Quality of life profile and psychometric properties of the EQ-5D-5L in HIV/AIDS patients (original) (raw)
Related papers
2002
Objective: Brief utility measures are needed in clinical trials in addition to existing descriptive measures of health-related quality of life (HRQOL). We examined the reliability and validity of the EuroQol (EQ-5D) and MOS-HIV and their responsiveness to HIV-related clinical events. Methods: Subjects with advanced HIV disease (CD4 < 100) were enrolled in a randomized trial for CMV prophylaxis (n ¼ 990). The EQ-5D includes a weighted sum of five domains (EQ-5D Index) and a visual analog scale (EQ-VAS). The MOS-HIV has 10 subscales and physical (PHS) and mental health summary scores (MHS). Construct validity of the EQ-5D was tested based on hypothesized relationships to subscales of the MOS-HIV. Relative precision and responsiveness to adverse experiences and opportunistic infections (OIs) were compared for the two instruments. Results: Mean age of the patients was 38, 94% were male, 80% white, and 7% had injected drugs. Mean baseline scores for EQ-5D Index and EQ-VAS were 0.80 and 76.0, respectively, 28 and 4% reported maximum scores. Mean MOS-HIV subscales score ranged from 55 (role) to 84 (cognitive); mean PHS and MHS were 47.4 and 49.5, respectively. Correlations between MOS-HIV subscales and EQ-5D Index ranged from 0.45 (role) to 0.63 (pain); correlations with EQ-VAS ranged from 0.33 (cognitive) to 0.66 (health perceptions). Correlations between MOS-HIV PHS and MHS with EQ-5D Index were 0.61 and 0.58; and with EQ-VAS, 0.57 and 0.60, respectively. Responsiveness to adverse experiences was highest for MOS-HIV pain and PHS (effect sizes ¼ 0.9 and 0.4); pain had the highest relative precision (2.4) for adverse experiences; EQ-VAS had the greatest relative precision (1.6) for developing an OI. Conclusion: In these patients with advanced HIV disease, EQ-5D showed good construct validity, but there may be a ceiling effect for its EQ-5D Index component. EQ-5D was less responsive to adverse events than the MOS-HIV. However, the EQ-VAS was most sensitive to developing an OI and is likely to be a useful measure of HRQOL for generating QALYs in cost-utility studies involving patients with advanced HIV disease.
Health and quality of life outcomes, 2007
Health-related quality of life (HR-QOL) is a relevant and quantifiable outcome of care. We implemented HR-QOL assessment at all primary care visits at UCSD Owen Clinic using EQ-5D. The study aim was to estimate the prognostic value of EQ-5D for survival, hospitalization, and emergency department (ED) utilization after controlling for CD4 and HIV plasma viral load (pVL). We conducted a retrospective analysis of HIV clinic based cohort (1996-2000). The EQ-5D includes single item measures of: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each item is coded using 3-levels (1 = no problems; 2 = some problems; 3 = severe problems). The instrument includes a global rating of current health using a visual analog scale (VAS) ranging from 0 (worst imaginable) to 100 (best imaginable). An additional single item measure of health change (better, much the same, worse) was included. A predicted VAS (pVAS) was estimated by regressing the 5 EQ-5D health states on V...
Value in Health Regional Issues, 2014
Objectives: To measure health-related quality of life (HRQOL) in Thai HIV patients using the patient-generated index for HIV (PGI-HIV) and to compare the psychometric properties of the PGI-HIV with those of the EuroQol five-dimensional (EQ-5D) questionnaire and the Medical Outcome Study HIV Health Survey in terms of practicality, reliability, validity, and responsiveness. Methods: In this study, two rounds of interviews were carried out in HIV outpatients who met the eligibility criteria and attended the HIV Clinic of Warinchamrap Hospital between January and March 2010. The patients were interviewed using a data collection form and three HRQOL measures (the PGI-HIV, the EQ-5D questionnaire, and the Medical Outcome Study HIV Health Survey) to assess the practicality and validity. The second interview was performed to check the test-retest reliability and responsiveness. Results: A total of 210 patients completed the study. They were mostly women (69.5%), with a mean age of 39.2 Ϯ 11.1 years. The majority with the US Centers for Disease Control and Prevention clinical stage C took the current antiretroviral drugs within 1 year. The average PGI score was about 0.60, implying HIV/AIDS and antiretroviral drug therapy decreased the patients' quality of life by 40% from their healthy life. Three mostly cited impact domains were hyperlipidemia, lipid maldistribution and lipodystrophy, and hepatitis. The PGI-HIV was considered as practical, with a mean difficulty score of 3.7 Ϯ 0.8, highly reliable (intraclass correlation coefficient ¼ 0.75; P o 0.001), and responsive to HRQOL changes (effect size ¼ 0.81; standardized response mean ¼ 0.99), but not valid when compared with CD4 levels and viral loads (all Pearson' r o 0.2; P 4 0.05). Conclusions: The PGI-HIV was used to measure the individual HRQOL in a Thai sample of HIV-positive patients. It proves to be practical, highly reliable, and very responsive to changes in patients' HRQOL.
The health-related quality of life of people living with HIV/AIDS
Disability & Rehabilitation, 2004
Background: While health outcomes of HIV/AIDS treatments in terms of increased longevity has been the subject of much research, there appears to be very limited research on the improved health related quality of life (HRQL) that can be applied in cost-utility analyses in Africa south of the Sahara (SSA). Most of the literature that does exist present HRQL measured by disease specific instruments, but such data is of little use as input to economic evaluations.
AIDS Research and Therapy, 2011
Background: The purpose of this study was to examine the relationship between the Medical Outcomes Study-HIV Health Survey (MOS-HIV) and the SF-12v2 to determine if the latter is adequate to assess the health-related quality of life (HRQoL) of men and women living with HIV/AIDS. 112 men and women living with HIV/AIDS who access care at a tertiary HIV clinic in Hamilton, Ontario were included in this cross-sectional analysis. Correlation coefficients of the MOS-HIV physical and mental health summary scores (PHS and MHS) and the SF-12v2 physical and mental component summary scales (PCS and MCS) were calculated along with common sub-domains of the measures including physical functioning (PF), bodily pain (BP), general health perceptions (GH), vitality (VT), social functioning (SF) and mental health (MH) to explore the relationship between these two HRQoL measures. The subdomains role physical (RP) and role emotional (RE) of the SF-12v2 were compared separately to the sub-domain role functioning (RF) of the MOS-HIV. Weighted kappa scores were calculated to determine agreement beyond chance between the MOS-HIV and SF-12v2 in assigning a HRQoL state (i.e. low, moderate, good, very good).
Objective: To design a Health-related Quality of Life (HRQoL) instrument for HIV-infected people in the era of highly active antiretroviral therapy (HAART). Methods: The self-administered questionnaire was developed by an Italian network including researchers, physicians, people living with HIV, national institutions and community-based organizations (CBO) through several steps: (1) review of existing HRQoL literature and questionnaires for HIV-infected people; (2) selection of relevant domains measuring HRQoL in HIV-infected people, and identification of new domains related to new aspects of HRQoL concerning HAART-treated individuals; (3) conduction of two pre-test analyses in independent groups of Italian HIV-positive people (n @ 100) distributed throughout the country. The objectives of the first pre-test were to verify the usefulness of the questionnaire, to construct a form easily understandable by everyone, to define the domains and their significance; the second pre-test aimed at evaluating and reshaping the questionnaire based on a statistical analysis of the outcomes of first pre-test; (4) validation analysis. A large cohort of people with HIV infection was recruited for the last step. Results: The internal consistence reliability (Cronbach's a) was ‡0.70 for all domains. Most domains had Cronbach's coefficient >0.80. All domains demonstrated convergent and discriminant validity. The final version of ISSQoL includes two sections: HRQoL Core Evaluation Form (9 domains) and Additional Important Areas for HRQoL (6 domains). The ISSQoL was administered together with two additional forms: a Daily Impact of Symptoms Form and a Demographic Information Form. The Additional Important Areas for HRQoL include social support, interaction with medical staff, treatment impact, body changes, life planning, and motherhood/fatherhood. Conclusion: The data reported in the present paper provide preliminary evidence of the reliability and validity of the ISSQoL questionnaire for the measurement of HRQoL in HIV-infected people. The direct involvement of HIV-positive people in all the phases of the project was a key aspect of our work.
Global View of HIV Infection, 2011
Assessing the quality of life (QoL) of people living with HIV/AIDS has become increasing. From 1995 to 2003, more than 300 papers on the subject were published. This fact encourages researchers to question the existence of suitable assessment instruments. Virtually all existing instruments until 2003 had been developed in the USA (Skevington & O'Connell, 2003). To apply these instruments in countries in which English is not the vernacular language, the instruments were subjected to literal translations, without the worry of a cultural adaptation. In this wise, came the proposal to develop an instrument from sundry centers, located in different countries (Skevington & O'Connell, 2003). The fact that there is no consensus on the QoL concept is a major problem in developing instruments to assess the QoL, while it is not possible to state clearly what elements these instruments are assessing (Fleck, 2008). From this premise, the starting point to build the instrument for QoL assessment of the World Health Organization (WHO) was to conceptualize QoL. In the concept adopted, QoL is understood as "individuals' perceptions of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns" (The WHOQOL Group, 1998a, p. 25). In face of this concept, WHO embarked on building the World Health Organization Quality of Life (WHOQOL) instruments, which assess QoL globally, e.g. WHOQOL-100 and WHOQOL-bref, and due to specific aspects, e.g. WHOQOL-HIV, WHOQOL-OLD, and WHOQOL-SRPB. One of these instruments, the WHOQOL-HIV, used to assess the QoL of HIV carriers, is the object of this study. Starting from the fact that 95% of people infected with HIV did not live in the USA but in developing countries of Asia, Latin America, and sub-Saharan Africa, WHO has developed a tool to assess the QoL directed to such audience. The instrument was designed based on the premise that a multidisciplinary approach, involving centers in several countries, would allow for greater dissemination of the developed instrument (O'Connell, 2003). The WHOQOL-HIV is a complementary module for WHOQOL-100 instrument, and was also translated into other languages and validated in sundry studies, among which are a
HIV & AIDS Review, 2013
Background: The tracking of outcome in HIV using a measure like health related quality of life (HRQOL), with broad coverage of general wellbeing of people living with HIV/AIDS (PLWHA) is indicated for evolvement of public health policies toward comprehensive HIV care. Aim: This study aimed at evaluating HRQOL across multiple domains among PLWHA. Methods: A total of 295 HIV-positive adults were recruited using systematic random sampling method. They were administered socio-demographic questionnaires and 26-item World Health Organisation Quality of Life (WHOQOL-Bref) was used to measure health related quality of life. Results: Multi-dimensional assessment of QOL indicated that more participants reported their physical (70.8%), psychological (61.0%), social relationships (70.5%) and environmental (69.2%) domains to be fair. A significant association was observed between unemployment and poor overall QOL ( 2 = 4.83, df = 1, p = 0.028), while being married seems to confer good overall QOL (Kw = 12.63, df = 2, p = 0.002). Again, unemployment status was associated with poorer quality of life in the physical ( 2 = 9.21, df = 2, p = 0.012), psychological ( 2 = 10.92, df = 2, p = 0.002) and environmental ( 2 = 10.13, df = 2, p = 0.012) domains. Conclusions: The study observed varied degrees of impairment across specific domains of QOL. To ensure improved QOL, HIV care with relevant policies should target multidimensional aspects of health. Additionally, socio-economic problems like stigma with relationships issues and unemployment should be addressed by the government with institutions of human rights (such as right to equal opportunity, autonomy, privacy and health, safe working environment and information) for all PLWHA. Further research on QOL and tracking of HIV disease outcome with multi-dimensional approach are implied.
Determinants of Quality of Life in Hiv/Aids Patients
Background: HIV/AIDS impacts heavily on the infected individual and the society at large, there is therefore a need to evaluate the quality of life of HIV-infected individuals. Objectives: To assess the impact of HIV/AIDS on the Health related quality of life (HRQOL) of people living with HIV/AIDS (PLWHA), and to investigate the determinants of the QOL of PLWHA. Methods: A descriptive cross-sectional study design was used. One hundred and three (103) PLWHA accessing healthcare were consecutively selected. A questionnaire, containing data on socio-demographic and medical profiles, on the WHOQOL-HIV Bref was used to assess each study participant. HRQOL was evaluated to assess quality of life domains that included physical and physiological health, level of independence, social relationships, environment, and spirituality/religion/personal beliefs. Means, standard deviations, and statistical tests for differences were performed. Results: The mean age of the respondents was 41.0 (range 21-73); 48 (46.6 %) of the participants were males. The QOL mean scores were highest for the spirituality/religion/personal beliefs domain (16.88 ± 2.83) and lowest for the environment domain (14.08 ± 1.95). The overall QOL mean scores in the other four domains were similar: physical health (15.92 ± 3.05), psychological health (15.35 ± 3.20), level of independence (15.90±3.52), social relationships (15.11±2.26). Significant differences were observed in all domains among respondents with family support compared to those without family support. Similarly, asymptomatic patients had significantly higher QOL scores compared to symptomatic patients. Improved QOL was influenced by higher educational levels in all domains except the spirituality/religion/personal beliefs domain.