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Marten O, Greiner W. Exploring differences and similarities of EQ-5D-3L, EQ-5D-5L and WHOQOL-OLD in recipients of aged care services in Germany. PLoS One 2023; 18:e0290606. [PMID: 37624857 PMCID: PMC10456181 DOI: 10.1371/journal.pone.0290606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
European countries more than ever face shifts towards aging societies with accompanying challenges for health and aged care services. Economic evaluation has mainly relied on health measures such as EQ-5D across populations and conditions. We want to know how well the EQ-5D performs in the target population to avoid bias to the disadvantage of older adults and care-dependents. Therefore, we aim to explore differences and similarities of EQ-5D-3L and EQ-5D-5L in comparison to the old-age specific WHOQOL-OLD instrument in a sample of older adults receiving aged care services. We collected data from n = 329 older adults (≥65 years) receiving aged care services in Germany; the majority was at least 80 years and had varying care needs. We assessed instruments' feasibility, test-retest reliability, instruments' association and sensitivity to known-group differences. In terms of feasibility and test-retest reliability both EQ-5D versions performed better than the WHOQOL-OLD. All measures differentiated well between groups based on aspects of general health and care levels. The analysis of relationship between measures indicated that EQ-5D and WHOQOL-OLD assess partially overlapping, but distinct constructs. We found no clear evidence of superiority of either EQ-5D version over the other. The EQ-5D-5L performed better in terms of test-retest reliability and stronger correlations with WHOQOL-OLD facets. We conclude that using the WHOQOL-OLD alongside EQ-5D in this sample added further information on different aspects of quality of life.
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Affiliation(s)
- Ole Marten
- Department of Health Economics and Health Care Management, Bielefeld University, Bielefeld, North Rhine-Westphalia, Germany
| | - Wolfgang Greiner
- Department of Health Economics and Health Care Management, Bielefeld University, Bielefeld, North Rhine-Westphalia, Germany
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Baricich A, Battaglia M, Cuneo D, Cosenza L, Millevolte M, Cosma M, Filippetti M, Dalise S, Azzollini V, Chisari C, Spina S, Cinone N, Scotti L, Invernizzi M, Paolucci S, Picelli A, Santamato A. Clinical efficacy of botulinum toxin type A in patients with traumatic brain injury, spinal cord injury, or multiple sclerosis: An observational longitudinal study. Front Neurol 2023; 14:1133390. [PMID: 37090974 PMCID: PMC10117778 DOI: 10.3389/fneur.2023.1133390] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/09/2023] [Indexed: 04/25/2023] Open
Abstract
Botulinum toxin type A (BoNT-A) is the treatment of choice for focal spasticity, with a concomitant effect on pain reduction and improvement of quality of life (QoL). Current evidence of its efficacy is based mainly on post stroke spasticity. This study aims to clarify the role of BoNT-A in the context of non-stroke spasticity (NSS). We enrolled 86 patients affected by multiple sclerosis, spinal cord injury, and traumatic brain injury with clinical indication to perform BoNT-A treatment. Subjects were evaluated before injection and after 1, 3, and 6 months. At every visit, spasticity severity using the modified Ashworth scale, pain using the numeric rating scale, QoL using the Euro Qol Group EQ-5D-5L, and the perceived treatment effect using the Global Assessment of Efficacy scale were recorded. In our population BoNT-A demonstrated to have a significant effect in improving all the outcome variables, with different effect persistence over time in relation to the diagnosis and the number of treated sites. Our results support BoNT-A as a modifier of the disability condition and suggest its implementation in the treatment of NSS, delivering a possible starting point to generate diagnosis-specific follow-up programs. Clinical trial identifier NCT04673240.
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Affiliation(s)
- Alessio Baricich
- Physical and Rehabilitation Medicine, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
- Physical and Rehabilitation Medicine, “Ospedale Maggiore della Carità” University Hospital, Novara, Italy
| | - Marco Battaglia
- Physical and Rehabilitation Medicine, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
- Physical and Rehabilitation Medicine, “Ospedale Maggiore della Carità” University Hospital, Novara, Italy
- *Correspondence: Marco Battaglia
| | - Daria Cuneo
- Physical and Rehabilitation Medicine, A.S.L. Vercelli, Vercelli, Italy
| | - Lucia Cosenza
- Rehabilitation Unit, Department of Rehabilitation, “Santi Antonio e Biagio e Cesare Arrigo” National Hospital, Alessandria, Italy
| | - Marzia Millevolte
- Neurorehabilitation Clinic, Department Neurological Sciences, University Hospital of Ancona, Ancona, Italy
| | - Michela Cosma
- Neuroscience and Rehabilitation Department, Ferrara University Hospital, Ferrara, Italy
| | - Mirko Filippetti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Stefania Dalise
- Neurorehabilitation Section, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Valentina Azzollini
- Neurorehabilitation Section, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Carmelo Chisari
- Neurorehabilitation Section, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Stefania Spina
- Spasticity and Movement Disorder Unit, Physical Medicine and Rehabilitation, Policlinico Riuniti, University of Foggia, Foggia, Italy
| | - Nicoletta Cinone
- Spasticity and Movement Disorder Unit, Physical Medicine and Rehabilitation, Policlinico Riuniti, University of Foggia, Foggia, Italy
| | - Lorenza Scotti
- Department of Translational Medicine, Unit of Medical Statistics, Università del Piemonte Orientale, Novara, Italy
| | - Marco Invernizzi
- Physical and Rehabilitation Medicine, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, “Santi Antonio e Biagio e Cesare Arrigo” National Hospital, Alessandria, Italy
| | | | - Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Andrea Santamato
- Spasticity and Movement Disorder Unit, Physical Medicine and Rehabilitation, Policlinico Riuniti, University of Foggia, Foggia, Italy
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