scholarly journals Health-Related Quality of Life Among Patients With Acute Ischemic Stroke and Large Vessel Occlusion in the ESCAPE Trial

Stroke ◽  
2021 ◽  
Author(s):  
Raed A. Joundi ◽  
Alexander D. Rebchuk ◽  
Thalia S. Field ◽  
Eric E. Smith ◽  
Mayank Goyal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Health Related Quality ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Related Quality ◽  
Health Related ◽  
Anxiety Depression ◽  
Free Status

Background and Purpose: Endovascular thrombectomy (EVT) reduces 90-day disability in patients following acute ischemic stroke due to large vessel occlusion. Patient-reported outcome measures after EVT, such as health-related quality of life and specific functional domains, are less well described. Methods: We report outcomes on the EuroQol-5D (EQ-5D) from the ESCAPE (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times) randomized controlled trial at 90 days after stroke. Death was assigned an index value of 0 for EQ-5D. We used quantile regression to evaluate the association between EVT and EQ-5D index scores and logistic regression for the association between EVT and symptom-free status among 90-day survivors for each EQ-5D dimension (self-care, usual activities, mobility, pain/discomfort, and anxiety/depression), assessing for modification by age or sex and adjusting for baseline factors including stroke severity, affected hemisphere, and receipt of alteplase. Lastly, the association between severe disability at 90 days and EQ-5D was evaluated with assessment for modification by EVT, age, and sex. Results: There were 165 patients randomized to EVT and 150 patients randomized to control. Median EQ-5D was significantly higher for those who received EVT compared with best medical management (0.80 versus 0.60; P <0.001). After accounting for the greater number of deaths in the elderly, there was evidence of modification of treatment effect by age, with older age associated with a larger effect size difference in EQ-5D with EVT. Those receiving EVT had higher odds of symptom-free status in self-care, usual activities, mobility for those aged 60 to 79 years, and pain/discomfort for women, but there was no association with anxiety/depression. Severe disability at 90 days was associated with lower EQ-5D in older compared with younger individuals, and the association was not modified by EVT. Conclusions: Patients treated with EVT report substantially improved health-related quality of life, with relatively greater impact in older individuals and observed benefit across multiple dimensions.

Abstract P521: Effect of Endovascular Thrombectomy on Health-Related Quality of Life Among Patients With Acute Ischemic Stroke and Large Vessel Occlusion in the Escape Trial

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Raed A Joundi ◽  
MAYANK GOYAL ◽  
Andrew M Demchuk ◽  
Dar Dowlatshahi ◽  
Alexandre Y Poppe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Related Quality ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Endovascular Thrombectomy ◽  
Related Quality ◽  
Health Related ◽  
Anxiety Depression ◽  
Free Status

Background: Endovascular thrombectomy (EVT) improves 90-day disability in patients following acute ischemic stroke due to large vessel occlusion. However, the effect of EVT on health-related quality of life and specific functional domains, and whether this effect differs by age or sex is less studied. Methods: We used data from the ESCAPE randomized controlled trial to obtain EuroQol-5D-3L (EQ-5D) at 90 days after acute stroke in patients randomized to EVT or standard care. Death was assigned an index value of 0 for EQ-5D. We used quantile regression to evaluate the association between EVT and EQ-5D index scores, and logistic regression for the association between EVT and symptom-free status among 90-day survivors for each EQ-5D dimension (self-care, usual activities, mobility, pain/discomfort, and anxiety/depression), assessing for modification by age or sex and adjusting for baseline factors including stroke severity, affected hemisphere, and receipt of alteplase. Results: There were 165 patients randomized to EVT and 150 patients randomized to control. Median EQ-5D was significantly higher for those who received EVT (0.80 versus 0.60; p<0.001). There was evidence of modification by age with older age associated with greater improvements in EQ-5D with EVT (Figure). Those receiving EVT had higher odds of symptom-free status in self-care, usual activities, mobility for those aged 60-79, and pain/discomfort for women, with no association with anxiety/depression (Table). Conclusions: EVT substantially improves health-related quality of life, with relatively greater impact in older individuals and observed benefit across multiple dimensions.

scholarly journals Impact of flooding on health-related quality of life in England: results from the National Study of Flooding and Health

2020 ◽  
Vol 30 (5) ◽  
pp. 942-948
Author(s):  
Charlotte Robin ◽  
Charles Beck ◽  
Ben Armstrong ◽  
Thomas David Waite ◽  
G James Rubin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
A Priori ◽  
National Study ◽  
Health Related Quality ◽  
Euroqol Group ◽  
Related Quality ◽  
Health Related ◽  
Anxiety Depression ◽  
The Impact

Abstract Background Flooding can have extensive effects on the health and wellbeing of affected communities. The impact of flooding on psychological morbidity has been established; however, the wider impacts of flooding exposure, including on health-related quality of life (HRQoL), have not been described. Methods Using data from the English National Study of Flooding and Health cohort, HRQoL 2 and 3 years post-flooding was assessed with the EuroQol Group EQ-5D-5L tool. Associations between exposure groups (flooding and disruption from flooding) and HRQoL were assessed, using ordinal and linear regression, adjusting for a priori confounders. Results For both 2 and 3 years post-flooding, the median HRQoL scores were lower in the flooded and disrupted groups, compared with unaffected respondents. A higher proportion of flooded and disrupted respondents reported HRQoL problems in most dimensions of the EQ-5D-5L, compared with unaffected respondents. In year 2, independent associations between exposure to flooding and experiencing anxiety/depression [adjusted odds ratio (aOR) 7.7; 95% CI 4.6–13.5], problems with usual activities (aOR 5.3; 95% CI 2.5–11.9) and pain/discomfort (aOR 2.4; 95% CI 1.5–3.9) were identified. These problems persisted 3 years post-flooding; associations between exposure to flooding and experiencing anxiety/depression (aOR 4.3; 95% CI 2.5–7.7), problems with usual activities (aOR 2.9; 95% CI 1.5–6.1) and pain/discomfort (aOR 2.5; 95% CI 1.5–4.2) were identified. Conclusions Exposure to flooding and disruption from flooding significantly reduces HRQoL. These findings extend our knowledge of the impacts of flooding on health, with implications for multi-agency emergency response and recovery plans.

scholarly journals DIFFERENTIATION OF HEALTH-RELATED QUALITY OF LIFE OUTCOMES BETWEEN FIVE DISEASE AREAS: RESULTS FROM AN INTERNATIONAL SURVEY OF PATIENTS

2018 ◽  
Vol 34 (5) ◽  
pp. 498-506 ◽  
Author(s):  
Olina Efthymiadou ◽  
Jean Mossman ◽  
Panos Kanavos
Keyword(s):  
Quality Of Life ◽  
Policy Decision ◽  
Future Research ◽  
Common Disease ◽  
Health Related Quality ◽  
Health Policy Decision ◽  
Related Quality ◽  
Health Related ◽  
Anxiety Depression

Objectives:Health-related quality of life (HRQoL) data generated by generic, preference-based instruments (i.e., EQ-5D) are highly demanded in health policy decision making, because they allow for direct comparisons of HRQoL outcomes between disease areas. We aimed to quantify HRQoL outcomes in breast cancer (BC), rheumatoid arthritis (RA), multiple sclerosis (MS), rare cancers (RC), and rare disease (RD) patients and understand the patterns that differentiate HRQoL outcomes between these disease areas, and more specifically between rare and more common disease population groups.Methods:An international, Web survey of patients measured HRQoL (EQ-5D-5L), self-perceived health (EQ-5D-5L Visual Analogue Scale), and additional QoL dimensions, such as patient disability level.Results:We received 675 completed responses. Average utility loss was 53.5 percent, 32.5 percent, and 33.3 percent for RD, RA, and MS patients, respectively, in contrast to 18.6 percent for BC and RC patients. Statistically significant differences (p < .05) were observed between disease groups in all EQ-5D-5L domain outcomes, apart from that of “Anxiety/Depression.” Severe and/or extreme problems were reported in performing usual activities for RD and RC (34 percent and 13 percent of overall problems reported respectively), mobility for MS (18 percent), pain/discomfort for RA (13 percent), and anxiety/depression for BC (7 percent) patients.Conclusions:We demonstrated significant differences in the dimensions that drive HRQoL outcomes between rare and more common diseases and showcased that the same EQ-5D utility may reflect very different severities depending on the patient population under investigation. Future research should examine whether outcomes in other, critical HRQoL domains not included in generic measures also highlight significant differences across disease areas.

scholarly journals Health-Related Quality of Life Impairment among Patients with Different Skin Diseases in Vietnam: A Cross-Sectional Study

2019 ◽  
Vol 16 (3) ◽  
pp. 305 ◽  
Author(s):  
Sau Huu Nguyen ◽  
Long Hoang Nguyen ◽  
Giang Thu Vu ◽  
Cuong Tat Nguyen ◽  
Thu Hoai Thi Le ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Skin Diseases ◽  
Cross Sectional Study ◽  
Health Related Quality ◽  
Sectional Study ◽  
Cross Sectional ◽  
Related Quality ◽  
Health Related ◽  
Anxiety Depression

Skin diseases have caused a heavy burden on the infected population worldwide. This study aimed to examine the health-related quality of life (HRQOL) among patients with different skin diseases and identify associated factors. A cross-sectional study with 430 participants was conducted at the Vietnam National Hospital of Dermatology and Venereology (NHD) from September to November 2018. The EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) instrument was employed, which measures the EQ-5D index from five domains including mobility, self-care, usual activity, pain/discomfort, and anxiety/depression. Multivariate Tobit regression was adopted to determine factors that were associated with HRQOL (EQ-5D index). The rate of atopic dermatitis was the highest with 28.8%, following by contact dermatitis (17.0%) and skin fungal infections (13.0%). Regarding HRQOL, anxiety/depression was the most common health problem in patients with skin diseases (71.8%), following by pain/discomfort (63.6%). The mean EQ-5D index score was 0.73 (SD = 0.19). The lowest EQ-5D index scores were obtained for females with skin infections (mean = 0.52) and for males with psoriasis (mean = 0.59). Females had significantly lower scores compared to males (Coef. = −0.06; 95% CI = −0.11 to −0.01). Higher income and living in rural areas were also negatively correlated with the EQ-5D index. This study demonstrated the low HRQOL among patients with skin diseases in Vietnam and emphasized the vulnerability of patients with different socioeconomic statuses to their HRQOL.

Improvements in Health-Related Quality of Life of Patients with DLBCL after Treatment with Yttrium-90 Ibritumomab Tiuxetan (90y-Zevalin).

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4794-4794
Author(s):  
S. S. Thompson ◽  
S. Macran ◽  
J. Kalmus ◽  
F. Morschhauser
Keyword(s):  
Quality Of Life ◽  
B Cell Lymphoma ◽  
Well Being ◽  
Maximal Response ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Anxiety Depression ◽  
The Impact

Abstract PURPOSE: This health-related quality of life (HRQL) study aimed to evaluate the impact of 90y-Zevalin therapy on the HRQL of older patients with relapsed diffuse large B-cell lymphoma (DLBCL) not eligible for stem cell transplantation. Ppsychometric performance of the FACT-G and EQ-5D in the same patient sample was also evaluated. The study was conducted alongside a single arm, phase II clinical trial of 90Y-Zevalin radioimmunotherapy. METHODS: The FACT-G scale contains 27 questions, grouped according to 4 “dimensions” of HRQL relevant to patients with cancer: Physical, Functional, Social and Emotional well-being. The scale provides a total score for overall HRQL and subscale scores for each dimension. The EQ-5D is a generic measure of HRQL used in a range of diseases and comprises a descriptive classification based on 5 broad dimensions and a visual analogue scale. Data from the 2 measures were analyzed with descriptive statistics. Validity was assessed in terms of correlations between individual dimensions. Changes in the dimensions and total scores of the FACT-G and EQ-5D from baseline to wk 12 post-90Y-Zevalin therapy were assessed using paired t-tests. Wk 12 corresponded to the time of expected maximal response to 90Y-Zevalin therapy. RESULTS: Sixty-six of 104 patients enrolled in the clinical study completed the FACT-G and EQ-5D questionnaires at baseline and 35 completed the questionnaires at wk 12. Those who completed the questionnaires at both baseline and wk 12 were more likely to have responded to 90Y-Zevalin (80% were responders) although they were comparable in terms of age (median = 72 yrs) and gender (54% male) to those who only completed the questionnaires at baseline. At baseline, the dimensions of HRQL with the worst scores and therefore most affected by DLBCL, included areas related to energy, pain, anxiety and depression, which would be expected given the symptoms commonly associated with DLBCL such as fatigue. The percentage of patients reporting “some or extreme problems” on each of the EQ-5D dimensions at baseline are summarized in the table. Moderate correlations were observed between the Physical Well-being of the FACT-G and the Usual Activities (=0.60) and Pain/Discomfort (=0.70) dimensions of the EQ-5D. The Emotional Well-being dimension of the FACT-G was moderately correlated with the Anxiety/Depression on the EQ-5D (=0.66). These data suggest the FACT-G and the EQ-5D were measuring some common concepts to patients. All summary dimensions of the FACT-G and EQ-5D showed either a positive trend or little change after treatment with 90Y-Zevalin, with the Physical Well-being dimension of the FACT-G reaching statistical significance (P=0.03) and measuring a 10% improvement over baseline. The change in total score of the FACT-G almost reached significance (P=0.06), as did the emotional dimension of the FACT-G (P=0.10) and the mobility dimension of the EQ-5D (P=0.08). CONCLUSION: Although number of participating patients was small, the EQ-5D and the FACT-G have demonstrated validity for patients with DLBCL following treatment with 90Y-Zevalin. The greatest impact of 90Y-Zevalin therapy is an improvement in physical well-being, with an increased level of energy, reduced amount of pain and reduced level of “feeling ill”. EQ-5D dimension % of patients reporting “Some or extreme problems” at baseline Mobility 26 Self-care 12 Usual activities 29 Pain/discomfort 54 Anxiety/depression 58

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