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Shayan NA, Rahimi A, Stranges S, Thind A. Factors affecting quality of life in hepatitis B patients in Herat, Afghanistan: A case-control study. J Viral Hepat 2024. [PMID: 38787307 DOI: 10.1111/jvh.13961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 04/30/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
Hepatitis B virus is a global health concern with a high death rate in Afghanistan. Limited data exist on the disease's impact on quality of life in low-resource settings. This case-control study aims to identify potential risk factors and assess the quality of life among hepatitis B patients in Herat, Afghanistan, with a focus on sex differences. Understanding these factors can inform prevention, care, and sex-specific interventions. A cross-sectional study conducted at Herat Regional Hospital examined hepatitis B patients above 18 years old, between October 2020 and February 2021. The control group consisted of age and sex-matched individuals without a history of hepatitis B. Data were collected through a structured questionnaire covering socio-demographic characteristics, signs and symptoms of hepatitis B, and the SF-36 questionnaire for measuring the quality of life of study participants. Statistical analysis was performed using multivariate General Linear Models, and logistic regression. We identified several potential risk factors for hepatitis B infection, including male sex, younger age groups, tobacco use, lower education levels, rural residence, family history, weak social networks, specific family structures and underlying chronic diseases (p < .05). The study found that hepatitis B cases had significantly lower mean scores across all SF-36 components, indicating an overall reduced quality of life (p < .05). These differences were more pronounced in males, although females had lower scores in most components. Role limitations due to physical and emotional health were particularly affected. These findings highlight the urgent need for targeted interventions, sex-specific strategies, improved healthcare access and comprehensive policies. These findings can inform prevention efforts to improve the overall quality of life of people with hepatitis B in Afghanistan.
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Affiliation(s)
- Nasar Ahmad Shayan
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Public Health and Infectious Disease, Faculty of Medicine, Herat University, Herat, Afghanistan
| | - Ali Rahimi
- Department of Curative Medicine, Faculty of Medicine, Jami University, Herat, Afghanistan
- Department of Pediatrics, Faculty of Medicine, Jami University, Herat, Afghanistan
| | - Saverio Stranges
- Department of Public Health and Infectious Disease, Faculty of Medicine, Herat University, Herat, Afghanistan
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Amardeep Thind
- Department of Public Health and Infectious Disease, Faculty of Medicine, Herat University, Herat, Afghanistan
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Farooq J, Sana M, Chetana P, Almuqbil M, Prabhakar Bhat N, Sultana R, Khaiser U, Mohammed Basheeruddin Asdaq S, Almalki MEM, Mohammed sawadi Khormi A, Ahmad Albraiki S, Almadani ME. Polypharmacy in chronic liver disease patients: Implications for disease severity, drug-drug interaction, and quality of life. Saudi Pharm J 2023; 31:101668. [PMID: 37576859 PMCID: PMC10415215 DOI: 10.1016/j.jsps.2023.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/03/2023] [Indexed: 08/15/2023] Open
Abstract
Multiple prescriptions for different medications may be needed for chronic conditions, increasing the risk of polypharmacy. The WHO defined polypharmacy as "the administration of many drugs at the same time or the administration of an excessive number of drugs". The primary goal of this study was to evaluate polypharmacy in patients with chronic liver disease and to identify potential drug-drug interactions associated with it. A cross-sectional study was conducted at a tertiary care hospital in Mangalore, Karnataka, for six months, from November 2020 to April 2021. The study involved 118 patients with chronic liver disease from various age groups. Data was gathered by analyzing patients' medical records kept on the ward and interviewing them individually. In admission and discharge prescriptions, polypharmacy was examined. Online interaction checkers from Drugs.com and Medscape were used to interpret potential drug-drug interactions. The SF-36 and Chronic Liver Disease Questionnaire were used to measure the quality of life. The data obtained were analyzed statistically to determine the significant correlation. The number of prescribed drugs was significantly correlated (P = 0.018) with the severity of liver disease in Child-Pugh categories B and C. Additionally, moderate polypharmacy reduced quality of life (P < 0.05), and the physical health category was significantly associated with disease severity (P < 0.05). Drug-drug interactions were found in 108 out of the 118 examined prescriptions, totaling 586 interactions in the admission list and 405 interactions in the discharge list. If the potentially serious main drug interaction identified in this study is not well monitored, it could lead to a serious, potentially fatal health condition. Despite being advised, safety is not always guaranteed by liver enzyme monitoring. Therefore, healthcare providers must take additional precautions to avoid inappropriate prescribing, minimize side effects, and ensure drug safety.
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Affiliation(s)
- Juveriya Farooq
- Department of Pharmacy Practice, Shree Devi College of Pharmacy, Mangaluru, 574142, Karnataka, India
- Department of pharmacology, Yenepoya (Deemed to be) University, Deralakatte, 575018, Karnataka, India
| | - M.M. Sana
- Department of Pharmacy Practice, Shree Devi College of Pharmacy, Mangaluru, 574142, Karnataka, India
| | - P.M. Chetana
- Department of Pharmacy Practice, Shree Devi College of Pharmacy, Mangaluru, 574142, Karnataka, India
| | - Mansour Almuqbil
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Nagapati Prabhakar Bhat
- Department of pharmacology, Yenepoya (Deemed to be) University, Deralakatte, 575018, Karnataka, India
| | - Rokeya Sultana
- Department of Pharmacognosy, Yenepoya Pharmacy College & Research Centre, Yenepoya (Deemed to be) University, Deralakatte, 575018, Karnataka, India
| | - UmaimaFarheen Khaiser
- Department of Pharmacy Practice, Yenepoya Pharmacy College & Research Centre, Yenepoya (Deemed to be) University, Deralakatte, 575018, Karnataka, India
| | | | | | - Amro Mohammed sawadi Khormi
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Dariyah, Riyadh 13713, Saudi Arabia
- King Saud University Medical city, Riyadh, Saudi Arabia
| | | | - Moneer E. Almadani
- Department of clinical medicine, College of medicine, AlMaarefa University, Dariyah, Riyadh 13713, Saudi Arabia
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Chugh Y, Katoch S, Sharma D, Bahuguna P, Duseja A, Kaur M, Dhiman RK, Prinja S. Health-Related Quality of Life Among Liver Disorder Patients in Northern India. Indian J Community Med 2022; 47:76-81. [PMID: 35368487 PMCID: PMC8971888 DOI: 10.4103/ijcm.ijcm_1033_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/29/2021] [Indexed: 11/26/2022] Open
Abstract
Objective: The present study aims to determine the health-related quality of life (HRQoL) among liver disorder patients being treated in tertiary care hospital in north India and exploration of factors affecting HRQoL. Methodology: The HRQoL was assessed among 230 patients visiting either the outpatient department (OPD) or those admitted in high dependency unit (HDU) or liver intensive care unit (ICU) using direct measuring tools such as Euro QoL five-dimension questionnaire (EQ-5D) and EQ visual analog scale. Multivariate regression was used to explore the factors influencing HRQoL. Results: Mean EQ-5D scores among chronic hepatitis and compensated cirrhosis patients were 0.639 ± 0.062 and 0.562 ± 0.048, respectively. Among those who were admitted in the ICU or HDU, mean EQ-5D score was 0.295 ± 0.031. At discharge, this score improved significantly to 0.445 ± 0.055 (P < 0.001). The multivariate results implied that HRQoL was significantly better among patients with lower literacy level (P = 0.018) and those treated in OPD settings (P < 0.001). Conclusion: HRQoL is impaired among patients suffering from liver disorders specifically those admitted in ICU. Further, there is a need to generate more evidence to explore the impact of determinants and treatment-associated costs on the HRQoL.
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Affiliation(s)
- Yashika Chugh
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Swati Katoch
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepshikha Sharma
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Bahuguna
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Duseja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manmeet Kaur
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radha Krishan Dhiman
- Department of Hepatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Health-related quality of life improves after entecavir treatment in patients with compensated HBV cirrhosis. Hepatol Int 2021; 15:1318-1327. [PMID: 34843068 DOI: 10.1007/s12072-021-10240-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIM Antiviral therapy is effective in decreasing disease progression in HBV cirrhosis. However, the long-term effect of antiviral therapy on health-related quality of life (HRQoL) in patients with compensated HBV cirrhosis is unknown. METHODS The patients with compensated HBV cirrhosis enrolled in a randomized controlled trial of entecavir-based therapy were recruited in the present study, if they had HRQoL score at 5-year follow-up or who developed liver-related events (LRE) during follow-up were included. HRQoL was measured with 36-Item Short-Form Health Survey (SF-36) and EuroQol-5D (EQ-5D) at baseline and yearly during follow-up. LRE was defined as the development of decompensation, HCC, or death. RESULTS A total of 161 patients were included in the present study, with a median age of 48.0 (41.0, 53.0) years, 77.6% being male and 37.2% being HBeAg-positive. During 5 years, 45 patients developed LRE. All eight dimensions of SF-36 were significantly improved after 5 years of antiviral therapy (all p < 0.001), with all dimensions improved more than five points except for physical functioning. Proportion of patients reporting no problems in all five dimensions in EQ-5D increased from 57.8 to 72.0%; visual analogue scale (VAS) and utility index (UI) increased significantly (VAS 79.8 ± 16.4 to 84.4 ± 13.2, UI 0.91 ± 0.13 to 0.95 ± 0.10, both p < 0.001). HRQoL improved or kept stable in the majority of patients who had LRE during follow-up, even stratified by Baveno VI criteria for clinically significant portal hypertension. CONCLUSION After 5 years of ETV treatment, HRQoL significantly improved in patients with compensated HBV cirrhosis. (NCT01943617, NCT02849132).
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Grønkjær LL, Lauridsen MM. Quality of life and unmet needs in patients with chronic liver disease: A mixed-method systematic review. JHEP REPORTS : INNOVATION IN HEPATOLOGY 2021; 3:100370. [PMID: 34805816 PMCID: PMC8585663 DOI: 10.1016/j.jhepr.2021.100370] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/23/2021] [Accepted: 09/21/2021] [Indexed: 02/06/2023]
Abstract
Background & Aims In an attempt to uncover unmet patient needs, this review aims to synthesise quantitative and qualitative studies on patients’ quality of life and their experience of having liver disease. Methods Three databases (CINAHL, Embase, and PubMed) were searched from January 2000 to October 2020. The methodological quality and data extraction of both quantitative and qualitative studies were screened and appraised using Joanna Briggs Institute instruments for mixed-method systematic reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A convergent, integrated approach to synthesis and integration was used. Studies including patients with autoimmune and cholestatic liver disease, chronic hepatitis B and C, non-alcoholic fatty liver disease and non-alcoholic steatohepatitis, cirrhosis, and hepatocellular carcinoma were considered. Results The searches produced 5,601 articles, of which 95 (79 quantitative and 16 qualitative) were included in the review. These represented studies from 26 countries and a sample of 37,283 patients. The studies showed that patients´ quality of life was reduced. Unmet needs for information and support and perceived stigmatisation severely affected patients’ quality of life. Conclusions Our study suggests changes to improve quality of life. According to patients, this could be achieved by providing better education and information, being aware of patients’ need for support, and raising awareness of liver disease among the general population to reduce misconceptions and stigmatisation. Registration number PROSPERO CRD42020173501. Lay summary Regardless of aetiology, patients with liver diseases have impaired quality of life. This is associated with disease progression, the presence of symptoms, treatment response, and mental, physical, and social factors such as anxiety, confusion, comorbidities, and fatigue, as well as limitations in daily living, including loneliness, low income, stigmatisation, and treatment costs. Patients highlighted the need for information to understand and manage liver disease, and awareness and support from healthcare professionals to better cope with the disease. In addition, there is a need to raise awareness of liver diseases in the general population to reduce negative preconceptions and stigmatisation. Patients with liver disease regardless of aetiology and severity have impaired quality of life. Patients call for better education and information to understand and manage their liver disease, and for increased awareness and support from healthcare professionals. Owing to the limited knowledge of liver diseases among the general population, patients experience stigmatisation, resulting in loneliness and social isolation. Addressing unmet needs of patients with liver disease could improve their quality of life.
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Key Words
- CLDQ, Chronic Liver Disease Questionnaire
- EQ-5D, European Quality of Life
- FACT-Hep, Functional Assessment of Cancer Therapy Hepatobiliary Carcinoma
- HBQOL, Hepatitis B Quality of Life
- HCC, hepatocellular carcinoma
- JBI, Joanna Briggs Institute
- LC-PROM, Liver Cirrhosis Patient Reported Outcome Measure
- LDQOL, Liver Disease Quality of Life
- Liver disease
- MELD, model for end-stage liver disease
- Mixed method
- NAFLD, non-alcoholic fatty liver disease
- NASH, non-alcoholic steatohepatitis
- PBC, Primary Biliary Cholangitis Questionnaire
- Patient experience
- Patient reported outcomes
- PedsQL, Pediatric Quality of Life Inventory
- Quality of life
- SF, Short Form
- SIP, Sickness Impact Profile
- Systematic review
- Unmet needs
- VAS, visual analogue scale
- WHOQOL-BREF, WHO Quality of Life
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Affiliation(s)
- Lea Ladegaard Grønkjær
- Department of Gastroenterology, University Hospital of Southern Denmark, Esbjerg, Denmark
- Corresponding author. Address: Department of Gastroenterology, University Hospital of Southern Denmark, Finsensgade 35, 6700 Esbjerg, Denmark. Tel.: +45-26668184; Fax: +45-79182316.
| | - Mette Munk Lauridsen
- Department of Gastroenterology, University Hospital of Southern Denmark, Esbjerg, Denmark
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Freeland C, Racho R, Kamischke M, Moraras K, Wang E, Cohen C, Kendrick S. Health-related quality of life for adults living with hepatitis B in the United States: a qualitative assessment. J Patient Rep Outcomes 2021; 5:121. [PMID: 34757456 PMCID: PMC8581088 DOI: 10.1186/s41687-021-00398-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 2019, an estimated 296 million people were living with chronic hepatitis B virus (HBV) globally with approximately 2.4 million living within the United States. Those living with HBV require years if not decades of regular monitoring to prevent liver complications from occurring. The aim of this study was to explore the working conceptual framework of health related quality of life (HRQL) for those living with chronic HBV through qualitative analysis. METHODS Data were collected by in-depth telephone interviews conducted in 2019 using purposeful sampling as part of a disease understanding assessment on the HBV patient experience within the United States. A directed content analysis approach was utilized by creation of a codebook to guide the organization of data, codes were developed by review of the literature (a priori) and through line-by-line reading of a subsample of queries. All transcripts were analyzed by at least two members of the study team and intercoder reliability was assessed using Dedoose software. FINDINGS A sample of 19 individuals living with chronic HBV were included within this study. Themes identified from transcripts noted the significant overlap between the reported experience of HBV and constructs within the HRQL model. The psychological impact of chronic HBV on study participants' HRQL overall was considerable and contributed to depression, anxiety, homelessness, drug use, and incarceration. CONCLUSION Our analysis supports the hypothesis that HBV impacts HRQL and often negatively affects emotional health. Our findings suggest that it would be beneficial to include HRQL assessment in the medical management of HBV, so that interventions can focus on reducing the burden of disease and improving quality of life for those living with HBV.
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Affiliation(s)
- Catherine Freeland
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA, 18902, USA.
| | - Rhea Racho
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA, 18902, USA
| | - Maureen Kamischke
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA, 18902, USA
| | - Kate Moraras
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA, 18902, USA
| | - Evangeline Wang
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA, 18902, USA
| | - Chari Cohen
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA, 18902, USA
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Wang L, Shi F, Guan X, Xu H, Liu J, Li H. A Systematic Review of Methods and Study Quality of Economic Evaluations for the Treatment of Schizophrenia. Front Public Health 2021; 9:689123. [PMID: 34746073 PMCID: PMC8564012 DOI: 10.3389/fpubh.2021.689123] [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: 03/31/2021] [Accepted: 09/21/2021] [Indexed: 02/03/2023] Open
Abstract
Background: Schizophrenia is a severe and complex disease with substantial economic and social burdens. Despite multiple treatment choices, adverse events, and impaired social functions are still challenges in clinical therapy. Pharmacoeconomic evaluations could provide evidence to help decision makers improve the utilization of scarce resources. However, there remains some challenges especially in modeling due to uncertainties in progression of schizophrenia. There are limited summaries about the overall methodologies of schizophrenia economic evaluations. Objective: The aim of this study is to review the existing economic evaluations of antipsychotics for the treatment of schizophrenia and summarize the evidence and methods applied. Methods: An electronic literature search was performed in PubMed, Web of Science, EBSCO host, The Cochrane Library and ScienceDirect from January 2014 to December 2020. Search terms included “schizophrenia,” “schizophrenic,” “pharmacoeconomic,” “economic evaluation,” “cost-effectiveness,” and “cost-utility.” The Literature was screened and extracted by two researchers independently and assessed with the Quality of Health Economic Studies (QHES) List and Consolidated Health Economic Evaluation Reporting Standards (CHEERS) Statement. Results: A total of 25 studies were included in the review. The regions included Europe, North America, Asia and Africa. Most of the studies chose second-generation antipsychotics as comparators and integrated treatment sequences. Time horizons varied from 1 year to lifetime. The healthcare sector was the most common perspective, accordingly, most of the evaluations considered only direct medical costs. The Markov model and decision tree model were the most common choices. Adverse events, compliance and persistence were considered important parameters. Quality-adjusted life-years were the major outcomes applied to the economic evaluations. All utilities for health states and adverse events were collected from published literature. All of the studies applied uncertainty analysis to explore the robustness of the results. The quality of the studies was generally satisfactory. However, improvements were needed in the choice of time horizons, the measurements of outcomes and the descriptions of assumptions. Conclusions: This study highlights the methodology of economic evaluation of schizophrenia. Recommendations for modeling method and future study are provided.
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Affiliation(s)
- Luying Wang
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.,Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
| | - Fenghao Shi
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.,Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
| | - Xin Guan
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.,Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
| | - He Xu
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.,Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
| | - Jing Liu
- Sumitomo Pharma (Suzhou) Co., Ltd., Shanghai, China
| | - Hongchao Li
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.,Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, China
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Zhang M, Li Y, Fan Z, Shen D, Huang X, Yu Q, Liu M, Ren F, Wang X, Dai L, Wang P, Ye H, Shi J, Yang X, Zhang S, Zhang J. Assessing health-related quality of life and health utilities in patients with chronic hepatitis B-related diseases in China: a cross-sectional study. BMJ Open 2021; 11:e047475. [PMID: 34526336 PMCID: PMC8444251 DOI: 10.1136/bmjopen-2020-047475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES The health-related quality of life (HRQoL) and utilities of patients with chronic hepatitis B (CHB) virus infection, including compensated cirrhosis (CC), decompensated cirrhosis (DC) and different stages of hepatocellular carcinoma (HCC), have not been well described in China. This study aimed to evaluate HRQoL and utilities and provide parameters for the economic evaluation of CHB-related diseases. METHODS We conducted a multicentre cross-sectional and study to measure the HRQoL of patients with CHB, CC, DC and HCC using the Chinese short form (SF) 36 health survey V.2. The utilities were extracted based on the SF-six dimension scoring model. Multivariable regression analyses identified the effects on HRQoL. RESULTS A total of 1071 patients (639 with CHB, 125 with CC, 85 with DC and 222 with HCC) were invited to complete the questionnaire. Physical HRQoL was not impaired in the CHB stage, while mental HRQoL was significantly impaired. Physical composite summary scores have a more significant decrease than mental composite summary scores at the advanced stages (CC, DC and HCC). The utility scores of CHB only, CC, DC and HCC were 0.773, 0.750, 0.683 and 0.640, respectively. The utility scores in the early, middle and terminal stages of HCC were 0.656, 0.635 and 0.615, respectively. CONCLUSION Slowing the progress of CHB-related diseases and providing psychological support early are the key points to improving the quality of life with the diseases. The utility values estimated in this study can provide a vital instrument for cost-effectiveness studies on CHB-related diseases.
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Affiliation(s)
- Meng Zhang
- Department of Epidemiology and Health Statistics & Henan Key Laboratory for Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yaoguang Li
- Department of Epidemiology and Health Statistics & Henan Key Laboratory for Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Zihao Fan
- Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Dongqi Shen
- Hepatobiliary and Pancreatic Surgery, The First Affillated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Xueying Huang
- Department of Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Qi Yu
- Department of Interventional Radiology, The First Affillated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Mei Liu
- Department of Oncology, Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Feng Ren
- Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xiao Wang
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Henan Academy of Medical and Pharmaceutical Sciences & BGI College, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Liping Dai
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Henan Academy of Medical and Pharmaceutical Sciences & BGI College, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Peng Wang
- Department of Epidemiology and Health Statistics & Henan Key Laboratory for Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Hua Ye
- Department of Epidemiology and Health Statistics & Henan Key Laboratory for Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Jianxiang Shi
- State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Henan Academy of Medical and Pharmaceutical Sciences & BGI College, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xiaoang Yang
- Henan Academy of Medical and Pharmaceutical Sciences & BGI College, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Shunxiang Zhang
- Department of Epidemiology and Health Statistics & Henan Key Laboratory for Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Henan Academy of Medical and Pharmaceutical Sciences & BGI College, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Jianying Zhang
- Department of Epidemiology and Health Statistics & Henan Key Laboratory for Tumor Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- Henan Academy of Medical and Pharmaceutical Sciences & BGI College, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
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Health-Related Quality of Life and Its Influencing Factors in Patients with Hepatitis B: A Cross-Sectional Assessment in Southeastern China. Can J Gastroenterol Hepatol 2021; 2021:9937591. [PMID: 34307240 PMCID: PMC8279869 DOI: 10.1155/2021/9937591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/27/2021] [Indexed: 11/24/2022] Open
Abstract
Health-related quality of life (HRQoL) is an important aspect in the management of patients with hepatitis B (HB), which remains a serious health problem in China. There have been relatively few HRQoL studies involving Chinese patients with HB. The aim of this study was to analyze HRQoL in patients diagnosed with HB living in Zhejiang Province, China. A cross-sectional sample of 98 patients with chronic HB (CHB), 56 patients with advanced HB that have developed cirrhosis, and 48 healthy controls (HCs), all from Zhejiang Province, was used in this study. HRQoL was assessed using Short-Form 36 (SF-36) version 2, European quality of life questionnaire-5 dimensions (EQ-5D), and chronic liver disease questionnaire (CLDQ). Intergroup score differences were detected with U tests. Factors with a significant effect on HRQoL were identified with Spearman correlational analyses. Patients with HB (both groups) had lower SF-36 scores than HCs (p < 0.01), with the exception of general health subscores. Patients with HB cirrhosis had the lowest scores in the EQ-5D visual analog scale (VAS) component. Furthermore, patients with HB cirrhosis had lower (p < 0.01) CLDQ scores than patients with CHB. In our HB patient cohort, disease stage and income level were the factors most associated with HRQoL variables; age, education level, and marital status were, each, also significantly associated with some HRQoL variables in patients with HB in our study (p < 0.05 or p < 0.01). HRQoL is diminished in patients with HB in southeastern China. Disease stage and income emerged as key determinants of HRQoL scores. Augmenting social and medical supports for patients with HB, especially those with a socioeconomic status and an advanced disease stage, may help to enhance HRQoL.
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Bauquier C, Préau M. Contribution of HIV/AIDS-Related Human and Social Sciences Research to a Better Understanding of the Challenges of Hepatitis B Prevention, Diagnosis and Care. Microorganisms 2021; 9:microorganisms9061166. [PMID: 34071536 PMCID: PMC8230355 DOI: 10.3390/microorganisms9061166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 01/05/2023] Open
Abstract
Recent scientific advances in hepatitis B virus research hint at the possibility of finding a cure in the medium term. In this context, the characterization of infected persons constitutes a major public health issue in terms of implementing adapted screening and prevention strategies. Overcoming the current challenges national health systems face in hepatitis B diagnosis is essential if the World Health Organization’s target of treating 80% of infected patients by 2030 is to be reached. These challenges reflect those previously faced in the fight against HIV/AIDS. Using the knowledge produced to date in Human and Social Sciences research in the fight against HIV/AIDS, we propose avenues of reflection to support and guide the development of research in the diagnosis of hepatitis B infection. More specifically, we present theoretical, methodological and epistemological considerations for how HSS research can be optimized in the following three HBV diagnosis-related areas: (i) access to screening; (ii) retention in care; and (iii) the integration of quality of life measurement in clinical trials.
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Firkins JL, Tarter R, Driessnack M, Hansen L. A closer look at quality of life in the hepatocellular carcinoma literature. Qual Life Res 2021; 30:1525-1535. [PMID: 33625648 DOI: 10.1007/s11136-021-02789-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 01/11/2023]
Abstract
PURPOSE Adults with hepatocellular carcinoma (HCC) have a high symptom burden. Their quality of life (QOL) has been shown to be significantly impacted by both the disease and its treatment, adding to the high symptom burden that these patients experience. The primary aims of this paper are as follows: (1) to identify how QOL is being defined in HCC literature and (2) to identify how QOL is being measured in the HCC literature using Ferrell's model of QOL. METHODS A systematic review was completed of relevant studies published after 2014, using PubMed, CINHAL, and PsycInfo. Relevant studies were reviewed by 2 reviewers using PRISMA guidelines. RESULTS From a total of 1312 papers obtained in the initial database search, 30 met inclusion criteria and are included in this review. From the included articles, 10% included a definition of QOL and 3% addressed the spiritual domain of QOL. Majority of study participants were in the early stage of HCC, though the majority of adults with HCC are diagnosed in the advanced stage. Only 3% of included studies included greater than 22% population of advanced stage of HCC. CONCLUSION The results of this systematic review demonstrate the need for future research into QOL in the advanced stage of QOL. It also identified gap in the literature concerning the definition of QOL in HCC and the spiritual domain of QOL in HCC.
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Affiliation(s)
- Jenny L Firkins
- School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA.
| | - Robin Tarter
- School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA
| | - Martha Driessnack
- School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA
| | - Lissi Hansen
- School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA
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Mahassadi AK, Team Machekam O, Attia AK. The Impact of Virologic Parameters and Liver Fibrosis on Health-Related Quality of Life in Black African Patients with Chronic Hepatitis B: Results from a High Endemic Area. Clin Exp Gastroenterol 2020; 13:407-418. [PMID: 33061519 PMCID: PMC7537806 DOI: 10.2147/ceg.s255102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/31/2020] [Indexed: 11/23/2022] Open
Abstract
Background The effects of virologic parameters, liver fibrosis, and treatment on the HRQoL in black African patients with CHB are unknown. Objective To determine the magnitude and the effects of hepatitis B e antigen (HBeAg), hepatitis B surface antigenemia (HBs antigenemia), viral load, liver fibrosis and treatment on HRQoL impairment in black African patients with CHB using the SF36 (SF36) and chronic liver disease questionnaires (CLDQ). Materials and Methods HRQoL comparison was determined in a case–control study and enrolled 214 patients with CHB (mean age: 42 years, male: 65.9%) and 210 healthy controls subjects (mean age: 37.8 years; male: 63.8%). Control subjects were younger than those with CHB (p=0.01). Analysis of covariance, Welch test and linear regression were used to compare HRQoL between subgroups. Results Adjusted to age and gender, patients with CHB elicited low mean scores on the subscales of role-physical (66.9 vs 78, p=0.001), role-emotional (64 vs 77.5, p=0.01), bodily pain (70.8 vs 96.2, p=0.001), social functioning (74.6 vs 84.5, p=0.003) and general health (64.6 vs 74.4, p=0.03) in comparison with control subjects. Multivariate analysis showed that CHB impaired HRQoL on physical (β= −16.7 (1.8), p<0.0001) and mental component summaries (β= −5.1 (2.0), p=0.01) adjusted to others variables. Patients with HBeAg negative CHB elicited low scores on physical (p=0.004) and mental (p=0.05) component summaries and low CLDQ’s average score (p=0.002) in comparison with those positive. Patients with low (≤1000 IU/mL) HBs antigenemia (p=0.03) or viral load (p=0.03) scored less on physical component summary and those with significant fibrosis or cirrhosis scored less (p=0.003) on mental component summary. Conclusion Black African patients with CHB expressed poor HRQoL, particularly those with HBeAg negative CHB, low viral load, or HBs Antigenemia.
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Affiliation(s)
- Alassan Kouamé Mahassadi
- Hepatology and Gastroenterology Unit, Yopougon Teaching Hospital, Abidjan, Côte d'Ivoire.,Faculty of Medicine, Department of Gastrointestinal Diseases, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire
| | - Olga Team Machekam
- Hepatology and Gastroenterology Unit, Yopougon Teaching Hospital, Abidjan, Côte d'Ivoire
| | - Alain Koffi Attia
- Hepatology and Gastroenterology Unit, Yopougon Teaching Hospital, Abidjan, Côte d'Ivoire.,Faculty of Medicine, Department of Gastrointestinal Diseases, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire
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Stigma in HBV-infected pregnant women in disclosed situations: Current status, influencing factors, and impacts on the quality of life. Appl Nurs Res 2020; 56:151347. [PMID: 33280787 DOI: 10.1016/j.apnr.2020.151347] [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] [Received: 10/10/2019] [Revised: 07/06/2020] [Accepted: 08/22/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Few studies have reported the status of stigma and the impact of stigma on the quality of life of HBV-infected pregnant women in disclosed situations. This study aims (a) to investigate the current status of the stigma of HBV-infected pregnant women in the situation of disease exposure, (b) to explore the influencing factors of the stigma, and (c) to identify the impacts quality of life. METHOD Using cross-sectional descriptive design and convenience sampling, 270 HBV-infected pregnant women from two infectious hospitals were investigated using the Chronic Hepatitis B Virus Infectors' Discrimination Measurement Scale, the Medical Outcomes Study Short-Form-36v2, and a demographic questionnaire. The collected data were analyzed by SPSS20.0. RESULTS The total stigma score is (74.05 ± 11.26). The variables of education, the payment method of medical expenses, living with family members, and spouse with hepatitis B virus infection accounted for 35.7% of the variance in the stigma altogether. Stigma is significantly negatively correlated with the quality of life and accounted for 18.1%-20.0% of the variance in scores for quality of life of HBV-infected pregnant women in disclosed situations. CONCLUSION The level of stigma and quality of life is serious in China. the stigma can significantly reduce the quality of life of affected individuals. Health care policy-maker and professionals should pay more attention to this issue and through improving health education, increasing the reimbursement rate of antiviral drugs and the number of professional medical staff to reduce stigma and promote their quality of life.
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Li G, Wang G, Hsu FC, Xu J, Pei X, Zhao B, Shetty A. Effects of Depression, Anxiety, Stigma, and Disclosure on Health-Related Quality of Life among Chronic Hepatitis B Patients in Dalian, China. Am J Trop Med Hyg 2020; 102:988-994. [PMID: 32124716 DOI: 10.4269/ajtmh.19-0007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Chronic hepatitis B virus (HBV) infection is a major public health problem in China. We evaluated the impact of psychosocial factors (stigma, disclosure, depression, and anxiety) on health-related quality of life (HRQoL) among people living with chronic HBV infection (CHB) in the city of Dalian, Liaoning Province, China. In this hospital-based cross-sectional study, 401 patients living with chronic HBV infection were enrolled as study participants. Study measures included the Beck depression and anxiety inventory, the WHO Quality of Life (WHOQOL-BREF) assessment, the Toronto Chinese HBV Stigma Scale, and disclosure of HBV status to sexual partners. The primary outcome was HRQoL score as measured by the WHOQOL-BREF. A linear regression model was used to examine the association between HRQoL and the potential risk factors including stigma, disclosure, depression, anxiety, and sociodemographic variables. Stigma, disclosure, depression, and anxiety were the covariates of interest. A majority of the participants were females (n = 251, 65.6%), married (81.6%), and had a college or higher degree (32.4%). Depression, anxiety, stigma, and disclosure of HBV infection were associated with low HRQoL in all four domains of the WHOQOL-BREF (physical, psychological, social, and environmental domains) (P < 0.05), when all psychological factors were included in the model separately. Depression was found to be independently associated with low HRQoL in people living with HBV, when all psychological factors were included in the model simultaneously (P < 0.0001). Our data indicate the urgent need for healthcare providers (HCPs) and policy-makers to implement psychological interventions to improve HRQoL among people living with CHB.
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Affiliation(s)
- Ge Li
- Department of Precision Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Gongchen Wang
- Department of Infectious Disease, Dalian Sixth People Hospital, Liaoning, China
| | - Fang-Chi Hsu
- Division of Public Health, Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jianzhao Xu
- Department of Biochemistry, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Xia Pei
- Department of Infectious Disease, Dalian Sixth People Hospital, Liaoning, China
| | - Bo Zhao
- Department of Infectious Disease, Dalian Sixth People Hospital, Liaoning, China
| | - Avinash Shetty
- Office of Global Health, Department of Pediatric/Infectious Disease, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Yi ZM, Men P, Qu S, Li C, Yu X, Zhai S. Comparative cost-effectiveness of amisulpride and olanzapine in the treatment of schizophrenia in China. Expert Rev Pharmacoecon Outcomes Res 2020; 20:313-320. [PMID: 32293194 DOI: 10.1080/14737167.2020.1752670] [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] [Indexed: 10/24/2022]
Abstract
BACKGROUND Both amisulpride and olanzapine are leading treatments for schizophrenia in China. This study aimed to investigate the long-term cost-effectiveness of amisulpride and olanzapine in the treatment of schizophrenia in China. METHODS A decision-analytic Markov model was developed to simulate the lifetime clinical and economic outcomes of schizophrenia treatment from the healthcare payer perspective. The long-term costs and QALYs were estimated. Sensitivity analyses were performed to explore the impact of variance of parameters on the results. RESULTS Treatment with amisulpride provided an effectiveness gain of 16.59 QALYs at an average cost of USD 25,884 whereas olanzapine resulted in 16.38 QALYs at a cost of USD 34,839 over a lifetime horizon. One-way sensitivity analysis suggested that the most sensitive variable was the unit cost of olanzapine. In a probabilistic sensitivity analysis based on a Monte Carlo simulation with a lifetime horizon, the probability of amisulpride being cost-effective was 99.8% at a willingness-to-pay threshold of USD 9,322, the GDP per capita in China 2018. A scenario analysis with updated olanzapine unit cost suggested an ICER of 7,857 USD/QALY. CONCLUSIONS Amisulpride is likely to be a cost-effective option with increased effectiveness compared with olanzapine in the treatment of schizophrenia patients in China.
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Affiliation(s)
- Zhan-Miao Yi
- Department of Pharmacy, Peking University Third Hospital , Beijing, China.,Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Science, Peking University , Beijing, China.,Institute for Drug Evaluation, Peking University Health Science Center , Beijing, China
| | - Peng Men
- Department of Pharmacy, Peking University Third Hospital , Beijing, China.,Institute for Drug Evaluation, Peking University Health Science Center , Beijing, China
| | - Shuli Qu
- Real-World Insights, IQVIA , Shanghai, China
| | - Chaoyun Li
- Health Economics & Outcome Research, Sanofi , Shanghai, China
| | - Xin Yu
- Department of Psychiatry, Peking University Sixth Hospital , Beijing, China
| | - Suodi Zhai
- Department of Pharmacy, Peking University Third Hospital , Beijing, China.,Institute for Drug Evaluation, Peking University Health Science Center , Beijing, China
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16
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Evon DM, Lin HHS, Khalili M, Fontana RJ, Yim C, Wahed AS, Fried MW, Hoofnagle JH. Patient-reported outcomes in a large North American cohort living with chronic hepatitis B virus: a cross-sectional analysis. Aliment Pharmacol Ther 2020; 51:457-468. [PMID: 31943262 PMCID: PMC6989387 DOI: 10.1111/apt.15618] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 11/04/2019] [Accepted: 11/27/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Patient-reported outcomes (PROs) such as health-related quality of life (HRQoL) and symptoms associated with chronic hepatitis B viral (HBV) infection have not been well-described in North American cohorts. AIMS To evaluate several PROs and associations with HBV disease activity markers. METHODS Cross-sectional analysis including 876 adults who completed PRO measures during the Hepatitis B Research Network Adult Cohort Study. Participants on HBV treatment were excluded. Outcomes included: HRQoL using the SF-36 mental component summary and physical component summary scores; symptom burden using a 10-item Total Symptom Checklist and fatigue using an instrument from the Patient-Reported Outcomes Measurement Information System®. Covariates included laboratory markers of disease severity, virological status, comorbidities and medications. RESULTS Median age was 42 (range: 19-79), 51% were female, 73% Asian, 19% HBeAg (+), 2% had AST-platelet ratio index (APRI) ≥1.5 and 74% without comorbidities. Mean mental component summary T-score = 52, physical component summary T-score = 54 and PROMIS Fatigue T-score = 47. On a scale from 0 (none) to 40 (extreme), the mean Symptom Checklist score = 3 and 25% reported no symptoms. The most frequent symptoms were fatigue (60%), irritability (32%) and itching (32%). Most symptoms were 'a little bit' bothersome. In multivariable regressions, APRI ≥1.50 and more comorbidities were associated with worse patient-reported outcomes; virological markers were not. Adding the Total Symptom Checklist score to original regression models increased explanation of variation in the mental component summary score from 4% to 44% and the Physical Component Summary Score from 17% to 34%. CONCLUSIONS Untreated North American HBV patients with mild liver disease report favourable health-related quality of life and minimal symptoms. HBV does not impact health-related quality of life unless advanced liver disease or comorbidities are present. High symptom burden explains substantial variation in health-related quality of life. (CT.gov identifier: NCT01263587).
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Affiliation(s)
- Donna M. Evon
- Department of Medicine, University of North Carolina at Chapel Hill
| | - Hsing-Hua S. Lin
- Departments of Epidemiology and Biostatistics, University of Pittsburgh
| | - Mandana Khalili
- Department of Medicine, University of California at San Francisco
| | | | - Colina Yim
- Toronto Centre for Liver Disease, University of Toronto
| | - Abdus S. Wahed
- Departments of Epidemiology and Biostatistics, University of Pittsburgh
| | - Michael W. Fried
- Department of Medicine, University of North Carolina at Chapel Hill
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Psychiatric Morbidity, Fatigue, Stigma and Quality of Life of Patients With Hepatitis B Infection. J Clin Exp Hepatol 2020; 10:429-441. [PMID: 33029051 PMCID: PMC7527840 DOI: 10.1016/j.jceh.2020.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/05/2020] [Indexed: 12/12/2022] Open
Abstract
AIMS This study aimed to evaluate the prevalence of psychiatric morbidity, fatigue, stigma and quality of life (QOL) of patients with hepatitis B infection. Additional aim of the study was to evaluate the correlates of psychiatric morbidity and QOL in patients with hepatitis B infection. METHODS A total of 150 patients with hepatitis B virus (HBV) infection (75 inactive carriers and 75 patients with chronic hepatitis) were evaluated on Mini International Neuropsychiatric Interview-PLUS, World Health Organization-QOL-BREF scale, Chronic Liver Disease Questionnaire, Toronto Chinese HBV Stigma Scale, HBV knowledge scale and Fatigue Severity scale. RESULTS About half of the study participants (49.3%) had at least one lifetime psychiatric morbidity and of these more than one-third (37.3%) fulfilled at least one current psychiatric diagnosis. Generalized anxiety disorder was seen in 19.3% of the participants. Major depressive disorder was the second most common psychiatric diagnosis fulfilled at the time of assessment, with nearly equal prevalence of first episode of depression (8%) and recurrent depressive disorder (7.3%). Compared to those with inactive hepatitis, patients in the chronic hepatitis group had poorer QOL and experienced more fatigue. However, both the groups did not differ in terms of knowledge and stigma. Compared to those without current or lifetime psychiatric diagnosis, those with current or lifetime psychiatric diagnosis had poorer QOL, higher level of stigma and higher fatigue scale. CONCLUSION About half of the patients with HBV infection have psychiatric morbidity, which has negative impact on QOL of patients. Hence, it is important to recognize psychiatric morbidity among patients with HBV.
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Coste M, De Sèze M, Diallo A, Carrieri MP, Marcellin F, Boyer S. Burden and impacts of chronic hepatitis B infection in rural Senegal: study protocol of a cross-sectional survey in the area of Niakhar (AmBASS ANRS 12356). BMJ Open 2019; 9:e030211. [PMID: 31320358 PMCID: PMC6661601 DOI: 10.1136/bmjopen-2019-030211] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Though Senegal has one of the highest estimated prevalence rates of chronic hepatitis B virus (HBV) infection worldwide, epidemiological data in the general population are lacking and consequences of the infection remain undocumented. The ANRS-12356 AmBASS study aims at evaluating the health and socioeconomic burden of chronic HBV infection at the individual, household and population level. Its specific objectives are (1) to document the epidemiology of chronic HBV infection, including prevalence and risk factors; (2) to assess the acceptability of home-based testing and first clinic visit; (3) to investigate the repercussions of chronic HBV infection on living conditions; and (4) to estimate the public health impact of chronic HBV infection at the population level and the feasibility of a decentralised model of HBV test and treat. METHODS AND ANALYSIS This multidisciplinary cross-sectional survey includes a twofold data collection: (1) home-based screening using dried blood spot (DBS) sampling and collection of sociodemographic, economic and behavioural data, and (2) additional clinical and biological data collection in chronic HBV carriers at the first clinic visit. The prevalence of chronic HBV infection will be estimated in the general population and in key subgroups. Risk factors for HBV acquisition in children will be explored using case-control analysis. HBV burden will be assessed through comparisons of health and economic outcomes between households affected by the disease versus non-affected households. Last, an economic evaluation will assess costs and health benefits of scaling-up HBV care. ETHICS AND DISSEMINATION This study was approved by the Senegalese National Ethical Committee for Research in Health, and received authorisation from the Senegalese Ministry of Health and the French Commission on Information Technology and Liberties (Senegalese Protocol Number: SEN17/15). The study results will be presented in peer-review journals, international conferences and at a workshop with national stakeholders in order to contribute to the design of programmes to address the HBV pandemic. TRIAL REGISTRATION NUMBER NCT03215732; Pre-results.
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Affiliation(s)
- Marion Coste
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Maëlle De Sèze
- Centre Européen de Sociologie et de Science Politique (CESSP-Paris, UMR 8209), Université Paris 1 Panthéon-Sorbonne, Paris, France
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Aldiouma Diallo
- Campus International IRD-UCAD de l'IRD, UMR VITROME, IRD-Université Aix Marseille, AP-HM, SSA, IHU-Méditerranée Infection, Dakar, Senegal
| | - Maria Patrizia Carrieri
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Fabienne Marcellin
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Sylvie Boyer
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
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Zhu L, Kong J, Zheng Y, Song M, Cheng X, Zhang L, Patrick DL, Wang H. Development and initial validation of the chronic hepatitis B quality of life instrument (CHBQOL) among Chinese patients. Qual Life Res 2019; 28:3071-3081. [PMID: 31243621 DOI: 10.1007/s11136-019-02240-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE This study developed and tested preliminary measurement properties of a Chinese scale specifically designed to measure HRQOL in patients with chronic hepatitis B (CHBQOL). METHODS We conducted 94 individual interviews with CHB patients to solicit items and five hepatitis expert interviews along with three rounds of cognitive interviews to identify problems with relevance and understanding of content. A cross-sectional validation study was then conducted to evaluate measurement properties (n = 578). Factor analysis was used to determine the latent structure of the scale. Reliability was evaluated through Cronbach's alpha coefficients and intra-class correlation coefficients (ICCs). Measurement model adequacy, convergent, discriminant, and known-groups validity were also examined. RESULTS A scale of 30 items was drafted. After item reduction, the remaining 23 items were assigned to the CHBQOL Somatic symptoms, Emotional symptoms, Belief and Social stigma domains, which had acceptable goodness of fit (χ2/df = 3.13, GFI = 0.90, AGFI = 0.88, RMSEA = 0.06, SRMR = 0.05). All the CHBQOL domains had satisfactory reliability with Cronbach's α coefficients ranging from 0.73 to 0.91 and ICCs were higher than 0.70 except for Belief domain (ICC = 0.54). Convergent and discriminant validity were acceptable as supported by significant item-domain correlations (0.64-0.90). In general, the correlations between CHBQOL and the SF-36 dimensions met hypotheses. Significant differences were found by mean scores in the subgroups of demographic and clinical variables, supporting the known-groups validity. CONCLUSIONS The CHBQOL instrument proved to be an appropriate tool for assessing HRQOL among Chinese CHB patients.
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Affiliation(s)
- Lin Zhu
- Department of Social Medicine of School of Public Health, Zhejiang University School of Medicine, 866 Yuhang Tang Road, Hangzhou, 310058, Zhejiang, People's Republic of China.,Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhang Tang Road, Hangzhou, 310058, Zhejiang, People's Republic of China
| | - Jingxia Kong
- Department of Social Medicine of School of Public Health, Zhejiang University School of Medicine, 866 Yuhang Tang Road, Hangzhou, 310058, Zhejiang, People's Republic of China
| | - Yingjing Zheng
- Department of Social Medicine of School of Public Health, Zhejiang University School of Medicine, 866 Yuhang Tang Road, Hangzhou, 310058, Zhejiang, People's Republic of China
| | - Mengna Song
- Department of Social Medicine of School of Public Health, Zhejiang University School of Medicine, 866 Yuhang Tang Road, Hangzhou, 310058, Zhejiang, People's Republic of China
| | - Xiao Cheng
- Department of Social Medicine of School of Public Health, Zhejiang University School of Medicine, 866 Yuhang Tang Road, Hangzhou, 310058, Zhejiang, People's Republic of China
| | - Li Zhang
- Department of Social Medicine of School of Public Health, Zhejiang University School of Medicine, 866 Yuhang Tang Road, Hangzhou, 310058, Zhejiang, People's Republic of China
| | - Donald L Patrick
- Department of Health Services, University of Washington, Seattle, WA, USA
| | - Hongmei Wang
- Department of Social Medicine of School of Public Health, Zhejiang University School of Medicine, 866 Yuhang Tang Road, Hangzhou, 310058, Zhejiang, People's Republic of China. .,Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhang Tang Road, Hangzhou, 310058, Zhejiang, People's Republic of China.
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Psychological Disorders and Quality of Life Among Patients With Chronic Viral Hepatitis: A Single-Center Cross-Sectional Study With Pair-Matched Healthy Controls. Gastroenterol Nurs 2018; 41:206-218. [PMID: 29847395 DOI: 10.1097/sga.0000000000000339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Recent research evidence has shown that patients with chronic viral hepatitis develop symptoms of anxiety and/or depression, which has a strong impact on their health-related quality of life. This study aimed to assess the levels of anxiety, depression, and health-related quality of life among patients with chronic hepatitis B or C in Greece. It was a cross-sectional study among 111 patients with chronic viral hepatitis, evaluated at a tertiary General Hospital of Athens from March to September of 2014. Anxiety, depression, and health-related quality of life were assessed by the use of specially designed questionnaires. For the comparison between patients' population and general population, a pair-matched population of 111 healthy participants was recruited. Mean age of patients was 44.85 years (SD = 14.4). Fifty-nine patients were infected by hepatitis B virus and 52 by hepatitis C virus. Levels of anxiety and depression were higher among patients than among controls and the overall health-related quality of life was poorer (p < .001). Female gender and liver parenchyma damage were associated with higher levels of anxiety (p < .05). Certain demographic, socioeconomic, and clinical-serological factors were related with higher levels of depression. Poorer health-related quality of life was reported by patients with liver cirrhosis and alanine aminotransferase of 40 IU/L or more. Patients with chronic viral hepatitis demonstrate psychological and physical impairment, especially those with advance liver disease and/or active viral activity.
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Multidimensional Fatigue Inventory in People With Hepatitis B Infection: Cross-cultural Adaptation and Psychometric Evaluation of the Persian Version. Gastroenterol Nurs 2018; 40:380-392. [PMID: 28957969 DOI: 10.1097/sga.0000000000000250] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
There is no valid and well-established tool to measure fatigue in people with chronic hepatitis B. The aim of this study was to translate the Multidimensional Fatigue Inventory (MFI) into Persian and examine its reliability and validity in Iranian people with chronic hepatitis B. The demographic questionnaire and MFI, as well as Chronic Liver Disease Questionnaire and EuroQol-5D (to assess criterion validity), were administered in face-to-face interviews with 297 participants. A forward-backward translation method was used to develop a culturally adapted Persian version of the questionnaire. Cronbach's α was used to assess the internal reliability of the scale. Pearson correlation was used to assess criterion validity, and known-group method was used along with factor analysis to establish construct validity. Cronbach's α for the total scale was 0.89. Convergent and discriminant validities were also established. Correlations between the MFI and the health-related quality of life scales were significant (p < .01). The scale differentiated between subgroups of persons with the hepatitis B infection in terms of age, gender, employment, education, disease duration, and stage of disease. Factor analysis indicated a four-factor solution for the scale that explained 60% of the variance. The MFI is a valid and reliable instrument to identify fatigue in Iranians with hepatitis B.
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Liu B, Wei M, Liu F, Chen S, Peng Z, Li B, Zhou Q, Wang H, Peng S, Kuang M. Radiofrequency ablation plus nucleotide analogous for hepatitis B virus-related hepatocellular carcinoma: a cost-effectiveness analysis. Am J Transl Res 2018; 10:2685-2695. [PMID: 30210705 PMCID: PMC6129532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 06/27/2018] [Indexed: 06/08/2023]
Abstract
In the real-world, it is unclear that after the radiofrequency ablation (RFA), whether it is a cost-effective strategy to administer nucleotide analogue (NA) for patients with hepatitis B virus (HBV)-related HCC patients. The aim of this study was to estimate the cost-effectiveness of the RFA plus NA versus RFA alone in patients with HBV-related HCC within the Milan criteria in China and the USA. A Markov model was developed to simulate a cohort of patients with HCC within the Milan criteria and Child-Pugh A/B cirrhosis and underwent RFA with or without NA therapy over their remaining life expectancy. Analysis was performed in two geographical cost settings: China and the USA. The RFA plus NA therapy provided an average of 7.57 years, whereas RFA monotherapy offered 5.83 years. The RFA plus NA therapy produced 5.09 quality-adjusted life years (QALYs), whereas RFA monotherapy achieved 3.89 QALYs. The incremental cost-effectiveness ratio (ICER) of the RFA plus NA therapy versus RFA monotherapy was $10368.19/QALY in China and $38805.45/QALY in the USA. These values were below the thresholds of the cost-effectiveness in both countries. Sensitivity analysis revealed that the utility of recurrent HCC was the most sensitive parameter in all cost scenarios in both of the RFA plus NA therapy and RFA monotherapy groups. Our Markov model has shown that for the patients with HBV-related HCC within the Milan criteria and Child-Pugh A/B cirrhosis, RFA plus NA is more cost-effective than RFA monotherapy across the two different cost scenarios namely, China and the USA.
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Affiliation(s)
- Baoxian Liu
- Division of Interventional Ultrasound, The First Affiliated Hospital, Sun Yat-Sen UniversityGuangzhou 510080, China
| | - Mengchao Wei
- Department of Liver Surgery, The First Affiliated Hospital, Sun Yat-Sen UniversityGuangzhou 510080, China
| | - Furong Liu
- Department of Liver Surgery, The First Affiliated Hospital, Sun Yat-Sen UniversityGuangzhou 510080, China
| | - Shuling Chen
- Division of Interventional Ultrasound, The First Affiliated Hospital, Sun Yat-Sen UniversityGuangzhou 510080, China
| | - Zhenwei Peng
- Department of Oncology, The First Affiliated Hospital, Sun Yat-Sen UniversityGuangzhou 510080, China
| | - Bin Li
- Clinical Research Unit, The First Affiliated Hospital, Sun Yat-Sen UniversityGuangzhou 510080, China
| | - Qian Zhou
- Clinical Research Unit, The First Affiliated Hospital, Sun Yat-Sen UniversityGuangzhou 510080, China
| | - Haibo Wang
- Clinical Research Unit, The First Affiliated Hospital, Sun Yat-Sen UniversityGuangzhou 510080, China
| | - Sui Peng
- Clinical Research Unit, The First Affiliated Hospital, Sun Yat-Sen UniversityGuangzhou 510080, China
- Department of Gastroenterology and Hepatology, The First Affiliated Hospital, Sun Yat-Sen UniversityGuangzhou 510080, China
| | - Ming Kuang
- Division of Interventional Ultrasound, The First Affiliated Hospital, Sun Yat-Sen UniversityGuangzhou 510080, China
- Department of Liver Surgery, The First Affiliated Hospital, Sun Yat-Sen UniversityGuangzhou 510080, China
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Lam CLK, Guo VY, Wong CKH, Yu EYT, Fung CSC. Poverty and health-related quality of life of people living in Hong Kong: comparison of individuals from low-income families and the general population. J Public Health (Oxf) 2018; 39:258-265. [PMID: 27222238 DOI: 10.1093/pubmed/fdw046] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background To assess health-related quality of life (HRQOL) among Chinese adults from low-income households in Hong Kong, and to explore any threshold of household income that impaired HRQOL. Methods A cross-sectional analysis was conducted on 298 adults from low-income families when they enrolled into a cohort study between 2012 and 2014. HRQOL was measured by the 12-item Short-Form Health Survey-version 2 (SF-12v2). Their mean SF-12v2 subscale and summary scores were compared with those of 596 age-sex-matched subjects randomly selected from a database of 2763 adults from the Hong Kong general population (ratio = 1:2). Multiple linear regressions were conducted to determine any association between monthly household income and HRQOL. Results Subjects from low-income households had significantly lower SF-12v2 bodily pain, general health, vitality and physical component summary (PCS) scores than the age-sex matched subjects from the general population. Subgroup analysis showed that a household income <50% of the median monthly household income in Hong Kong (HK$10 000 ≈ US$1290, i.e. poverty line in Hong Kong) was independently associated with poorer PCS and mental component summary (MCS) scores after adjustment for socio-demographics and co-morbidities. Conclusion Chinese adults from low-income households had poorer HRQOL, and <50% of the median monthly household income seems to be the threshold for impairment of both physical and mental HRQOL. The findings support the current definition of the poverty line.
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Affiliation(s)
- Cindy Lo Kuen Lam
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong
| | - Vivian Yawei Guo
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong
| | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong
| | - Esther Yee Tak Yu
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong
| | - Colman Siu Cheung Fung
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong
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Chen MC, Hung HC, Chang HJ, Yang SS, Tsai WC, Chang SC. Assessment of Educational Needs and Quality of Life of Chronic Hepatitis Patients. BMC Health Serv Res 2017; 17:148. [PMID: 28212644 PMCID: PMC5314709 DOI: 10.1186/s12913-017-2082-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 02/09/2017] [Indexed: 12/02/2022] Open
Abstract
Background Patient education is crucial in improving the health-related quality of life (HRQOL) of patients. At the same, understanding the concerns and needs of patients is essential in providing appropriate education. This study assessed the educational needs and HRQOL experienced by chronic hepatitis patients. Methods We developed structured questionnaires with satisfactory validity and reliability to assess the educational needs of patients. HROQL was measured using a generic Short Form 36 (SF-36) and a liver disease-specific Chronic Liver Disease Questionnaire (CLDQ). Descriptive statistic measures and Pearson’s correlation analysis were applied for data analysis. Results A total of 135 subjects were recruited from two regional teaching hospitals in Taiwan. “Disease characteristics and management” exhibited the highest mean score (3.17) among all the subscales of educational needs. In comparison with those without antiviral therapy, chronic hepatitis patients undergoing antiviral treatment scored significantly higher on all subscales of educational needs, especially on “side effects of antiviral treatment” (p < 0.010). The median range of the physical component summary score was 45.94, the mental component summary score was 49.37, and the mean CLDQ was 5.70. Several domains of educational needs were significantly inversely correlated with the CLDQ and SF-36 subscales. Conclusions Education is highly required by chronic hepatitis patients, especially those receiving antiviral therapy and patients with poor HRQOL. These findings can serve as a useful reference for nursing personnel who perform needs assessment to develop individual nursing instruction and thereby improve the quality of care for chronic hepatitis patients.
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Affiliation(s)
- Ming-Chuan Chen
- Department of Health Services Administration, China Medical University, No.91, Hsueh-Shih Road, 40402, Taichung, Taiwan.,Department of Healthcare Administration, Central Taiwan University of Science and Technology, No. 666, Buzih Road, Beitun District, Taichung, 40601, Taiwan
| | - Hung-Chang Hung
- Ministry of Health and Welfare Nantou Hospital, No. 478 Fuxing Rd., Nantou City, 540 Nantou County, Taiwan
| | - Hsiu-Ju Chang
- Department of Nursing, Lee's Medical Corporation, No. 2 Bade St., Taichung, 43748, Taiwan
| | - Sheng-Shun Yang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, No. 1650, Taiwan Boulevard Sec. 4, 40705, Taichung, Taiwan
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, No.91, Hsueh-Shih Road, 40402, Taichung, Taiwan
| | - Shu-Chuan Chang
- Department of Nursing, Central Taiwan University of Science and Technology, No. 666, Buzih Road, Beitun District, Taichung City, 40601, Taiwan.
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Development and Application of the Chinese (Mainland) Version of Chronic Liver Disease Questionnaire to Assess the Health-Related Quality of Life (HRQoL) in Patients with Chronic Hepatitis B. PLoS One 2016; 11:e0162763. [PMID: 27631983 PMCID: PMC5025145 DOI: 10.1371/journal.pone.0162763] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/29/2016] [Indexed: 02/07/2023] Open
Abstract
Objective To develop the Chinese (Mainland) version of Chronic Liver Disease Questionnaire (CLDQ) and use it to assess the health-related quality of life (HRQoL) of chronic hepatitis B (CHB) patients in China and identify the determinants of HRQoL. Methods The Chinese (Mainland) CLDQ was developed by expert consultation, focus group interviews with patients, and pilot study. The final version of questionnaire was adopted to assess the HRQoL of chronic hepatitis B outpatients enrolled from two largest infectious hospitals in Beijing. Cronbach’ s alpha was used to measure the internal consistency reliability. The construct validity was measured by factor analysis. T-test, one-way analysis of variance (ANOVA), and multi-variable linear regression were used to analyze the data. Results Cronbach’s alpha of the overall CLDQ is 0.935, ranging from 0.628 to o.881 among six subscales. Six factors were identified via factor analysis, including a new factor sleeping(SL). A total of 519 patients with CHB were included in the investigation with the final version of questionnaire, 405 of them were only with CHB, 53 with compensated cirrhosis, and 61 with decompensated cirrhosis. The CHB group scored the highest in the overall score of CLDQ (p<0.05). The score of worry (WO) domain was significantly lower in the compensated group than the CHB group (p<0.05). Decompensated cirrhosis patients scored lower than the CHB group in all CLDQ domains and the overall score (p<0.05). Stages of illness, gender, regular visits to specialized hospitals, and work status in last year were determinants of HRQoL. Conclusion The psychometric properties of the Chinese(Mainland) CLDQ is acceptable. The HRQoL of CHB patients deteriorated with disease progression. Advanced stages of CHB, female, long time absence from work after illness, and no job or retirement were determinants of poor HRQoL. Regular visits to specialized hospitals was a positive determinant of HRQoL.
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Evon DM, Wahed AS, Johnson G, Khalili M, Lisker-Melman M, Fontana RJ, Sarkar S, Reeve BB, Hoofnagle JH. Fatigue in Patients with Chronic Hepatitis B Living in North America: Results from the Hepatitis B Research Network (HBRN). Dig Dis Sci 2016; 61:1186-96. [PMID: 26831489 PMCID: PMC4791302 DOI: 10.1007/s10620-015-4006-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 12/14/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Fatigue is a common symptom of liver disease but not well characterized in patients with chronic hepatitis B virus (HBV). AIMS We assessed the rate of fatigue using a validated instrument in patients with HBV and identified demographic, virologic, and clinical features associated with fatigue in a cross-sectional cohort study from the Hepatitis B Research Network. METHODS Participants were English- and Spanish-speaking adults with chronic HBV who were not pregnant nor on treatment. Fatigue was measured using the PROMIS® Fatigue 7-item Short Form. RESULTS The sample included 948 adults: median age 42; 51 % female; 71 % Asian; 74 % college educated; 77 % employed; 41 % inactive HBV carriers; 36 % with active chronic disease; and 2 % with advanced fibrosis, defined as AST-platelet ratio index (APRI) > 1.50. Patients with chronic HBV had a mean fatigue T-score of 46.8 ± SD = 7.9, compared to a mean fatigue T-score of 50.0 ± 10 in the US general population (p < .0001). In univariate analyses, greater fatigue was associated with demographic and clinical features such as female sex, lower income, more comorbidities, higher APRI score, and poorer mental health (p < 0.05). In multivariate analysis, female sex (p < .001), poorer mental health (p < .001), APRI score (p = .005), and history of diabetes (p = .039) were the strongest independent predictors. CONCLUSIONS The frequency of fatigue in this large cohort of North American chronic HBV patients may be equal to or lower than that reported in the US general population. Patients with advanced fibrosis, more comorbidities, and poorer mental health report worse fatigue.
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Affiliation(s)
- Donna M. Evon
- Department of Medicine, University of North Carolina at Chapel Hill
| | - Abdus S. Wahed
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health
| | - Geoffrey Johnson
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health
| | - Mandana Khalili
- Department of Medicine, University of California, San Francisco
| | | | | | - Souvik Sarkar
- Department of Medicine, University of California at Davis
| | - Bryce B. Reeve
- Department of Health Policy and Management, University of North Carolina at Chapel Hill
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Tanaka A, Kikuchi K, Miura R, Miura K, Mikami M, Aiso M, Takamori Y, Takikawa H. Validation of the Japanese version of the Chronic Liver Disease Questionnaire for the assessment of health-related quality of life in patients with chronic viral hepatitis. Hepatol Res 2016; 46:E45-50. [PMID: 25858357 DOI: 10.1111/hepr.12524] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 04/03/2015] [Accepted: 04/06/2015] [Indexed: 02/08/2023]
Abstract
AIM Patients with chronic liver diseases (CLD) suffer from a variety of subjective symptoms, and the assessment of health-related quality of life (HRQOL) is crucial. The Chronic Liver Disease Questionnaire (CLDQ) is the first liver disease-specific instrument for this purpose. In this study we aimed to develop the Japanese version of CLDQ and to assess its validity and reliability in Japanese patients with chronic viral hepatitis. METHODS The participants included 135 Japanese patients chronically infected with hepatitis B or C virus. The Japanese version of the CLDQ was developed according to the standard "back-translation" method. In addition to the Japanese version of the CLDQ, we asked the patients to fill out two other self-report questionnaires: the Japanese versions of the 36-Item Short Form Survey (SF-36) and Hospital Anxiety and Depression Scale (HADS). Then, the internal consistency, convergent and discriminant validity of the Japanese version of CLDQ were statistically examined. RESULTS Cronbach's alpha of the Japanese version of the CLDQ was acceptable. The mean score was lower in emotional domains of the CLDQ, compared with those in somatic domains. Pearson correlations between Japanese CLDQ and SF-36 and HADS were significant. The mean of the CLDQ scores decreased in all domains in patients with liver cirrhosis compared with those in patients with chronic hepatitis. CONCLUSION The Japanese version of the CLDQ is a reliable and valid instrument for assessment of the HRQOL of Japanese patients with chronic viral hepatitis. The results also suggest that the HRQOL of Japanese patients is mainly impaired by emotional factors rather than somatic symptoms, and significantly worsened by progression of the disease.
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Affiliation(s)
- Atsushi Tanaka
- Department of Medicine, Teikyo University School of Medicine, Tokyo
| | - Kentaro Kikuchi
- The 4th Department of Internal Medicine, Teikyo University, School of Medicine, Kanagawa, Japan
| | - Ryo Miura
- Department of Medicine, Teikyo University School of Medicine, Tokyo
| | - Kotaro Miura
- Department of Medicine, Teikyo University School of Medicine, Tokyo
| | - Masaki Mikami
- Department of Medicine, Teikyo University School of Medicine, Tokyo
| | - Mitsuhiko Aiso
- Department of Medicine, Teikyo University School of Medicine, Tokyo
| | | | - Hajime Takikawa
- Department of Medicine, Teikyo University School of Medicine, Tokyo
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Valizadeh L, Zamanzadeh V, Negarandeh R, Zamani F, Hamidia A, Zabihi A. Psychological Reactions among Patients with Chronic Hepatitis B: a Qualitative Study. J Caring Sci 2016; 5:57-66. [PMID: 26989666 PMCID: PMC4794545 DOI: 10.15171/jcs.2016.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 07/02/2015] [Indexed: 01/05/2023] Open
Abstract
Introduction: Hepatitis B is the most prevalent type of
viral hepatitis. Psychological reactions among patients with hepatitis B infection is
considerably different and affects their decision about treating and following up the
disease. The present study aims at explaining the psychological demonstrations experienced
by these patients. Methods: In this qualitative study, a total of 18 patients
with hepatitis B (8 women and 10 men) were selected by purposive sampling method. Data
were collected by unstructured in-depth interviews during 2014-2015 in the medical centers
of three cities in Iran. All interviews were recorded, typed and analyzed by the
conventional content analysis approach. Results: By analyzing the data, the main theme including
psychological instability, with three sub-themes were emerged: grief reaction (stupor,
denial, anger and aggression), emotional challenges (worry and apprehension, contradiction
with beliefs, fear of deprivation, fear of stigma, waiting for death and prognosis
ambiguity) and inferiority complex (social withdrawal, sense of humiliation and
embarrassment and sense of guilt and blame) were acquired. Conclusion: The findings indicate that patients with
hepatitis B experience various psychological reactions that need to be controlled and
managed by themselves or healthcare providers. Thus, implementation of health
interventions with emphasis on psychological care to prevent problems and execution of
educational and consultation programs about hepatitis especially by medical centers and
mass media is seems necessary.
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Affiliation(s)
- Leila Valizadeh
- Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Zamanzadeh
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Negarandeh
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Zamani
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Angela Hamidia
- Department of Psychiatry, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Ali Zabihi
- Department of Community Health, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Kim SJ, Han KT, Lee SY, Park EC. Quality of life correlation with socioeconomic status in Korean hepatitis-B patients: a cross sectional study. Health Qual Life Outcomes 2015; 13:55. [PMID: 25964056 PMCID: PMC4487580 DOI: 10.1186/s12955-015-0251-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 04/29/2015] [Indexed: 02/07/2023] Open
Abstract
Background In Korea, more than two-thirds of hepatocellular carcinoma patients are hepatitis B virus (HBV) surface antigen-seropositive. The effects of HBV infection on health-related quality of life (HRQoL) are important aspects in the overall management of HBV infection. However, other effects of other parameters on HBV patient HRQoL remain unknown and require clarification. Our study evaluated HRQoL in hepatitis-B patients, according to socioeconomic status. Methods We used community health survey data to analyze the relationship between HRQoL of HBV+ patients according to socioeconomic status. We used propensity score matching (Ratio = 1:5) to balancing the patients and general population. Final analytic sample consisted of 7,098 hepatitis B patients and compared group (35,490 general populations). We examined the HRQoL in HBV+ patients (n = 7,098), stratified by socioeconomic status, compared with general populations, using the EuroQOL visual analog scale (EQ-VAS) and EQ-5D questionnaires. We used the Chi-square test and ANOVA to compare demographic variables. Multiple linear regression analysis identified associations between demographic variables and HRQoL. Results Participants with hepatitis B numbered 7,098 (16.7 %) of the study population. HRQoL was lower in hepatitis-B patients compared to the general population (EQ-VAS: −0.985, p = 0.0004; EQ-5D: −0.673, p = 0.0003). According to occupation type, clerks (EQ-VAS: −2.628, p = 0.0030; EQ-5D: −0.802, p = 0.0099) and managers and professionals (EQ-VAS: −1.518, p = 0.0356) had the lowest HRQoLs. Higher family income and education level groups had lower HRQoLs compared to the general population. Conclusions Patients from higher socioeconomic status groups had HRQoLs that were more affected by hepatitis B. Thus, we require more accurate information about the disease to develop appropriate patient management guidelines. This will facilitate formulating policies and management strategies that alleviate HRQoL declines in HBV+ patients.
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Affiliation(s)
- Seung Ju Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea. .,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
| | - Kyu-Tae Han
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea. .,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
| | - Seo Yoon Lee
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea. .,Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea. .,Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
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Cost effectiveness of response-guided therapy with peginterferon in the treatment of chronic hepatitis B. Clin Gastroenterol Hepatol 2015; 13:377-385.e5. [PMID: 24993366 DOI: 10.1016/j.cgh.2014.06.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 06/01/2014] [Accepted: 06/10/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The high prevalence of chronic hepatitis B in Asian countries produces a substantial economic burden. Peginterferon has immunomodulatory effects and a finite course for treatment of hepatitis B, but also a high cost and side effects. The recent introduction of a 12-week stopping rule (stopping treatment after 12 weeks) has increased its appeal as a first-line treatment for hepatitis B. We aimed to determine the cost effectiveness of the 12-week stopping rule for peginterferon in hepatitis B e antigen (HBeAg)-positive and HBeAg-negative patients. METHODS We used Markov modeling, with data from the Hong Kong population, to compare the cost effectiveness of peginterferon therapy with a 12-week stopping rule vs conventional therapy (48 weeks) and with other antiviral agents. RESULTS For HBeAg-positive patients, stopping peginterferon therapy after 12 weeks had the lowest cost-effectiveness ratio (CER), of $9501/quality-adjusted life-year (QALY), compared with no treatment, making it the most cost-effective option. Conventional (48-week) peginterferon treatment had a CER of $9664/QALY. For HBeAg-negative patients, entecavir had the lowest CER ($34,310/QALY). Entecavir was more cost effective than either peginterferon strategies (CERs of $37,423/QALY for 12 weeks of peginterferon and $38,474/QALY for 48 weeks of treatment). CONCLUSIONS The 12-week stopping rule increases the cost effectiveness of peginterferon therapy, and is the most cost-effective treatment for HBeAg-positive patients. The need for long-term antiviral therapy for HBeAg-negative patients makes entecavir the most cost-effective strategy.
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Che YH, You J, Chongsuvivatwong V, Li L, Sriplung H, Yan YZ, Ma SJ, Zhang X, Shen T, Chen HM, Rao SF, Zhang RY. Dynamics and Liver Disease Specific Aspects of Quality of Life Among Patients with Chronic Liver Disease in Yunnan, China. Asian Pac J Cancer Prev 2014; 15:4765-71. [DOI: 10.7314/apjcp.2014.15.12.4765] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Chang SC, Yang SS, Chang CC, Lin CC, Chung YC, Li TC. Assessment of health-related quality of life in antiviral-treated Taiwanese chronic hepatitis C patients using SF-36 and CLDQ. Health Qual Life Outcomes 2014; 12:97. [PMID: 24941994 PMCID: PMC4073178 DOI: 10.1186/1477-7525-12-97] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Accepted: 04/21/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Interferon (IFN) therapy can cause significant side effects in chronic hepatitis C (CHC) patients; however, the health-related quality of life (HRQOL) of antiviral-treated CHC patients has not been established in Taiwan. This study evaluated domains and the degree to which antiviral treatment affects the HRQOL in CHC patients and identifies factors associated with variations between patients. METHODS Health-related quality of life (HRQOL) was assessed using the Short Form-36 (SF-36) and the Chronic Liver Disease Questionnaire (CLDQ) in 108 antiviral-treated CHC patients. Eight scales and two summary scales of the SF-36 were compared with 256 age- and gender-matched population norms and 64 age- and gender-matched CHC patients without antiviral therapy. Descriptive statistic measures, one-way ANOVA, and regression analysis were used for data analysis. RESULTS (1) CHC patients receiving antiviral treatment displayed significantly lower scores in six scales, the Physical Component Summary (PCS), and the Mental Component Summary (MCS) of the SF-36, when compared to the population norms and patients without antiviral therapy (p < 0.05). (2) The mean CLDQ score of antiviral-treated patients was lower than that of patients without antiviral therapy, including subscales of 'fatigue', 'systemic symptoms', and 'role emotion'. (3) All SF-36 subscales significantly correlated with all CLDQ subscales, with the greatest correlation coefficients shown between fatigue and vitality and mental health of SF-36. (4) Antiviral therapy had a greater negative impact on females in the CLDQ, on all patients during treatment weeks 9-16 in the PCS and on patients with a monthly income of less than NT$10,000 in the CLDQ, PCS, and MCS. CONCLUSIONS This study highlighted impairments in the quality of life of chronic hepatitis C patients treated with IFN-based therapy. The significant factors associated with HRQOL include gender, income, and treatment duration. The results of this study might provide nurses with a comprehensive understanding of HRQOL and its determining factors in antiviral-treated CHC patients. The findings can serve as a useful reference for nursing personnel in developing instructions for upgrading the care of CHC patients.
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Affiliation(s)
| | | | | | | | | | - Tsai-Chung Li
- Graduate Institute of Biostatistics, College of Management, China Medical University, Taichung, Taiwan.
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Zhuang G, Zhang M, Liu Y, Guo Y, Wu Q, Zhou K, Ji Z, Zhang X. Significant impairment of health-related quality of life in mainland Chinese patients with chronic hepatitis B: a cross-sectional survey with pair-matched healthy controls. Health Qual Life Outcomes 2014; 12:101. [PMID: 24928466 PMCID: PMC4067057 DOI: 10.1186/1477-7525-12-101] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 06/08/2014] [Indexed: 02/02/2023] Open
Abstract
Objective Few studies have evaluated health-related quality of life (HRQoL) of patients with chronic hepatitis B (CHB) in mainland China. We aimed at characterizing the impact of CHB on HRQoL in mainland Chinese and finding out factors associated with HRQoL. Methods 460 CHB patients (323 with CHB only, 54 with compensated cirrhosis and 83 with decompensated cirrhosis) and 460 pair-matched healthy controls were recruited in Xi’an city. They answered a structured questionnaire including the Short Form 36 version 2 (SF-36v2), the Chronic Liver Disease Questionnaire (CLDQ) (only for patients), and questions on socio-demographic and clinical characteristics. A blood sample was collected from each of patients for liver function tests. SF-36v2 scores were compared between patients and controls overall and by groups by paired-samples t-test, and CLDQ scores and paired differences of SF-36v2 scores were compared among three patient groups by one-way ANOVA or Kruskal-Wallis test. Multi-variable linear regression analyses were performed to identify determinants of HRQoL in patients. Results Patients, overall and by groups had significantly lower SF-36v2 scores than controls on all summaries and domains, with differences higher than the suggested minimally important difference values. Both the SF-36v2 and the CLDQ showed that HRQoL of patients with cirrhosis further deteriorated, but compensated and decompensated cirrhosis patients had similar total HRQoL impairments. The gradually increasing impairment with disease progression was confirmed only on physical components. Impaired liver function and currently taken anti-viral treatment were associated with lower HRQoL. Education attainment and annual per capita household income had a positive effect on HRQoL. Conclusions Mainland Chinese CHB patients suffered significant HRQoL impairment on all health dimensions, and the impairment reached a high level on mental health at initial stage of illness and increased gradually on physical health with disease progression. Attention should be paid to the reduction of patients’ treatment cost burden and the provision of early health education accompanied with proper treatments.
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Affiliation(s)
- Guihua Zhuang
- Department of Epidemiology and Biostatistics, School of Public Heath, Xi'an Jiaotong University Health Science Center, No, 76 West Yanta Road, Xi'an, Shaanxi 710061, China.
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Enescu A, Mitrut P, Balasoiu M, Turculeanu A, Enescu AS. Psychosocial issues in patients with chronic hepatitis B and C. CURRENT HEALTH SCIENCES JOURNAL 2014; 40:93-6. [PMID: 25729588 PMCID: PMC4340448 DOI: 10.12865/chsj.40.02.02] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 02/15/2014] [Indexed: 02/06/2023]
Abstract
Psychosocial issues and the quality of life are important components at the patients diagnosed with chronic hepatitis B and C. In function of the severity of the infection with virus B or the patients who already have cirrhosis, the treatment and psychosocial education should be improved because they have bigger problems. The frequency of psychosocial disorders seems to be raised at the patients diagnosed with chronic hepatitis B. Factors as alcohol abuse and a low social support have a negatively impact above mental health of these patients. The prevalence rate of chronic hepatitis C infection at patients with severe mental illness can be nine times higher than in healthy population. Usually patients with chronic hepatitis B have a quality of life and a mental health better than patients with chronic hepatitis C. Patients with psychiatric affections (especially institutionalized people) have generally a higher risk of being infected with virus B in comparison with general population. Patients with chronic hepatitis B and C suggest a higher grade of stigmatization from society. Despite clinical challenges which treatment with interferon at patients with chronic hepatitis and comorbidities represents, recent studies indicate the fact that treatment can be administrated in safe conditions at patients with viral chronic hepatitis and psychiatric disorders.
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Affiliation(s)
- Aurelia Enescu
- Emergency Medicine Discipline, University of Medicine and Pharmacy of Craiova, Romania
| | - P Mitrut
- Medical Semiology Discipline, University of Medicine and Pharmacy of Craiova, Romania
| | - Maria Balasoiu
- Microbiology Discipline, University of Medicine and Pharmacy of Craiova, Romania
| | - Adriana Turculeanu
- Microbiology Discipline, University of Medicine and Pharmacy of Craiova, Romania
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Altered quality of life in the early stages of chronic hepatitis C is due to the virus itself. Clin Res Hepatol Gastroenterol 2014; 38:40-5. [PMID: 24239318 PMCID: PMC5061030 DOI: 10.1016/j.clinre.2013.08.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 08/22/2013] [Accepted: 08/27/2013] [Indexed: 02/04/2023]
Abstract
UNLABELLED Health-related quality of life (HRQOL) is impaired in chronic viral hepatitis and a direct role of the virus, although suggested, has not been demonstrated. Our aim was to evaluate HRQOL at blood donation before knowledge of the diagnosis of both hepatitis C virus (HCV) and hepatitis B virus (HBV) so as to elucidate this matter. METHODS Prospectively, 67 sequential patients, 35 with HCV and 32 with HBV, and 67 matched controls were administered the generic Short Form-36 (SF-36) questionnaire. After knowledge of diagnosis, the SF-36 was repeated and a disease-specific questionnaire (Liver Disease Quality of Life, LDQOL-1.0) was also administered. The Wilcoxon test and Mann-Whitney U were used for between-group comparisons. RESULTS Before knowledge of diagnosis, patients with HCV had worse HRQOL than controls, with statistically significant changes in 7/8 domains of the SF-36, and also in its physical and mental components. In the HBV group, only 2/8 domains and the physical component were significantly different from controls. After diagnosis, similar changes persisted in the HCV group, whereas two more domains were compromised in the HBV group. Comparisons between the HCV and HBV groups did not show significant differences. CONCLUSION The finding of greater HRQOL impairment in the HCV group before diagnosis confirms the theory that the presence of HCV in the early stage of the disease is associated with worse quality of life.
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Liang Y, Lu W, Wu W. Are social security policies for Chinese landless farmers really effective on health in the process of Chinese rapid urbanization? A study on the effect of social security policies for Chinese landless farmers on their health-related quality of life. Int J Equity Health 2014; 13:5. [PMID: 24433258 PMCID: PMC3896694 DOI: 10.1186/1475-9276-13-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 01/01/2014] [Indexed: 11/16/2022] Open
Abstract
Background The continuing urbanization in China has resulted in a loss of land and rights among farmers. The social security of landless farmers has attracted considerable research attention. However, only few studies measure the health-related quality of life (HRQOL) of landless farmers by employing scientific standardized scales. By using five-dimensional European quality of life (EQ-5D) scales, this study measures the HRQOL of landless farmers from a new perspective and examines how the social security policies affect their HRQOL. Methods This study is based on a 2013 household survey that has been conducted among 1,500 landless famers who are residing in six resettlement areas in three cities within the Yangtze River Delta region, namely, Nanjing, Hangzhou, and Yangzhou. This study adopts EQ-5D scales to measure the HRQOL of these farmers. More than 50% of the respondents are in poor or non-serious health conditions, and over 50% are not satisfied with their current social security policies. The health conditions and social security policies are analyzed by multinomial regression analysis and the relationship between these two factors are analyzed via structural equation modeling (SEM). Results First, the descriptive statistical analysis shows that more than 50% of the respondents are in poor or non-serious health conditions, and that the largest proportion of these farmers are suffering from anxiety or depression, which is the most serious of the five dimensions. Second, multinomial regression analysis shows that the satisfaction of landless farmers with their social security policies improves their living conditions, particularly in their capacity for self-care, in their ability to perform daily activities, and in the reduction of pain, anxiety, and depression. Third, SEM model analysis shows that the satisfaction of landless farmers with their social security policies positively influences their HRQOL. Among the five dimensions of EQ-5D, daily activities produce the greatest influence on the HRQOL of landless farmers. As regards social security policies, the land acquisition compensation policy and the employment security policy produce the greatest and weakest influences on the HRQOL of landless farmers, respectively. Conclusions The rapid urbanization in China has deprived many farmers of their lands and of the benefits of urbanization. These farmers are often in a disadvantaged position in the land acquisition process. Statistic analysis in this paper shows that the satisfaction of landless farmers with their social security policies positively influences their HRQOL. The implementation and improvement of social security policies is very important for the long-term and sustainable development of these landless farmers.
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Affiliation(s)
- Ying Liang
- Department of Social Work and Social Policy, School of Social and Behavioral Sciences, Nanjing University, 210023 Nanjing, People's Republic of China.
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Crawford B, Yeung CK, Tanaka E, Kraemer M, Leteneux C. Hepatitis C virus in Asia: utility values based on the Short Form-36 questionnaire. Expert Rev Pharmacoecon Outcomes Res 2014; 12:765-73. [DOI: 10.1586/erp.12.61] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Chao J, Song L, Zhang H, Zhu L, Tian L, Jin H, Liu P. Effects of comprehensive intervention on health-related quality of life in patients with chronic hepatitis B in China. BMC Health Serv Res 2013; 13:386. [PMID: 24093163 PMCID: PMC3852560 DOI: 10.1186/1472-6963-13-386] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 09/30/2013] [Indexed: 01/28/2023] Open
Abstract
Background Hepatitis B virus (HBV) infection is a significant global health problem, especially in China. Chronic liver disease affects health related quality of life (HRQOL). The intervention method to improve HRQOL in patients with hepatitis B has been one-dimensional with inconsistent results. The purpose of this study was to evaluate the effect of comprehensive intervention on health-related quality of life and provide guidance on improving HRQOL for patients with chronic hepatitis B. Methods Patients with chronic hepatitis B eligible for our study were randomly selected in three model regions of Jiangsu Province in June 2010. 272 patients were invited and 254 took part, with a refusal rate of 6.62%. Comprehensive intervention included government support, technical guidance from the Chinese Centre for Disease Control and Prevention, standardised medical care, and community involvement. HRQOL before and 1 year after intervention was measured with the Short Form 36 and HBV-specific health surveys. Chi-square test, t-test and multiple linear regressive analyses were used. Results After comprehensive intervention, the HRQOL in patients with chronic hepatitis B showed significantly improvements in bodily pain, vitality, social functioning, and mental, as well as physical and mental component score (p < 0.05). Family and social support increased, and financial concerns decreased (p < 0.05). Marital status, duration of illness-related absence from work, education level, family financial status, and health insurance type were important factors affecting HRQOL change between the baseline and final assessment in patients with chronic hepatitis B. Conclusion The comprehensive intervention was effective in improving the HRQOL of patients with chronic hepatitis B. Trial registration ChiCTR-OCH-12001882
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Affiliation(s)
- Jianqian Chao
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
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Health-related quality of life and survival in Chinese patients with chronic liver disease. Health Qual Life Outcomes 2013; 11:131. [PMID: 23902894 PMCID: PMC3734055 DOI: 10.1186/1477-7525-11-131] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Accepted: 07/30/2013] [Indexed: 12/20/2022] Open
Abstract
Background To investigate the relationship between health-related quality of life (HRQOL) and survival in Chinese patients with chronic liver disease (CLD). Methods HRQOL was measured with the Chinese version of Short Form 36 (SF-36). SF-36 scores, demographic and clinical data were collected at baseline and after 18 months follow-up. Kaplan-Meier and Cox Proportional Hazard Regression survival analyses were used for interpretation of data. Surviving patients were censored in the analyses. Results A total of 415 Chinese patients with CLD and 86 healthy controls were enrolled. During the follow-up period 50 patients died. SF-36 scores in healthy controls and surviving patients were higher compared with those in deceased patients. Scores of physical component summary (PCS) in healthy controls, surviving and deceased patients were 54.1 ± 5.2, 48.9 ± 7.7 and 33.5 ± 8.2 respectively (p < 0.001). Scores of mental component summary (MCS) in healthy controls, surviving and deceased patients were 56.6 ± 8.2, 53.0 ± 5.6 and 37.1 ± 12.1 (p < 0.001) respectively. Survival was significantly associated with PCS and MCS scores, and the presence of ascites. Conclusions HRQOL was associated with survival in patients with CLD. PCS and MCS scores were predictors of survival.
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Zhou KN, Zhang M, Wu Q, Ji ZH, Zhang XM, Zhuang GH. Psychometrics of chronic liver disease questionnaire in Chinese chronic hepatitis B patients. World J Gastroenterol 2013; 19:3494-3501. [PMID: 23801844 PMCID: PMC3683690 DOI: 10.3748/wjg.v19.i22.3494] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 03/14/2013] [Accepted: 03/29/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate psychometrics of the Chinese (mainland) chronic liver disease questionnaire (CLDQ) in patients with chronic hepatitis B (CHB).
METHODS: A cross-sectional sample of 460 Chinese patients with CHB was selected from the Outpatient Department of the Eighth Hospital of Xi’an, including CHB (CHB without cirrhosis) (n = 323) and CHB-related cirrhosis (n = 137). The psychometrics includes reliability, validity and sensitivity. Internal consistency reliability was measured using Cronbach’s α. Convergent and discriminant validity was evaluated by item-scale correlation. Factorial validity was explored by principal component analysis with varimax rotation. Sensitivity was assessed using Cohen’s effect size (ES), and independent sample t test between CHB and CHB-related cirrhosis groups and between alanine aminotransferase (ALT) normal and abnormal groups after stratifying the disease (CHB and CHB-related cirrhosis).
RESULTS: Internal consistency reliability of the CLDQ was 0.83 (range: 0.65-0.90). Most of the hypothesized item-scale correlations were 0.40 or over, and all of such hypothesized correlations were higher than the alternative ones, indicating satisfactory convergent and discriminant validity. Six factors were extracted after varimax rotation from the 29 items of CLDQ. The eligible Cohen’s ES with statistically significant independent sample t test was found in the overall CLDQ and abdominal, systematic, activity scales (CHB vs CHB-related cirrhosis), and in the overall CLDQ and abdominal scale in the stratification of patients with CHB (ALT normal vs abnormal).
CONCLUSION: The CLDQ has acceptable reliability, validity and sensitivity in Chinese (mainland) patients with CHB.
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Wong CKH, Lam ETP, Lam CLK. Comparison of direct-measured and derived short form six dimensions (SF-6D) health preference values among chronic hepatitis B patients. Qual Life Res 2013; 22:2973-81. [PMID: 23564621 DOI: 10.1007/s11136-013-0403-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE The short form six dimensions (SF-6D) are derived from the SF-36 Health Survey with the intention that item data of the latter are often converted to a preference value, which was subsequently used in economic evaluations of interventions. The aim was to compare the equivalence and sensitivity of health preference values derived from the SF-36/SF-12 Health Surveys to that measured directly by the SF-6D for chronic hepatitis B (CHB) patients. METHODS This was a secondary analysis of the SF-6D and SF-36 data from a baseline sample of 589 patients with CHB infection with different stages of liver diseases. Degree of agreement (equivalence) between direct-measured and derived SF-6D values was determined using spearman correlation and intra-class correlation. Sensitivity and discriminative power of different SF-6D values were compared by standardized effect size and relative efficiency (RE) statistics. RESULTS Significant differences in the direct-measured or derived SF-6D preference values were found between CHB groups. Degree of agreement between SF-6D values was satisfactory. Direct-measured SF-6D was the most efficient, followed by SF-12-derived and the SF-36-derived was the least, based on the standardized effect size and the RE statistics. Sensitivity and discriminative power of direct-measured SF-6D were superior to derived SF-6D among people with different CHB health states. CONCLUSIONS Although direct-measured and derived SF-6D preference values had satisfactory sensitivity in discriminating between CHB groups, direct-measured SF-6D is the most sensitive and preferable method of obtaining health preference.
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Affiliation(s)
- Carlos K H Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Ap Lei Chau Main Street, Ap Lei Chau, Hong Kong Island, Hong Kong,
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Zhou KN, Zhang M, Wu Q, Ji ZH, Zhang XM, Zhuang GH. Reliability, validity and sensitivity of the Chinese (simple) short form 36 health survey version 2 (SF-36v2) in patients with chronic hepatitis B. J Viral Hepat 2013; 20:e47-55. [PMID: 23490389 DOI: 10.1111/jvh.12030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Accepted: 09/27/2012] [Indexed: 01/19/2023]
Abstract
The purpose of the study was to evaluate reliability, validity and sensitivity of the Chinese (simple) SF-36v2 in patients with chronic hepatitis B (CHB). Four hundred and sixty patients were recruited and allocated to CHB (CHB without cirrhosis) (n = 323) and CHB-related cirrhosis (n = 137) groups. Internal consistency reliability was estimated with Cronbach's α-coefficient. Convergent and discriminant validity were assessed by item-scale-component correlation. Factorial validity was explored by principal component factor analysis with varimax rotation. Sensitivity was measured with Cohen's effect size (ES), and independent sample t-test between the CHB and CHB-related cirrhosis groups and between alanine aminotransferase (ALT) normal and abnormal groups after stratifying illness stages. The results showed that Cronbach's α of the total SF-36v2 was 0.92, with the range from 0.72 to 0.87 in the eight scales and 0.76 to 0.77 in the two summary components. Most of the hypothesized item-scale-component correlations were 0.40 or over, and all of such hypothesized correlations were higher than the alternative ones, indicating satisfactory convergent and discriminant validity. Two and seven factors were extracted after varimax rotation at the scale level and item level. The eligible ES with statistically significant independent sample t-test was found in the physical component summary (PCS) and physical function (PF), role-physical (RP), general health (GH), vitality (VT), social functioning (SF) scales by comparison between CHB and CHB-related cirrhosis groups, and in the PCS and PF, GH, SF scales by comparison between the ALT normal and abnormal groups in the stratification of patients with CHB. In conclusion, the Chinese (simple) SF-36v2 has acceptable reliability, validity and sensitivity in patients with CHB.
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Affiliation(s)
- K N Zhou
- Department of Epidemiology and Biostatistics, Xi'an Jiaotong University College of Medicine, Xi'an, Shaanxi, P. R., China
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Lu SQ, McGhee SM, Xie X, Cheng J, Fielding R. Economic evaluation of universal newborn hepatitis B vaccination in China. Vaccine 2013; 31:1864-9. [PMID: 23384752 DOI: 10.1016/j.vaccine.2013.01.020] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 01/11/2013] [Accepted: 01/14/2013] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To estimate the long-term cost-effectiveness of universal newborn hepatitis B vaccination in China, an area of high endemicity. METHOD A decision tree was used to describe perinatal hepatitis B virus (HBV) transmission, early infection and impact of vaccination. A Markov model based on 1-year cycles was used to simulate these impacts for the lifetime of a cohort of 10,000,000 infants born in 2002 in China. We compared both cost and health outcomes for two strategies: universal newborn vaccination comprising a timely birth dose (HepB1) with a three-dose vaccination (HepB3) compared with no vaccination. Univariate and probabilistic sensitivity analyses using Monte Carlo simulations were performed to test parameter uncertainty. RESULTS Over the cohort's lifetime, 79,966 chronic infections, 37,553 cases of hepatocellular carcinoma (HCC) and 130,796 HBV related deaths would be prevented by universal infant vaccination. The prevalence of HBV infection is reduced by 76%. Over 743,000 life-years and 620,000 quality adjusted life years (QALYs) would be gained and there would be monetary benefits of more than 1 billion US dollars in medical care costs and lost productivity avoided. CONCLUSION The newborn vaccination programme for Hepatitis B in China both gains QALYs and saves medical care costs. It is important to ensure that timely and comprehensive vaccination programmes continue.
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Affiliation(s)
- Sandy Qiuying Lu
- Department of Community Medicine, School of Public Health, the University of Hong Kong, Hong Kong Special Administrative Region, China
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Drazic YN, Caltabiano ML. Chronic hepatitis B and C: Exploring perceived stigma, disease information, and health-related quality of life. Nurs Health Sci 2012; 15:172-8. [DOI: 10.1111/nhs.12009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 09/04/2012] [Accepted: 09/30/2012] [Indexed: 01/21/2023]
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Chen PX, Yan LN, Wang WT. Health-related quality of life of 256 recipients after liver transplantation. World J Gastroenterol 2012; 18:5114-21. [PMID: 23049223 PMCID: PMC3460341 DOI: 10.3748/wjg.v18.i36.5114] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Revised: 05/02/2012] [Accepted: 05/05/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate health-related quality of life (HRQoL) and psychological outcomes in 256 adults who had undergone liver transplantation (LT).
METHODS: A stratified random sampling method was used in this follow-up multicenter study to select a representative sample of recipients undergoing either living donor liver transplantation (LDLT) or deceased donor liver transplantation (DDLT). HRQoL was measured by using the Chinese version of Medical Outcome Study Short Form-36 (SF-36), and psychological outcomes by using the beck anxiety inventory (BAI) and the self-rating depression scale (SDS). Clinical and demographic data were collected from the records of the Chinese Liver Transplant Registry and via questionnaires.
RESULTS: A total of 256 patients were sampled, including 66 (25.8%) receiving LDLT and 190 (74.2%) undergoing DDLT; 15 (5.9%) recipients had anxiety and four (1.6%) developed severe depression after the operation. Compared with LDLT recipients, DDLT patients had higher scores in general health (60.33 ± 16.97 vs 66.86 ± 18.42, P = 0.012), role-physical (63.64 ± 42.55 vs 74.47 ± 36.46, P = 0.048), role-emotional (61.11 ± 44.37 vs 78.95 ± 34.31, P = 0.001), social functioning (78.60 ± 22.76 vs 88.16 ± 21.85, P = 0.003), vitality (70.30 ± 15.76 vs 75.95 ± 16.40, P = 0.016), mental health (65.88 ± 12.94 vs 71.85 ± 15.45, P = 0.005), physical component summary scale (PCS, 60.07 ± 7.36 vs 62.58 ± 6.88, P = 0.013) and mental component summary scale (MCS, 52.65 ± 7.66 vs 55.95 ± 10.14, P = 0.016). Recipients > 45 years old at the time of transplant scored higher in vitality (77.33 ± 15.64 vs 72.52 ± 16.66, P = 0.020), mental health (73.64 ± 15.06 vs 68.00 ± 14.65, P = 0.003) and MCS (56.61 ± 10.00 vs 54.05 ± 9.30, P = 0.037) than those aged ≤ 45 years. MCS was poorer in recipients with than in those without complications (52.92 ± 12.21 vs 56.06 ± 8.16, P = 0.017). Regarding MCS (55.10 ± 9.66 vs 50.0 ± 10.0, P < 0.05) and PCS (61.93 ± 7.08 vs 50.0 ± 10.0, P < 0.05), recipients scored better than the Sichuan general and had improved overall QoL compared to patients with chronic diseases. MCS and PCS significantly correlated with scores of the BAI (P < 0.001) and the SDS (P < 0.001).
CONCLUSION: Age > 45 years at time of transplant, DDLT, full-time working, no complications, anxiety and depression were possible factors influencing postoperative HRQoL in liver recipients.
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ul Haq N, Hassali MA, Shafie AA, Saleem F, Aljadhey H. A cross sectional assessment of health related quality of life among patients with Hepatitis-B in Pakistan. Health Qual Life Outcomes 2012; 10:91. [PMID: 22866752 PMCID: PMC3480955 DOI: 10.1186/1477-7525-10-91] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 08/01/2012] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The study aims to assess Health Related Quality of Life (HRQoL) among Hepatitis B (HB) patients and to identify significant predictors of the HRQoL in HB patients of Quetta, Pakistan. METHODS A cross sectional study by adopting European Quality of Life scale (EQ-5D) for the assessment of HRQoL was conducted. All registered HB patients attending two public hospitals in Quetta, Pakistan were approached for study. Descriptive statistics were used to describe demographic and disease related characteristics of the patients. HRQoL was scored using values adapted from the United Kingdom general population survey. EQ-5D scale scores were compared with Mann-Whitney and Kruskal-Wallis test. Standard multiple regression analysis was performed to identify predictors of HRQoL. All analyses were performed using SPSS v 16.0. RESULTS Three hundred and ninety HB patients were enrolled in the study. Majority of the participants (n = 126, 32.3%) were categorized in the age group of 18-27 years (36.07 ± 9.23). HRQoL was measured as poor in the current study patients (0.3498 ± 0.31785). The multivariate analysis revealed a significant model (F(10, 380) = 40.04, P < 0.001, adjusted r(2) = 0.401). Educational level (β = 0.399, p = 0.025) emerged as a positive predictor of HRQoL. Age, gender, occupation, income and locality were not predictive of better quality of life in HB patients. CONCLUSIONS Hepatitis B has an adverse affect on patients' well-being and over all HRQoL. The study findings implicate the need of health promotion among HB patients. Improving the educational status and imparting disease related information for the local population can results in better control and management of HB.
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Affiliation(s)
- Noman ul Haq
- Department of Pharmacy, University of Baluchistan, Quetta, Pakistan/Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Mohamed Azmi Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Asrul A Shafie
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Fahad Saleem
- Department of Pharmacy, University of Baluchistan, Quetta, Pakistan/Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Hisham Aljadhey
- College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Health-related quality of life in chinese patients with chronic liver disease. Gastroenterol Res Pract 2012; 2012:516140. [PMID: 22701477 PMCID: PMC3371692 DOI: 10.1155/2012/516140] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Revised: 04/09/2012] [Accepted: 04/11/2012] [Indexed: 12/17/2022] Open
Abstract
Aim. To investigate the factors contributing to health-related quality of life (HRQOL) in Chinese patients with chronic liver disease (CLD). Methods. HRQOL was measured with SF-36v2 Chinese version. Demographic and clinical data were collected, and patients with liver cirrhosis were divided into Child's Class A, B, and C according to Child-Turcotte-Pugh scoring system. Results. A total of 392 Chinese patients with CLD and 91 healthy controls were enrolled. HRQOL in patients with CLD was lower than that in healthy controls. Score of PCS in healthy controls was 54.6 ± 5.5 and in CLD was 47.8 ± 8.8 (P = 0.000). Score of MCS in healthy controls was 56.4 ± 8.1 and in CLD was 51.7 ± 7.4 (P = 0.000). Increasing severity of CLD from no cirrhosis to advanced cirrhosis was associated with a decrease on all domains of the SF-36 (P < 0.05). Stepwise linear regression analysis showed that severity of disease, age, present ascites, present varices, and prothrombin time had significant effect on physical health area. Severity of disease, female, present varices, total bilirubin, prothrombin time, and hemoglobin had significant effect on mental health area.
Conclusions. Patients with CLD had impaired HRQOL. Increasing severity of CLD was associated with a decrease on HRQOL. Old age, female gender, advanced stage of CLD, present ascites, hyperbilirubinemia, and prolonging prothrombin time were important factors reducing HRQOL.
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Wong CKH, Lam CLK, Rowen D, McGhee SM, Ma KP, Law WL, Poon JTC, Chan P, Kwong DLW, Tsang J. Mapping the Functional Assessment of Cancer Therapy-general or -Colorectal to SF-6D in Chinese patients with colorectal neoplasm. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2012; 15:495-503. [PMID: 22583460 DOI: 10.1016/j.jval.2011.12.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 11/06/2011] [Accepted: 12/23/2011] [Indexed: 05/07/2023]
Abstract
OBJECTIVES To map Functional Assessment of Cancer Therapy-General (FACT-G) and Functional Assessment of Cancer Therapy-Colorectal (FACT-C) subscale scores onto six-dimensional health state short form (derived from short form 36 health survey) (SF-6D) preference-based values in patients with colorectal neoplasm, with and without adjustment for clinical and demographic characteristics. These results can then be applied to studies that have used FACT-G or FACT-C to predict SF-6D utility values to inform economic evaluation. METHODS Ordinary least square regressions were estimated mapping FACT-G and FACT-C onto SF-6D by using cross-sectional data of 537 Chinese subjects with different stages of colorectal neoplasm. Mapping functions for SF-6D preference-based values were developed separately for FACT-G and FACT-C in four sequential models for addition of variables: 1) main-effect terms, 2) squared terms, 3) interaction terms, and 4) clinical and demographic variables. Predictive performance in each model was assessed by the R(2), adjusted R(2), predicted R(2), information criteria (Akaike information criteria and Bayesian information criteria), the root mean square error, the mean absolute error, and the proportions of absolute error within the threshold of 0.05 and 0.10. RESULTS Models including FACT variables and clinical and demographic variables had the best predictive performance measured by using R(2) (FACT-G: 59.98%; FACT-C: 60.43%), root mean square error (FACT-G: 0.086; FACT-C: 0.084), and mean absolute error (FACT-G: 0.065; FACT-C: 0.065). The FACT-C-based mapping function had better predictive ability than did the FACT-G-based mapping function. CONCLUSIONS Models mapping FACT-G and FACT-C onto SF-6D reached an acceptable degree of precision. Mapping from the condition-specific measure (FACT-C) had better performance than did mapping from the general cancer measure (FACT-G). These mapping functions can be applied to FACT-G or FACT-C data sets to estimate SF-6D utility values for economic evaluation of medical interventions for patients with colorectal neoplasm. Further research assessing model performance in independent data sets and non-Chinese populations are encouraged.
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Affiliation(s)
- Carlos K H Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong.
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Wiens A, Venson R, Januário Correr C, Pontarolo R. Cost-effectiveness of telbivudine versus lamivudine for chronic hepatitis B. Braz J Infect Dis 2011; 15:225-30. [DOI: 10.1016/s1413-8670(11)70180-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Accepted: 12/15/2010] [Indexed: 01/05/2023] Open
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