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Prevolnik Rupel V, Mori Lukančič M, Ogorevc M. Costs and Quality of Life in Patients With Systemic Arterial Hypertension in Slovenia. Value Health Reg Issues 2023; 33:49-55. [PMID: 36242818 DOI: 10.1016/j.vhri.2022.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 08/02/2022] [Accepted: 09/02/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Systemic arterial hypertension (SAH) is one of the most critical risk factors for morbidity in chronic noncommunicable diseases. The aim of this study was to estimate the costs incurred by and the health-related quality of life (HRQoL) for a sample of patients with AH aged ≥ 65, in 2019. METHODS A sample of 142 patients who were taking medicines for SAH was selected from the urban and rural areas. The patients consented to participate in the study. Patients also reported their out-of-pocket expenditures connected to SAH and their HRQoL. HRQoL was measured using generic 5-level version of EQ-5D (EQ-5D-5L) and the disease-specific MINICHAL questionnaires. Descriptive analysis was used to present the results. Calculations were made using R (v4.01) software. RESULTS A sample of 141 patients filled out 17-item MINICHAL and 142 filled out the EQ-5D-5L questionnaire. Patients' MINICHAL mood and somatic domain scores were 5.5 and 3.5, respectively. EQ-5D-5L mean index utility score was 0.7 and the mean EQ VAS was 70.9. Pain/discomfort was the most affected health dimension as 60.6% of patients reported having problems. The 2 HRQoL questionnaires are moderately correlated (-0.215). The average annual costs of SAH treatment amounted to €274.3 per patient. The largest share of costs is represented by pharmacological treatment (30.5%) and out-of-pocket expenses (28.2%). CONCLUSIONS Our study is the first study in Slovenia to assess the costs incurred by and HRQoL of patients with SAH using bottom-up approach and societal perspective. It offers important input in a decision-analytic model to assess cost-effectiveness of interventions to reduce the burden of SAH.
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Affiliation(s)
| | | | - Marko Ogorevc
- Institute for Economic Research, Ljubljana, Slovenia
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2
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Nair T, Kumar AS, Unni TG, Tiwaskar MH, Sharma S, Gaurav K. 24-Hour Blood Pressure Control with Amlodipine: A Review of the Current Scenario. JOURNAL OF CARDIAC CRITICAL CARE TSS 2022. [DOI: 10.1055/s-0042-1750195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Abstract
Introduction Hypertension is the leading cause of cardiovascular diseases and premature death worldwide. Antihypertensive therapy using calcium channel blockers (CCBs) is one of the preferred choices to treat blood pressure (BP) and control blood pressure variability (BPV). In contrast to clinic BP, 24-hour ambulatory BP monitoring (ABPM) has evolved into an accurate and reproducible tool for the assessment and management of hypertension. Amlodipine, a longer acting dihydropyridine CCB is effective for 24 hours BP control and also minimizing BPV. The present article is the comprehensive review highlighting the efficacy of amlodipine in controlling 24-hour BP and minimizing BPV from the review of recent studies.
Materials and Methods The literature search was done using PubMed, Google Scholar, and MEDLINE databases. The studies to be included for review, were identified through the keywords: “amlodipine,” “ambulatory BP monitoring (ABPM),”“blood pressure variability (BPV),” “CCBs,” and filtering articles published in English language only.
Results Pharmacological evidence suggests that amlodipine has the ability to block all the subtypes of CCBs such as L-, N-, P-, Q-, R-, and T-type. Various clinical studies reported that amlodipine is a powerful, well-tolerated, and safe antihypertensive agent which is widely used either alone or as a key component of combination therapy for control of 24 hours BP.
Conclusion Overall, amlodipine is a proven and effective antihypertensive drug and helpful in controlling 24-hour BP, minimizing BP variability and hence reducing the risk of cardiovascular complications.
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Affiliation(s)
- Tiny Nair
- Department of Cardiology, PRS Hospital, Trivandrum, Kerala, India
| | | | - T Govindan Unni
- Department of Cardiology, Jubilee Mission Medical College & Research Institute, Thrissur, Kerala, India
| | - Mangesh Harihar Tiwaskar
- Department of Cardiology, Jubilee Mission Medical College & Research Institute, Thrissur, Kerala, India
| | - Shweta Sharma
- Dr. Reddy's Laboratories, Hyderabad, Telangana, India
| | - Kumar Gaurav
- Dr. Reddy's Laboratories, Hyderabad, Telangana, India
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Jordan AN, Anning C, Wilkes L, Ball C, Pamphilon N, Clark CE, Bellenger NG, Shore AC, Sharp ASP, Valderas JM. Cross-cultural adaptation of the Spanish MINICHAL instrument into English for use in the United Kingdom. Health Qual Life Outcomes 2022; 20:39. [PMID: 35246164 PMCID: PMC8895672 DOI: 10.1186/s12955-022-01943-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/20/2022] [Indexed: 12/12/2022] Open
Abstract
Background Hypertension is a highly prevalent condition, with optimal treatment to BP targets conferring significant gains in terms of cardiovascular outcomes. Understanding why some patients do not achieve BP targets would be enhanced through greater understanding of their health-related quality of life (HRQoL). However, the only English language disease-specific instruments for measurement of HRQoL in hypertension have not been validated in accordance with accepted standards. It is proposed that the Spanish MINICHAL instrument for the assessment of HRQoL in hypertension could be translated, adapted and validated for use in the United Kingdom. The aim of the study was therefore to complete this process. Methods The MINICHAL authors were contacted and the original instrument obtained. This was then translated into English by two independent English-speakers, with these versions then reconciled, before back-translation and subsequent production of a 2nd reconciled version. Thereafter, a final version was produced after cognitive debriefing, for administration and psychometric analysis in the target population of patients living in the Exeter area (Southwest UK) aged 18–80 years with treatment-naïve grade II-III hypertension, before, during and after 18 weeks’ intensive treatment. Results The English-language instrument was administered to 30 individuals (median age: 58.5 years, 53% male). Psychometric analysis demonstrated a floor effect, though no ceiling effect. Internal consistency for both state of mind (StM) and somatic manifestations (SM) dimensions of the instrument were acceptable (Cronbach’s alpha = 0.81 and 0.75), as was test–retest reliability (ICC = 0.717 and 0.961) and construct validity, which was measured through co-administration with the EQ-5D-5L and Bulpitt-Fletcher instruments. No significant associations were found between scores and patient characteristics known to affect HRQoL. The EQ-5D-5L instrument found an improvement in HRQoL following treatment, with the StM and SM dimensions of the English language MINICHAL trending to support this (d = 0.32 and 0.02 respectively). Conclusions The present study details the successful English translation and validation of the MINICHAL instrument for use in individuals with hypertension. The data reported also supports an improvement in HRQoL with rapid treatment of grade II-III hypertension, a strategy which has been recommended by contemporaneous European guidelines. Trial registration ISRCTN registry number: 57475376 (assigned 25/06/2015).
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Affiliation(s)
- Andrew N Jordan
- NIHR Exeter Clinical Research Facility, Vascular Medicine, University Hospitals Dorset, Exeter, UK. .,Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, EX2 5AX, UK.
| | - Christine Anning
- NIHR Exeter Clinical Research Facility, Vascular Medicine, University Hospitals Dorset, Exeter, UK
| | - Lindsay Wilkes
- NIHR Exeter Clinical Research Facility, Vascular Medicine, University Hospitals Dorset, Exeter, UK
| | - Claire Ball
- NIHR Exeter Clinical Research Facility, Vascular Medicine, University Hospitals Dorset, Exeter, UK
| | - Nicola Pamphilon
- NIHR Exeter Clinical Research Facility, Vascular Medicine, University Hospitals Dorset, Exeter, UK
| | - Christopher E Clark
- Health Services and Policy Research Group, Exeter Collaboration for Academic Primary Care (APEx), NIHR School for Primary Care Research, University of Exeter, Smeall Building, St Luke's Campus, Magdalen Road, Exeter, EX1 2LU, UK
| | - Nicholas G Bellenger
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, EX2 5AX, UK.,Department of Cardiology, Royal Devon and Exeter Hospital, Exeter, UK
| | - Angela C Shore
- NIHR Exeter Clinical Research Facility, Vascular Medicine, University Hospitals Dorset, Exeter, UK.,Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, EX2 5AX, UK
| | - Andrew S P Sharp
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, EX2 5AX, UK.,Department of Cardiology, Royal Devon and Exeter Hospital, Exeter, UK
| | - Jose M Valderas
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, EX2 5AX, UK.,Health Services and Policy Research Group, Exeter Collaboration for Academic Primary Care (APEx), NIHR School for Primary Care Research, University of Exeter, Smeall Building, St Luke's Campus, Magdalen Road, Exeter, EX1 2LU, UK
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Wong ELY, Xu RH, Cheung AWL. Health-related quality of life among patients with hypertension: population-based survey using EQ-5D-5L in Hong Kong SAR, China. BMJ Open 2019; 9:e032544. [PMID: 31562165 PMCID: PMC6773333 DOI: 10.1136/bmjopen-2019-032544] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES To evaluate the effect of hypertension and related comorbidities on the health-related quality of life (HRQoL) using EuroQol 5-dimensions instrument with five-level scale (EQ-5D-5L) Hong Kong (HK) version. DESIGN Data were analysed by a secondary data analysis based on a cross-sectional study assessing experience on public specialist outpatient service. SETTING A representative sample was recruited from 26 specialist outpatient clinics in HK. PARTICIPANTS A total of 4528 patients with hypertension aged 18 or above who responded to the survey. INTERVENTION EQ-5D-5L HK was applied to assess the HRQoL. The five-dimension descriptive system and the utility index of EQ-5D-5L were treated as the dependent variable in the current study. Regression modelling was applied to estimate the effect of hypertension and related comorbidities on health-related quality of life. RESULTS More respondents were women (53.9%), aged ≥65 years old (60.1%), and with primary educational attainment or below (52.3%). A total of 1466 respondents (32.4%) also reported suffering from diabetes, heart disease (20.8%), vision problem (1.7%) and cancer (1.5%). In the ordinal least squares model, utility decreased most when patients reported having physical disability associated with hypertension (beta=-0.395, SE=0.047), and 0.128, 0.064, 0.05 and 0.048 for mental problem, cancer, vision problem and heart problem. In the Tobit model, the utility reduced most for comorbidity of physical disability, and then mental problem, cancer, vision problem, heart problem and diabetes. For first part of two-part model, respondents coliving with mental problem were 10% less likely to report a full health. For the second part of two-part model, the respondents with physical disability had 0.294 lower in utility. CONCLUSIONS Respondents with hypertension reported a low EQ-5D utility score. Respondents were women, with a high education, fully employed and living with families reported better HRQoL. There is a significant effect of comorbidity influence on the decreased HRQoL, particularly those with physical disability and mental problem.
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Affiliation(s)
- Eliza Lai Yi Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Richard Huan Xu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Annie Wai Ling Cheung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Abstract
BACKGROUND Clinical researchers found that Amlodipine besylate and Valsartan (ABVS) can effectively treat mild to moderate hypertension (MMH). However, no study has systematically investigated its efficacy and safety for patients with MMH. Thus, present study will systematically assess the efficacy and safety of ABVS for patients with MMH. METHODS MEDICINE, Cochrane Library, EMBASE, Ovid, PsycINFO, Web of Science, Allied and Complementary Medicine Database, and China National Knowledge Infrastructure will be searched for literatures related to the topic from inception to the present without language limitations. All randomized controlled trials that assess the efficacy and safety of ABVS for patients with MMH will be considered for inclusion. Two researchers will independently select study, extract data, and assess risk of bias for all eligible studies. RESULTS The primary outcome includes the change of seated diastolic blood pressure. The secondary outcomes consist of the change of seated systolic blood pressure, health-related quality of life, and the tolerability. CONCLUSIONS The results of this study will summarize the latest evidence on ABVS for the treatment of MMH. ETHICS AND DISSEMINATION This study does not need ethical approval, because it will not use individual data. The results of this study are expected to be published at peer-reviewed journals. PROSPERO REGISTRATION NUMBER PROSPERO CRD42019133123.
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Lo C, Zimbudzi E, Teede HJ, Kerr PG, Ranasinha S, Cass A, Fulcher G, Gallagher M, Polkinghorne KR, Russell G, Usherwood T, Walker R, Zoungas S. Patient-reported barriers and outcomes associated with poor glycaemic and blood pressure control in co-morbid diabetes and chronic kidney disease. J Diabetes Complications 2019; 33:63-68. [PMID: 30621853 DOI: 10.1016/j.jdiacomp.2018.09.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 06/18/2018] [Accepted: 09/26/2018] [Indexed: 12/21/2022]
Abstract
AIMS In patients with comorbid diabetes and chronic kidney disease, the extent to which patient-reported barriers to health-care and patient reported outcomes influence the quality of health care is not well established. This study explored the association between patient-reported barriers to health-care, patient activation, quality of life and diabetes self-care, with attainment of glycaemic and blood pressure (BP) targets. METHODS This cross-sectional study recruited adults with diabetes and CKD (eGFR 20 to <60 ml/min/1.73m2) across four hospitals. We combined clinical data with results from a questionnaire comprising measures of patient-identified barriers to care, the Patient Activation Measure (PAM), 12-Item Short Form Survey (SF-12), and the Summary of Diabetes Self-Care Activity (SDSCA). RESULTS 199 patients, mean age 68.7 (SD 9.6), 70.4% male and 90.0% with type 2 diabetes were studied. Poor glycaemic control was associated with increased odds of patient reported "poor family support" (OR 4.90; 95% CI 1.80 to 13.32, p < 0.002). Poor BP control was associated with increased odds of patient reported, "not having a good primary care physician" (OR 6.01; 2.42 to 14.95, p < 0.001). The number of barriers was not associated with increased odds of poor control (all p > 0.05). CONCLUSIONS Specific patient-reported barriers, lack of patient perceived family and primary care physician support, are associated with increased odds of poor glycaemic and blood pressure control respectively. Interventions addressing these barriers may improve treatment target attainment.
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Affiliation(s)
- Clement Lo
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia; Diabetes and Vascular Medicine Unit, Monash Health, VIC, Australia
| | - Edward Zimbudzi
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia; Department of Nephrology, Monash Health, VIC, Australia
| | - Helena J Teede
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia; Diabetes and Vascular Medicine Unit, Monash Health, VIC, Australia
| | - Peter G Kerr
- Department of Nephrology, Monash Health, VIC, Australia
| | - Sanjeeva Ranasinha
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - Alan Cass
- Menzies School of Health Research, Casuarina, NT, Australia; The George Institute for Global Health, NSW, Australia
| | - Gregory Fulcher
- Department of Diabetes and Endocrinology, Royal North Shore Hospital, NSW, Australia
| | - Martin Gallagher
- The George Institute for Global Health, NSW, Australia; Department of Nephrology, Concord Hospital, NSW, Australia
| | - Kevan R Polkinghorne
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia; Department of Nephrology, Monash Health, VIC, Australia
| | - Grant Russell
- Department of General Practice, School of Primary and Allied Health Care, Monash University, VIC, Australia
| | - Tim Usherwood
- The George Institute for Global Health, NSW, Australia; Department of General Practice, Sydney Medical School Westmead, NSW, Australia
| | - Rowan Walker
- Department of Renal Medicine, Alfred Health, VIC, Australia
| | - Sophia Zoungas
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia; Diabetes and Vascular Medicine Unit, Monash Health, VIC, Australia; The George Institute for Global Health, NSW, Australia.
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Olmesartan medoxomil/amlodipine/hydrochlorothiazide 20 mg/5 mg/12.5 mg fixed-dose combination in hypertension: a profile of its use. DRUGS & THERAPY PERSPECTIVES 2018. [DOI: 10.1007/s40267-017-0465-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Brownstein DJ, Salagre E, Köhler C, Stubbs B, Vian J, Pereira C, Chavarria V, Karmakar C, Turner A, Quevedo J, Carvalho AF, Berk M, Fernandes BS. Blockade of the angiotensin system improves mental health domain of quality of life: A meta-analysis of randomized clinical trials. Aust N Z J Psychiatry 2018; 52:24-38. [PMID: 28754072 DOI: 10.1177/0004867417721654] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE It is unclear whether blockade of the angiotensin system has effects on mental health. Our objective was to determine the impact of angiotensin converting enzyme inhibitors and angiotensin II type 1 receptor (AT1R) blockers on mental health domain of quality of life. STUDY DESIGN Meta-analysis of published literature. DATA SOURCES PubMed and clinicaltrials.gov databases. The last search was conducted in January 2017. STUDY SELECTION Randomized controlled trials comparing any angiotensin converting enzyme inhibitor or AT1R blocker versus placebo or non-angiotensin converting enzyme inhibitor or non-AT1R blocker were selected. Study participants were adults without any major physical symptoms. We adhered to meta-analysis reporting methods as per PRISMA and the Cochrane Collaboration. DATA SYNTHESIS Eleven studies were included in the analysis. When compared with placebo or other antihypertensive medications, AT1R blockers and angiotensin converting enzyme inhibitors were associated with improved overall quality of life (standard mean difference = 0.11, 95% confidence interval = [0.08, 0.14], p < 0.0001), positive wellbeing (standard mean difference = 0.11, 95% confidence interval = [0.05, 0.17], p < 0.0001), mental (standard mean difference = 0.15, 95% confidence interval = [0.06, 0.25], p < 0.0001), and anxiety (standard mean difference = 0.08, 95% confidence interval = [0.01, 0.16], p < 0.0001) domains of QoL. No significant difference was found for the depression domain (standard mean difference = 0.05, 95% confidence interval = [0.02, 0.12], p = 0.15). CONCLUSIONS Use of angiotensin blockers and inhibitors for the treatment of hypertension in otherwise healthy adults is associated with improved mental health domains of quality of life. Mental health quality of life was a secondary outcome in the included studies. Research specifically designed to analyse the usefulness of drugs that block the angiotensin system is necessary to properly evaluate this novel psychiatric target.
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Affiliation(s)
- Daniel J Brownstein
- 1 Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Estela Salagre
- 2 Bipolar Disorders Unit, Hospital Clinic, Institute of Neurosciences, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Cristiano Köhler
- 3 Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Brendon Stubbs
- 4 Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK.,5 Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK.,6 Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
| | - João Vian
- 7 Psychiatry and Mental Health Department, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.,8 Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Ciria Pereira
- 7 Psychiatry and Mental Health Department, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.,8 Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Victor Chavarria
- 9 Institut de Neuropsiquiatria i Adiccions (INAD), Parc de Salut Mar (PSM), Barcelona, Spain
| | - Chandan Karmakar
- 10 Center for Pattern Recognition and Data Analytics, School of Information Technology, Deakin University, Geelong, VIC, Australia
| | - Alyna Turner
- 11 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,12 Barwon Health, Geelong, VIC, Australia
| | - João Quevedo
- 13 Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,14 Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,15 Neuroscience Graduate Program, Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center UTHealth, Houston, TX, USA.,16 Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - André F Carvalho
- 3 Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Michael Berk
- 11 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,12 Barwon Health, Geelong, VIC, Australia.,17 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,18 Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia.,19 The Florey Institute for Neuroscience Mental Health, Parkville, VIC, Australia
| | - Brisa S Fernandes
- 11 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,12 Barwon Health, Geelong, VIC, Australia.,20 Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Borges JWP, Moreira TMM, Schmitt J, de Andrade DF, Barbetta PA, de Souza ACC, Lima DBDS, Carvalho IS. Measuring the quality of life in hypertension according to Item Response Theory. Rev Saude Publica 2017; 51:45. [PMID: 28492764 PMCID: PMC5433789 DOI: 10.1590/s1518-8787.2017051006845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 05/11/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To analyze the Miniquestionário de Qualidade de Vida em Hipertensão Arterial (MINICHAL - Mini-questionnaire of Quality of Life in Hypertension) using the Item Response Theory. METHODS This is an analytical study conducted with 712 persons with hypertension treated in thirteen primary health care units of Fortaleza, State of Ceará, Brazil, in 2015. The steps of the analysis by the Item Response Theory were: evaluation of dimensionality, estimation of parameters of items, and construction of scale. The study of dimensionality was carried out on the polychoric correlation matrix and confirmatory factor analysis. To estimate the item parameters, we used the Gradual Response Model of Samejima. The analyses were conducted using the free software R with the aid of psych and mirt. RESULTS The analysis has allowed the visualization of item parameters and their individual contributions in the measurement of the latent trait, generating more information and allowing the construction of a scale with an interpretative model that demonstrates the evolution of the worsening of the quality of life in five levels. Regarding the item parameters, the items related to the somatic state have had a good performance, as they have presented better power to discriminate individuals with worse quality of life. The items related to mental state have been those which contributed with less psychometric data in the MINICHAL. CONCLUSIONS We conclude that the instrument is suitable for the identification of the worsening of the quality of life in hypertension. The analysis of the MINICHAL using the Item Response Theory has allowed us to identify new sides of this instrument that have not yet been addressed in previous studies. OBJETIVO Analisar o Miniquestionário de Qualidade de Vida em Hipertensão Arterial (MINICHAL) por meio da Teoria da Resposta ao Item. MÉTODOS Estudo analítico realizado com 712 pessoas com hipertensão arterial atendidas em 13 unidades de atenção primária em saúde de Fortaleza, CE, em 2015. As etapas da análise pela Teoria da Resposta ao Item foram: avaliação da dimensionalidade, estimação dos parâmetros dos itens e construção da escala. O estudo da dimensionalidade foi realizado sobre a matriz de correlação policórica e análise fatorial confirmatória. Para a estimação dos parâmetros dos itens, foi utilizado o Modelo de Resposta Gradual de Samejima. As análises foram conduzidas no software livre R com o auxílio dos pacotes psych e mirt. RESULTADOS A análise permitiu a visualização dos parâmetros dos itens e suas contribuições individuais na mensuração do traço latente, gerando mais informação, permitindo a construção de uma escala com um modelo interpretativo que demonstra a evolução da piora da qualidade de vida em cinco níveis. Quanto aos parâmetros dos itens, houve bom desempenho daqueles referentes ao estado somático, pois apresentaram melhor poder de discriminar os indivíduos com pior qualidade de vida. Os itens relacionados ao estado mental foram os que contribuíram com menor quantidade de informação psicométrica no MINICHAL. CONCLUSÕES Conclui-se que o instrumento é indicado para a identificação da deterioração da qualidade de vida em hipertensão arterial. A análise do MINICHAL pela Teoria da Resposta ao Item permitiu identificar novas facetas desse instrumento ainda não abordadas em estudos anteriores.
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Affiliation(s)
- José Wicto Pereira Borges
- Programa de Pós-Graduação em Saúde e Comunidade. Universidade Federal do Piauí. Floriano, PI, Brasil
| | - Thereza Maria Magalhães Moreira
- Programa de Pós-Graduação em Cuidados Clínicos em Enfermagem e Saúde. Programa de Pós-Graduação em Saúde Coletiva. Centro de Ciências da Saúde. Universidade Estadual do Ceará. Fortaleza, CE, Brasil
| | - Jeovani Schmitt
- Programa de Pós-Graduação em Engenharia de Produção. Universidade Federal de Santa Catarina. Florianópolis, SC, Brasil
| | - Dalton Francisco de Andrade
- Departamento de Informática e Estatística. Programa de Pós-Graduação em Engenharia de Produção. Universidade Federal de Santa Catarina. Florianópolis, SC, Brasil
| | - Pedro Alberto Barbetta
- Departamento de Informática e Estatística. Programa de Pós-Graduação em Engenharia de Produção. Universidade Federal de Santa Catarina. Florianópolis, SC, Brasil
| | - Ana Célia Caetano de Souza
- Unidade de Farmacologia Clínica. Núcleo de Pesquisa e Desenvolvimento de Medicamentos. Universidade Federal do Ceará. Fortaleza, CE, Brasil
| | | | - Irialda Saboia Carvalho
- Programa de Pós-Graduação em Saúde Coletiva. Universidade Estadual do Ceará. Fortaleza, CE, Brasil
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de Souza ACC, Borges JWP, Moreira TMM. Quality of life and treatment adherence in hypertensive patients: systematic review with meta-analysis. Rev Saude Publica 2016; 50:71. [PMID: 28099657 PMCID: PMC5152803 DOI: 10.1590/s1518-8787.2016050006415] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 10/11/2015] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To verify the effects of antihypertensive treatment (pharmacological and non-pharmacological) on the health-related quality of life of individuals with hypertension. METHODS We conducted a systematic review with meta-analysis using the following databases: IBECS, LILACS, SciELO, Medline, Cochrane, Science Direct, Scopus and the Brazilian Capes Theses and Dissertations Database. The statistical analysis was performed using Review Manager, version 5.2. The average difference was used for the summarization of meta-analytic effect by the fixed-effect model. Twenty studies were included. RESULTS The summarization of the effect showed an average increase of 2.45 points (95%CI 1.02-3.87; p < 0.0008) in the quality of life of individuals adhering to non-pharmacological treatment for arterial hypertension. Adherence to pharmacological treatment indicated an average increase of 9.24 points (95%CI 8.16-10.33; p < 0.00001) in the quality of life of individuals with arterial hypertension. CONCLUSIONS Non-pharmacological treatment improves the overall quality of life and physical domain of people with arterial hypertension. Adherence to pharmacological treatment has a positive impact on the mental and physical domains of patients, as it did on the overall quality of life score. OBJETIVO Verificar os efeitos do tratamento anti-hipertensivo (farmacológico e não-farmacológico) na qualidade de vida relacionada à saúde de pessoas com hipertensão arterial. MÉTODOS Foi conduzida revisão sistemática com metanálise utilizando as bases de dados IBECS, Lilacs, SciELO, Medline, Cochrane, Science Direct, Scopus e o banco de teses da Capes. A análise estatística foi realizada pelo Review Manager versão 5.2. Foi utilizada a diferença da média na sumarização do efeito metanalítico pelo modelo de efeito fixo. Vinte estudos foram incluídos. RESULTADOS A sumarização do efeito mostrou incremento de 2,45 pontos na média (IC95% 1,02-3,87; p < 0,0008) da qualidade de vida em pessoas com adesão ao tratamento não farmacológico para hipertensão arterial. A adesão ao tratamento farmacológico indicou aumento de 9,24 pontos na média (IC95% 8,16-10,33; p < 0,00001) da qualidade de vida em pessoas com hipertensão arterial. CONCLUSÕES O tratamento não-farmacológico melhora a qualidade de vida global e o domínio físico de pessoas com hipertensão arterial. A adesão ao tratamento farmacológico impacta positivamente nos domínios mental, físico e escore total da qualidade de vida.
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Affiliation(s)
- Ana Célia Caetano de Souza
- Unidade de Farmacologia Clínica. Núcleo de Pesquisa e Desenvolvimento de Medicamentos. Universidade Federal do Ceará. Fortaleza, CE, Brasil
| | - José Wicto Pereira Borges
- Programa de Graduação em Enfermagem. Programa de Pós-Graduação em Saúde e Comunidade. Campus Amilcar Ferreira Sobral. Universidade Federal do Piauí. Floriano, PI, Brasil
| | - Thereza Maria Magalhães Moreira
- Programa de Pós-Graduação em Saúde Coletiva. Programa de Pós-Graduação em Cuidados Clínicos em Enfermagem e Saúde. Centro de Ciências da Saúde. Universidade Estadual do Ceará. Fortaleza, CE, Brasil
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Gan L, Wang ZH, Zhang H, Zhou X, Zhou H, Sun C, Si J, Zhou R, Ma CJ, Li J. Endothelium-independent vasorelaxant effect of 20(S)-protopanaxadiol on isolated rat thoracic aorta. Acta Pharmacol Sin 2016; 37:1555-1562. [PMID: 27616575 DOI: 10.1038/aps.2016.74] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 06/30/2016] [Indexed: 12/15/2022] Open
Abstract
AIM Ginsenosides are considered to be the major pharmacologically active ginseng constituents, whereas 20(S)-protopanaxadiol [20(S)-PPD] is the active metabolite of ginsenosides in gut. In this study we investigated the effect of 20(S)-PPD on isolated rat thoracic aortas as well as its vasorelaxant mechanisms. METHODS Aortic rings with or without endothelium were prepared from Wistar rats and suspended in organ-chambers. The changes in tension of the preparations were recorded through isometric transducers connected to a data acquisition system. The aortic rings were precontracted with phenylephrine (PE, 1 μmol/L) or high-K+ (80 mmol/L). RESULTS Application of 20(S)-PPD (21.5-108.5 μmol/L) caused concentration-dependent vasodilation of endothelium-intact aortic rings precontracted with PE or high-K+, which resulted in the EC50 values of 90.4 or 46.5 μmol/L, respectively. The removal of endothelium had no effect on 20(S)-PPD-induced relaxation. The vasorelaxant effect of 20(S)-PPD was also not influenced by the preincubation with β-adrenergic receptor antagonist propranolol, or with ATP-sensitive K+ channel blocker glibenclamide, voltage-dependent K+ channel blocker 4-AP and inward rectifier K+ channel blocker BaCl2, whereas it was significantly attenuated by the preincubation with Ca2+-activated K+ (BKCa) channel blocker TEA (1 mmol/L). Furthermore, the inhibition of NO synthesis, cGMP and prostacyclin pathways did not affect the vasorelaxant effect of 20(S)-PPD. In Ca2+-free solution, 20(S)-PPD (108.5 μmol/L) markedly decreased the extracellular Ca2+-induced contraction in aortic rings precontracted with PE or high-K+ and reduced PE-induced transient contraction. Voltage-dependent Ca2+ channel antagonist nifedipine inhibited PE-induced contraction; further inhibition was observed after the application of receptor-operated Ca2+ channel inhibitor SK&F 96365 or 20(S)-PPD. CONCLUSION 20(S)-PPD induces vasorelaxation via an endothelium-independent pathway. The inhibition of voltage-dependent Ca2+ channels and receptor-operated Ca2+ channels and the activation of Ca2+-activated K+ channels are probably involved in the relaxation.
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de Souza ACC, Moreira TMM, de Oliveira ES, de Menezes AVB, Loureiro AMO, Silva CBDA, Linard JG, de Almeida ILS, Mattos SM, Borges JWP. Effectiveness of Educational Technology in Promoting Quality of Life and Treatment Adherence in Hypertensive People. PLoS One 2016; 11:e0165311. [PMID: 27851752 PMCID: PMC5112805 DOI: 10.1371/journal.pone.0165311] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 10/09/2016] [Indexed: 12/01/2022] Open
Abstract
The objective of this study was to test the effectiveness of an educational intervention with use of educational technology (flipchart) to promote quality of life (QOL) and treatment adherence in people with hypertension. It was an intervention study of before-and-after type conducted with 116 hypertensive people registered in Primary Health Care Units. The educational interventions were conducted using the flipchart educational technology. Quality of life was assessed through the MINICHAL (lowest score = better QOL) and the QATSH (higher score = better adherence) was used to assess the adherence to hypertension treatment. Both were measured before and after applying the intervention. In the analysis, we used the Student's t-test for paired data. The average baseline quality of life was 11.66 ± 7.55, and 7.71 ± 5.72 two months after the intervention, showing a statistically significant reduction (p <0.001) and mean of differences of 3.95. The average baseline adherence to treatment was 98.03 ± 7.08 and 100.71 ± 6.88 two months after the intervention, which is statistically significant (p < 0.001), and mean of differences of 2.68. The conclusion was that the educational intervention using the flipchart improved the total score of quality of life in the scores of physical and mental domains, and increased adherence to hypertension treatment in people with the disease.
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Affiliation(s)
- Ana Célia Caetano de Souza
- Postgraduate Program Clinical Care in Nursing and Health (PPCCLIS), Universidade Estadual do Ceará (UECE), Unit of Clinical Pharmacology, Center for Research and Development of Medicines (NPDM), Universidade Federal do Ceará, Fortaleza, Brazil
| | - Thereza Maria Magalhaes Moreira
- Postgraduate Program Clinical Care in Nursing and Health (PPCCLIS), Postgraduate Program in Public Health (PPSAC), Universidade Estadual do Ceará, Fortaleza, Brazil
| | | | | | | | | | - Jair Gomes Linard
- Postgraduate Program in Public Health (PPSAC), Universidade Estadual do Ceará, Fortaleza, Brazil
| | | | - Samuel Miranda Mattos
- Scholarship of scientific initiation, Universidade Estadual do Ceará, Fortaleza, Brazil
| | - José Wicto Pereira Borges
- Postgraduate Program Clinical Care in Nursing and Health (PPCCLIS), Universidade Estadual do Ceará, Fortaleza, Brazil, Postgraduate Program in Health and Community (PPGSC), Universidade Federal do Piauí, Teresina, Brazil
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Schmieder RE, Jumar A, Fronk EM, Alexandre AF, Bramlage P. Quality of life and emotional impact of a fixed-dose combination of antihypertensive drugs in patients with uncontrolled hypertension. J Clin Hypertens (Greenwich) 2016; 19:126-134. [DOI: 10.1111/jch.12936] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 08/19/2016] [Accepted: 08/22/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Roland E. Schmieder
- Department for Nephrology and Hypertension; University Hospital Erlangen; Erlangen Germany
| | - Agnes Jumar
- Department for Nephrology and Hypertension; University Hospital Erlangen; Erlangen Germany
| | | | | | - Peter Bramlage
- Institute for Pharmacology and Preventive Medicine; Mahlow Germany
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Olmesartan medoxomil: a guide to its use as monotherapy or in fixed-dose combinations with amlodipine and/or hydrochlorothiazide. DRUGS & THERAPY PERSPECTIVES 2016. [DOI: 10.1007/s40267-016-0335-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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