Search Results (49)

Background/Objectives: Iron deficiency without anaemia (IDNA) is common in non-dialysis-dependent chronic kidney disease (CKD) and contributes to fatigue, reduced exercise tolerance, and impaired quality of life (QoL). While intravenous (IV) iron replacement is known to benefit anaemic patients, its role in IDNA remains uncertain. This study aimed to evaluate the impact of ferric derisomaltose (FDI) on patient-reported QoL outcomes in CKD patients with IDNA. Methods: This was a post hoc analysis of the double-blind, multicentre Iron and the Heart randomised controlled trial. Fifty-four participants with IDNA (ferritin < 100 µg/L or transferrin saturation < 20% and haemoglobin 110–150 g/L) and CKD stages G3b–G5 were randomised 1:1 to receive either 1000 mg FDI (n = 26) or placebo (n = 28). An additional 10 iron-replete CKD patients served as controls. SF-36v2 QoL surveys were collected at baseline, 1 month, and 3 months. Results: SF-36v2 scores declined across all domains, but deterioration was consistently milder in the FDI group. Role physical declined by 3% in the FDI group versus 12% with placebo and 4% in controls. Bodily pain improved by 2.8% with FDI but worsened by 1.5% in the placebo group. Mental health improved by 3.4 points with FDI and declined by 2.7 points in the placebo group, creating a 6.1-point separation. While differences did not reach statistical significance, likely due to small sample size, the consistent trends favour FDI. Conclusions: IV iron may attenuate QoL decline in non-dialysis-dependent CKD patients with IDNA. These findings support the need for larger, adequately powered trials to assess patient-centred outcomes in this population. Full article

Introduction: Desirable outcome after venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome (ARDS) is frequently defined by survival. However, quality of life (QoL) and mental health status may take precedence over mere survival, from a patient-centered perspective. We aimed to evaluate QoL and mental health status in survivors after V-V ECMO for coronavirus disease 2019 (COVID-19)-related ARDS, hypothesizing a similar QoL comparable to the general population. Methods: All patients supported with venovenous ECMO for COVID-19-related ARDS between 01/2020 and 03/2022 in our center were included. Survivors were invited to participate in a follow-up interview assessing QoL, anxiety, and depression one year after hospital discharge. Primary endpoint was the quality of life, measured by the SF-36 questionnaire, with results compared to data from the DEGS1 study (German normative population). Results: During the study period, 97 patients received venovenous ECMO for COVID-19 ARDS at our ICU. Overall, 43/97 (44.3%) survived, and 21/97 (21.6%) completed the SF-36 questionnaire. The median follow-up duration was 1.7 years. Patients who completed the SF-36 were significantly younger than those who did not (48.7 vs. 55.6 years, p = 0.012); other patient characteristics and ECMO parameters were similar between those with and without questionnaire. Anxiety, depression, and post-traumatic stress disorder were detected in 33%, 14%, and 29% of patients, respectively. Compared to the German normative population, ECMO survivors had significantly lower QoL (mean 77.2 vs. 61.0, p < 0.001). Conclusions: QoL and mental health status after venovenous ECMO for ARDS was significantly lower compared to the normative population. These findings highlight the importance of further research and comprehensive follow-up care for ECMO survivors. Full article

Background: Real-world data on the prevalence and burden of patients with chronic spontaneous urticaria (CSU) are limited in Japan. This study aimed to estimate CSU prevalence and assess its humanistic and economic burden. Methods: This analysis utilized data from Japanese adult respondents self-reporting physician-diagnosed CSU collected through the 2019 National Health and Wellness Survey. The weighted 12-month prevalence was estimated using 2018 international census projections. Outcomes included the SF-12v2 (physical and mental component summary [PCS and MCS] scores), health utility index (SF-6D and EQ-5D), Dermatology Life Quality Index (DLQI), Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Work Productivity and Activity Impairment scores at data collection, and healthcare resource utilization over the past 6 months. Results: Among 30,006 respondents, 334 reported having CSU, of whom 62.3% were female. The mean (SD) age at data collection and CSU diagnosis was 50.8 (15.3) and 39.2 (14.9) years, respectively. The weighted prevalence of CSU was 1.1%. The mean (SD) PCS and MCS scores were 50.3 (7.0) and 45.1 (10.0), respectively. The mean (SD) health utility measures (SF-6D and EQ-5D) were 0.71 (0.13) and 0.79 (0.18), respectively. The mean (SD) DLQI score was 3.8 (6.0). More than 40% of patients reported mild/moderate/severe anxiety and depression. The mean % (SD) scores for absenteeism, presenteeism, overall work impairment, and activity impairment were 7.6 (17.6), 27.2 (27.2), 30.3 (29.6), and 28.5 (27.8), respectively. Approximately 90.0% of patients visited healthcare providers, including emergency room visits (6.9%) and hospitalizations (9.9%). Conclusions: This study provides insights into the diagnosed prevalence and burden of CSU in Japan, highlighting its impact on patients’ lives. Full article

The University of Otago School of Pharmacy Clinic serves as a model for innovative medication management, tackling critical medication-related problems (MRPs) to enhance patient outcomes and advance pharmacy education. This study evaluated the clinic’s impact, examining 456 patient consultations over four years, with a focus on MRPs such as dosing errors, non-adherence, and inadequate monitoring. Using the DOCUMENT classification system, pharmacists identified 754 MRPs and issued 836 recommendations, primarily related to medication adjustments and monitoring. Patients reported significant improvements in health-related quality of life, as measured by the SF12V2 survey, with notable gains in mental and physical health metrics. This outcome highlights the clinic’s dual role in optimising patient care and providing pharmacy students with experiential learning opportunities. By integrating hands-on training within a supervised clinical environment, the clinic addresses workforce shortages and reinforces the value of pharmacist-led interventions. The findings advocate for university-based clinics as pivotal hubs for resolving MRPs through interprofessional collaboration, targeted interventions, and innovative technologies such as telepharmacy. The study underscores the need for expanded roles for clinical pharmacists in healthcare policy and practice, showcasing their potential to prevent medication errors, enhance lives, and reshape the future of pharmacy education and patient care. Full article

Background/Objectives: Multicomponent, non-pharmacological therapies are the preferred first-line treatments for fibromyalgia (FM), but little is known about them in primary care settings. Our study assessed the effectiveness of the FIBROCARE Program in improving the quality of life, functional impact, mood, and pain of people with FM. Methods: We conducted a pragmatic, randomized controlled trial that was not blinded for both patients and the professionals delivering the treatments in the study groups. We compared a group receiving non-pharmacological multicomponent group therapy (MT) based on health education, physical exercise, and cognitive–behavioral therapy with another group receiving the usual clinical care. The MT group was treated in the primary care context in Catalonia (Spain) through 12 consecutive weekly sessions. Both groups were followed up with at the end of the MT group sessions and 6 and 12 months after the group sessions with the Short-Form 36 (SF-36) v2 Health Survey questionnaire, the Hospital Anxiety and Depression Scale (HADS-A and HADS-D), the Visual Analog Scale, and the Revised Fibromyalgia Impact Questionnaire (ClinicalTrials.gov: NCT04049006). Results: Improvements in pain intensity, functional impact, physical health, fatigue, and emotional problems that affect daily activities in the MT group lasted up to 12 months. Benefits measured by the SF-36 Mental Health dimension and the HADS-A subscale were lost after 6 months. Effects on the SF-36 Social Functioning dimension and HADS-D present at 6 months persisted for up to 12 months. Generally, the longer the time since the FM diagnosis, the better was a patient’s mood. Conclusions: The FIBROCARE Program effectively improves all the studied health outcomes except patient mood, since anxiety symptoms persist. The program should reinforce patient psychological support overall, focusing particularly on the years initially after diagnosis. Full article

Background: With limited pharmacological interventions, post-COVID-19 condition is a clinical challenge, and supplementary therapies are essential for symptom relief and enhancing quality of life (QoL). In our prospective observational study, we aimed to evaluate the impact of Salus per aquam (Spa) therapy on post-COVID-19 symptoms and QoL in individuals who suffer from chronic joint, musculoskeletal, skin, and/or respiratory conditions. Methods: A total of 159 individuals undergoing Spa therapy were enrolled, and 78 of them had post-COVID-19 symptoms, assessed using Visual Analogue Scale (VAS) and modified British Medical Research Council Questionnaire (mMRC-DS scales), as well as the Short Form 36 Health Status Survey (SF-36) questionnaire for QoL. Results: Spa therapy significantly reduced most post-COVID-19 symptoms, especially chronic fatigue, pain, brain fog, and persistent cough (all p < 0.05), as well as physical (+72%) and emotional (+66%) limitations. When stratified by sex, males showed a greater improvement from baseline, while females consistently displayed a higher amelioration in all QoL dimensions. Moreover, full vaccination with 3–4 doses significantly protected against SARS-CoV-2 re-infections and post-COVID-19 development (p < 0.05). Conclusions: Spa therapy demonstrated effectiveness in mitigating post-COVID-19 symptoms and enhancing QoL in patients suffering from chronic diseases. Full article

Background: Long COVID refers to the persistence or development of signs and symptoms well after the acute phase of COVID-19. Objective of the study: To investigate the long-term outcomes of the SARS-CoV-2 infection in terms of psychological, social, and relational consequences within the Italian population. Materials and methods: We conducted an observational, cross-sectional, and multicenter study using an online questionnaire distributed to a sample of the Italian population. By utilizing the Short Form 12 Health Survey (SF-12) and the Hikikomori scale, we assessed perceived quality of life and social isolation, respectively. The questionnaire also included an open-answer question: “What will you remember about the pandemic period?”. We used generative artificial intelligence to analyze and summarize the corresponding answers. Results: A total of 1097 people participated in this study. A total of 79.3% (n = 870) of participants declared that they had been hospitalized and 62.8% (n = 689) received home care. Physical symptoms included headaches (43%, n = 472) and asthma (30.4%, n = 334). Additionally, 29.2% (n = 320) developed an addiction during the pandemic and, among these, 224 claimed internet addiction while 73 declared an emotional addiction. Furthermore, 51.8% (n = 568) experienced limitations in carrying out daily life activities. According to the Hikikomori scale, participants with positive SARS-CoV-2 infection exhibited higher levels of isolation compared to the others (p < 0.001). Participants without COVID-19 showed higher levels of emotional support (p < 0.001). Our semiautomatic analysis of the open-ended responses, obtained by a procedure based on a free large language model, allowed us to deduce and summarize the main feelings expressed by the interviewees regarding the pandemic. Conclusions: The data collected emphasize the urgent need to investigate the consequences of long COVID in order to implement interventions to support psychological well-being. Full article

Kazakhstan is in Central Asia and is the ninth-largest country in the world. Some socially vulnerable segments of the Kazakh population residing in subsidised social housing have experienced a range of problems due to the low quality of housing construction and its planning. Poor indoor environmental conditions in social housing contribute to occupants’ comfort, health, and general well-being. This study assessed social housing residents’ health and quality of life, focusing on their perceived indoor air quality and thermal comfort satisfaction. A cross-sectional survey in Kazakhstan was conducted to test the effects of environmental factors on social housing residents’ health and satisfaction. Four hundred thirty-one responses were analysed, and the SF12v2 questionnaire was used to measure the health-related quality of life. Multiple regression analysis showed that air quality negatively predicted the respondents’ physical (PCS) and mental (MCS) health. In addition, age, smoking, and employment status had a significantly negative effect on PCS, while education level had a predictive positive effect. Thermal conditions negatively predicted only MCS, as well as alcohol consumption. Next, the air-conditioning control factor had a negative effect. In contrast, low air circulation, low humidity, high solar gain, temperature imbalance, duration of the residence and alcohol consumption had a significantly positive effect on overall satisfaction with the temperature. The odour sources from tobacco, furniture and external sources were predictors of respondents’ overall air quality satisfaction, along with the duration of the residence, alcohol consumption and smoking status. Full article

The assessment of health-related quality of life (HRQoL) in thalassemia offers a holistic approach to the disease and facilitates better communication between physicians and patients. This study aimed to evaluate the HRQoL of transfusion-dependent thalassemia (TDT) patients in Greece. This was a multicentric, cross-sectional study conducted in 2017 involving 283 adult TDT patients. All participants completed a set of two QoL questionnaires, the generic SF-36v2 and the disease-specific TranQol. Demographic and clinical characteristics were used to predefine patient subgroups. Significant factors identified in the univariate analysis were entered into a multivariate analysis to assess their effect on HRQoL. The SF-36 scores of TDT patients were consistently lower compared to the general population in Greece. The mean summary score of TranQol was relatively high (71 ± 14%), exceeding levels observed in national surveys in other countries. Employment emerged as the most significant independent factor associated with better HRQoL, whereas age had the most significant negative effect. This study represents the first comprehensive QoL assessment of a representative sample of the TDT population in Greece. The implementation of TranQol allowed for the quantification of HRQoL in Greece, establishing a baseline for future follow-up, and identifying more vulnerable patient subgroups. Full article

Background and objectives: Limited evidence exists regarding the influence of glycemic index (GI) in the context of a healthy diet on self-reported health status and sleep. We therefore aimed to investigate the effects of a low- vs. high-GI Mediterranean-style healthy eating pattern (MED-HEP) on subjective well-being and sleep, and whether measures of well-being and sleep were related to glycemia. Methods: The MedGICarb-intervention trial is a 12-week randomized, controlled, parallel multi-center trial (Italy, Sweden and USA). During the intervention, participants consumed an eu-energetic diet profiled as a MED-HEP with either high or low GI. Well-being and sleep were measured by the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 (SF-36v2), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) at baseline and after the 12-week intervention. Similarly, postprandial glucose was measured from oral glucose tolerance tests, and indices of glycemic variability were calculated from 24 h continuous glucose monitoring. Results: 161 adults with ≥2 features of the metabolic syndrome completed the intervention (53% females, mean age 56 ± 10 y, mean BMI 31 ± 3 kg/m²). Low- vs. high-GI MED-HEP resulted in differential changes between the groups in domains of well-being, driven mostly by improvements in the low-GI group, of which role physical (5.6 AU vs. −2.5 AU, p = 0.022) and vitality (6.9 AU vs. −0.3 AU, p = 0.008) were significant (ANOVA with group, site and sex as fixed factors and age and BMI as covariates). There was no significant difference between the diets for aggregated physical or mental components, or for the other domains of well-being (physical functioning, bodily pain, general health, social functioning, role emotional, mental health) or for sleep quality (PSQI) or daytime sleepiness (ESS). The aggregated physical and mental component, as well as some domains of well-being and sleep quality, were correlated with glycemic measures at baseline (Spearman correlation). Discussion: Low compared to high GI in the context of a MED-HEP resulted in improvements in domains of subjective well-being. No major differences were seen between the groups for indexes of sleep. Full article

Purpose: To assess the prevalence of symptoms of Post-Traumatic Stress Disorder (PTSD) in survivors of COVID-19 Acute Respiratory Distress Syndrome that needed ICU care; to investigate risk factors and their impact on the Health-Related Quality of life (HR-QoL). Materials and Methods: This multicenter, prospective, observational study included all patients who were discharged from the ICU. Patients were administered the European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L) questionnaire, the Short-Form Health Survey 36Version 2 (SF-36v2), a socioeconomic question set and the Impact of Event Scale—Revised (IES-R) to assess PTSD. Results: The multivariate logistic regression model found that an International Standard Classification of Education Score (ISCED) higher than 2 (OR 3.42 (95% CI 1.28–9.85)), monthly income less than EUR 1500 (OR 0.36 (95% CI 0.13–0.97)), and more than two comorbidities (OR 4.62 (95% CI 1.33–16.88)) are risk factors for developing PTSD symptoms. Patients with PTSD symptoms are more likely to present a worsening in their quality of life as assessed by EQ-5D-5L and SF-36 scales. Conclusion: The main factors associated with the development of PTSD-related symptoms were a higher education level, a lower monthly income, and more than two comorbidities. Patients who developed symptoms of PTSD reported a significantly lower Health-Related Quality of life as compared to patients without PTSD. Future research areas should be oriented toward recognizing potential psychosocial and psychopathological variables capable of influencing the quality of life of patients discharged from the intensive care unit to better recognize the prognosis and longtime effects of diseases. Full article

Little is known about the associations between insomnia severity, insomnia symptoms, and key health outcomes. Using 2020 United States National Health and Wellness Survey (NHWS) data, we conducted a retrospective, cross-sectional analysis to determine the associations between insomnia severity and a number of health outcomes germane to patients (health-related quality of life (HRQoL), employers and government (workplace productivity), and healthcare payers (healthcare resource utilization (HCRU)). The Insomnia Severity Index (ISI) questionnaire was used to evaluate overall insomnia severity. HRQoL was assessed using the physical and mental component summary scores of the Short Form-36v2 (SF-36v2) questionnaire, and health utility status was measured using the Short Form-6D (SF-6D) and EuroQoL-5D (EQ-5D) questionnaires. Workplace productivity was measured using the Work Productivity and Activity Impairment (WPAI) questionnaire. After adjusting for confounders, greater insomnia severity was significantly associated with worsened quality of life, decreased productivity, and increased HCRU in an apparent linear fashion. These findings have important implications for future research, including the need for specific assessment of insomnia symptoms and their impact on key health outcomes. Full article

Health empowerment can be an effective way to reduce health inequities. This prospective cohort study evaluated the 5 year impact of a health empowerment program (HEP) on health outcomes among adults from low-income families. The Patient Enablement Instrument version 2 (PEI-2), Depression, Anxiety and Stress Scale 21 (DASS-21), and 12 item Short-Form Health Survey version 2 (SF-12v2) were administered at baseline and follow-up for both intervention and comparison groups. A total of 289 participants (n = 162 for intervention group, n = 127 for comparison group) were included in the analysis. Most of the participants were female (72.32%), and aged from 26 to 66 years old (M = 41.63, SD = 6.91). Linear regressions weighted by inverse probability weighting using the propensity score showed that, after follow-up of 5 years, the intervention group demonstrated significantly greater increases in all items and total scores for the PEI-2 (all B > 0.59, p < 0.001), greater decreases in the DASS depression score (B = −1.98 p = 0.001), and greater increases in the Mental Component Summary score of the SF-12v2 (B = 2.99, p = 0.027) than the comparison group. The HEP may be an effective intervention enabling adults from low-income families to manage their health-related issues and improve their mental health, as evidenced by our study. Full article

Background: Depression is a common problem in patients with cardiovascular diseases. Identifying a risk factor model of depression has been postulated. A model of the risk of depression would provide a better understanding of this disorder in this population. We sought to construct a model of the risk factors of depression in patients following cardiac surgery, with the use of machine learning. Methods and Measures: Two hundred and seventeen patients (65.4% men; mean age 65.14 years) were asked to complete the short form health survey-12 (SF-12v.2), three months after hospital discharge. Those at risk of depression were identified based on the SF-12 mental component summary (MCS). Centroid class principal component analysis (CCPCA) and the classification and regression tree (CART) were used to design a model. Results: A risk of depression was identified in 29.03% of patients. The following variables explained 82.53% of the variance in depression risk: vitality, limitation of activities due to emotional problems (role-emotional, RE), New York Heart Association (NYHA) class, and heart failure. Additionally, CART revealed that decreased vitality increased the risk of depression to 45.44% and an RE score > 68.75 increased it to 63.11%. In the group with an RE score < 68.75, the NYHA class increased the risk to 41.85%, and heart failure further increased it to 44.75%. Conclusion: Assessing fatigue and vitality can help health professionals with identifying patients at risk of depression. In addition, assessing functional status and dimensions of fatigue, as well as the impact of emotional state on daily functioning, can help determine effective intervention options. Full article

This study aimed to examine the difference in health-related quality of life (HRQOL) and diabetes-related healthcare events (HCEs) among adults with diabetes who were on metformin, sulfonylurea, insulin, or thiazolidinedione (TZD) monotherapy. The data were sourced from the Medical Expenditure Panel Survey (MEPS). Diabetes patients ≥18 years old who had a complete record of physical component score and mental component scores in round 2 and round 4 of the survey were included. The primary outcome was HRQOL of diabetes patients as measured by the Medical Outcome Study short-form (SF-12v2^TM). Multinomial logistic regression and negative binomial regression were conducted to determine associated factors of HRQOL and HCE, respectively. Overall, 5387 patients were included for analysis. Nearly 60% of patients had unchanged HRQOL after the follow-up, whereas almost 15% to 20% of patients showed improvement in HRQOL. The relative risk of declined mental HRQOL was 1.5 times higher relative to unchanged mental HRQOL in patients who were on sulfonylurea 1.55 [1.1–2.17, p = 0.01] than metformin users. The rate of HCE decreased by a factor of 0.79, [95% CI: 0.63–0.99] in patients with no history of hypertension. Patients on sulfonylurea 1.53 [1.20–1.95, <0.01], insulin 2.00 [1.55–2.70, <0.01], and TZD 1.78 [1.23–2.58, <0.01] had increased risk of HCE compared to patients who were on metformin. In general, antidiabetic medications modestly improved HRQOL in patients with diabetes during the follow-up period. Metformin had a lower rate of HCE as compared to other medications. The selection of anti-diabetes medications should focus on HRQOL in addition to controlling glucose level. Full article