scholarly journals Could the choice of patient versus proxy ratings for assessing quality of life in dementia affect resource allocation in health care?

2012 ◽  
Vol 13 (1) ◽  
pp. 25-31
Author(s):  
Jenny Alwin ◽  
Thor-Henrik Brodtkorb
Keyword(s):  
Quality Of Life ◽  
Resource Allocation ◽  
Substantial Effect ◽  
Quality Adjusted Life Year ◽  
Published Data ◽  
Model Of Alzheimer’S Disease ◽  
Patient Health ◽  
Related Quality ◽  
Health Related

OBJECTIVE: The aim of this paper is to demonstrate how the choice of patient versus proxy ratings of patient health-related quality of life (HRQoL) in dementia, for use in cost-effectiveness analyses (CEAs), could potentially affect resource allocation in health care.METHODS:A model of Alzheimer’s disease (AD) based on cognitive ability was used to assess the consequences of using HRQoL ratings from either patients themselves or proxies if a new treatment was to be introduced. The model was based on previously published data on costs related to AD stages as well as HRQoL ratings from AD patients and from their caregivers as proxy raters.RESULTS:The results show that there can be large differences in the results of the CEAs depending on whether the ratings of patients’ HRQoL were made by the patients themselves or by the proxy. When patient self-ratings of HRQoL were used, the cost/quality-adjusted life year (QALY) gained was much higher as compared to the scenario when proxy ratings were used for the same analysis.CONCLUSIONS: The choice of patient self-ratings compared to proxy ratings of patients’ HRQoL can have a substantial effect on the results of CEAs. These differences in results may have an important impact on decision making and, ultimately, on resource allocation. In order to critically appraise the results of CEA studies in dementia we advise that both patient and proxy ratings are used in the CEA. To decide on methodology it is of great importance that focus is directed towards determining the most valid way to measure HRQoL in AD.

Demoralization and Quality of Life of Patients with Parkinson Disease

2021 ◽  
pp. 1-7
Author(s):  
Boheng Zhu ◽  
Robert Kohn ◽  
Amar Patel ◽  
Brian B. Koo ◽  
Elan D. Louis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson Disease ◽  
Behavioral Interventions ◽  
Short Form ◽  
Published Data ◽  
Patient Health ◽  
Related Quality ◽  
Health Related ◽  
Demoralization Scale

Introduction: Demoralization is quite prevalent in patients with Parkinson disease (PD). Unrecognized or untreated, demoralization may progress, at times, to demands for euthanasia and the desire for suicide. Typically, patients with PD do not complain of being “demoralized”; rather, they report disruptions in the quality of their lives. Hence, early identification of disruptions in health-related quality of life (HRQoL) specifically associated with demoralization may prompt earlier recognition and treatment. Published data on such associations, however, could not be found. Alleviation of demoralization in PD is likely to improve treatment outcomes. Objective: This research aimed at identifying the disruptions of HRQoL specifically associated with the demoralization of patients with PD. Methods: Consecutive general hospital outpatients with PD (n = 95) were assessed for: demoralization, with the Diagnostic Criteria for Psychosomatic Research Demoralization Scale (DCPR-D) and the Demoralization Scale (DS); depression, with the Patient Health Questionnaire-9 (PHQ-9); HRQoL, with the Parkinson Disease Questionnaire-Short Form (PDQ-8); sociodemographic variables; medical comorbidities; PD severity; and types of treatment. Results: The prevalence of demoralization was 19%. Regression analyses showed that demoralization was significantly more likely to be experienced by participants who had difficulty with mobility and felt embarrassed in public due to having PD. Demoralization explained HRQoL over and above depression. Conclusions: Stigma and perceived difficulty with mobility are associated with demoralization of PD patients, and they may signal the need for psychotherapeutic and behavioral interventions to prevent the progression to helplessness, hopelessness, demands for euthanasia, and desire for suicide.

Quality of life after interventions for malignant pleural effusions: a systematic review

2019 ◽  
Vol 10 (1) ◽  
pp. 45-54 ◽  
Author(s):  
Parthipan Sivakumar ◽  
Anita Saigal ◽  
Liju Ahmed
Keyword(s):  
Quality Of Life ◽  
Meta Analysis ◽  
Published Data ◽  
Attrition Rates ◽  
Related Quality ◽  
Registration Number ◽  
Health Related ◽  
Pleural Catheter ◽  
Talc Poudrage

BackgroundMalignant pleural effusion (MPE) results in breathlessness and impairment of health-related quality of life (HRQOL). This study reviews the existing literature on HRQOL following invasive interventions in MPE.MethodsFive electronic databases were systematically searched and assessed three times during the review process and last completed on 15 June 2018. We included all studies evaluating HRQOL outcomes for the following interventions: therapeutic thoracocentesis, talc slurry (TS) pleurodesis, indwelling pleural catheter (IPC) insertion and thoracoscopic talc poudrage (TTP) pleurodesis. Meta-analysis was not performed due to substantial heterogeneity in the published data.Results17 studies were included in the review reporting HRQOL outcomes in 2515 patients. TTP, TS and IPC were associated with modest but inconsistent improvements in HRQOL up to 12 weeks. No intervention was significantly different from another in HRQOL outcomes at any time point. The attrition to follow-up was 48.3% (664/1374) at 3 months. The overall quality of studies was inadequate.ConclusionTTP, TS and IPC seem to improve HRQOL in MPE over 4–12 weeks, but there are insufficient longer term data due to high attrition rates. Evidence on the most effective treatment strategy is limited by the small number of randomised or comparative studies.Trial registration numberCRD42016051003.

The effect of carpal tunnel release on health-related quality of life of 2346 patients over a 5-year period

2021 ◽  
pp. 175319342110456
Author(s):  
Justin D. Postma ◽  
Marius A. Kemler
Keyword(s):  
Quality Of Life ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Quality Adjusted Life Year ◽  
Health Related Quality ◽  
Level Of Evidence ◽  
Related Quality ◽  
Health Related ◽  
Index Value

In this prospective cohort study, the health-related quality of life (HRQoL) from a societal perspective of carpal tunnel syndrome (CTS) patients was determined and compared with other diseases. In addition, the effect of carpal tunnel release (CTR) was analysed 6 weeks postoperatively with regard to mean EQ-5D index value improvement, side-effects of surgery and cost per quality adjusted life year (QALY) gained. We found a baseline mean EQ-5D index value of 0.75 (SD: 0.23), comparable with values seen in other disease like breast cancer, diabetes and asthma. Furthermore, we found that CTR improved HRQoL substantially 6 weeks postoperatively (mean + 0.12, SD: 0.22) and significantly reduced symptom reporting (mean −52%, SD: 53) with a cost per QALY gained of €396.05. In conclusion, CTS has a comparable impact on quality of life as compared with other diseases, and CTR has the potential to substantially improve patient’s HRQoL at a fairly modest cost. Level of evidence: III

The Chronic Care Model and Relationships to Patient Health Status and Health-Related Quality of Life

2008 ◽  
Vol 35 (5) ◽  
pp. S398-S406 ◽  
Author(s):  
Dorothy Y. Hung ◽  
Russell E. Glasgow ◽  
L. Miriam Dickinson ◽  
Desireé B. Froshaug ◽  
Douglas H. Fernald ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Health Related Quality ◽  
Care Model ◽  
Patient Health Status ◽  
Patient Health ◽  
Related Quality ◽  
Health Related

scholarly journals Quality of Life in Huntington's Disease: Critique and Recommendations for Measures Assessing Patient Health-Related Quality of Life and Caregiver Quality of Life

2018 ◽  
Vol 33 (5) ◽  
pp. 742-749 ◽  
Author(s):  
Tiago A. Mestre ◽  
Noelle E. Carlozzi ◽  
Aileen K. Ho ◽  
Jean-Marc Burgunder ◽  
Francis Walker ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Health Related Quality ◽  
Caregiver Quality ◽  
Patient Health ◽  
Related Quality ◽  
Health Related
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