Findings Children accessing HIV care were often orphaned, cared for by elderly relatives and experiencing multiple vulnerabilities. Services were divided into three stages, 1. Diagnosis and linkage: Despite strong policies there were supply and demand-side gaps in the prevention of mother-to-child transmission ‘cascade’ preventing early diagnosis and/or treatment. 2. Maintenance on ART - Children did well on treatment; caregivers took adherence seriously and valued the quality of services. Drug resistance, adherence and psychosocial issues were important concerns from all perspectives. 3. Adolescents and transition: Adolescent service-users faced greater complexity in their physical and emotional lives for which providers lacked skills; transition from the security of paediatric clinic was a daunting prospect. Dedicated healthcare providers felt they struggled to deliver services that met service-users' diverse needs at all stages. Child- and adolescent-specific elements of HIV policy were considered low priority. Conclusions Using the notion of the continuum of care a number of strengths and weaknesses were identified. Features of paediatric services need to evolve alongside the changing needs of service users. Peer-support volunteers have potential to add continuity and support at all stages. It is critical that adolescents receive targeted support, particularly during transition to adult services.
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Affiliation(s)
- Olivia Tulloch
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- * E-mail:
| | - Sally Theobald
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Jintanat Ananworanich
- SEARCH and HIV-NAT, The Thai Red Cross AIDS Research Center, Bangkok, Thailand
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sanchai Chasombat
- Bureau of AIDS, Tuberculosis and Sexually Transmitted Infections, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Pope Kosalaraksa
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Thidaporn Jirawattanapisal
- Bureau of AIDS, Tuberculosis and Sexually Transmitted Infections, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Sudrak Lakonphon
- SEARCH and HIV-NAT, The Thai Red Cross AIDS Research Center, Bangkok, Thailand
| | - Pagakrong Lumbiganon
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Miriam Taegtmeyer
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Mabugu T, Revill P, van den Berg B. The Methodological Challenges for the Estimation of Quality of Life in Children for Use in Economic Evaluation in Low-Income Countries. Value Health Reg Issues 2013; 2:231-239. [PMID: 29702870 DOI: 10.1016/j.vhri.2013.07.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The assessment of quality of life (QOL) in children has been underresearched in high- and low-income countries alike. This is partly due to practical and methodological challenges in characterizing and assessing children's QOL. This article explores these challenges and highlights considerations in developing age-specific instruments for children affected by HIV and other health conditions in Africa and other low-income settings. METHODS A literature search identified works that have 1) developed, 2) derived utilities for, or 3) applied QOL tools for use in economic evaluations of HIV interventions for children. We analyzed the existing tools specifically in terms of domains considered, variations in age bands, the recommended respondents, and the relevance of the tools to African and also other low-income country contexts. RESULTS Only limited QOL research has been conducted in low-income settings on either adults or children with HIV. A few studies have developed and applied tools for children (e.g., in Thailand, Brazil, and India), but none have been in Africa. The existing methodological literature is inconclusive on the appropriate width or depth by which to define pediatric QOL. The existing instruments include QOL domains such as "physical functioning," "emotional and cognitive functioning," "general behavior (social, school, home)," "health perception," "coping and adaptation," "pain and discomfort," "extended effects," "life perspective," and "autonomy." CONCLUSIONS QOL assessment in children presents a series of practical and methodological challenges. Its application in low-income settings requires careful consideration of a number of context-specific factors.
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Affiliation(s)
- Travor Mabugu
- Clinical Research Centre, University of Zimbabwe, Harare, Zimbabwe.
| | - Paul Revill
- Centre for Health Economics, University of York, York, UK
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