การทดสอบเบื้องต้นแบบประเมินผลลัพธ์ด้านการรักษาด้วยการใช้ยาที่ได้จากการรายงานของผู้ป่วยสำหรับคุณภาพชีวิตด้านยาโดยใช้วิธีเชิงผสมผสาน Preliminary Test of the Patient-Reported Outcomes Measure of Pharmaceutical Therapy for Quality of Life (PROMPT-QoL) Using

Objective: To preliminarily test PROMPT-QoL (Patient-Reported OutcomesMeasure of Pharmaceutical Therapy for Quality of Life) using mixedmethods based on qualitative (cognitive interviews) and quantitative (aRasch model) approaches. Method: The test of PROMPT-QoL wasconducted with 60 outpatients at King Chulalongkorn Memorial hospitalwho had been using medications for at least 3 months. Cognitive interviewswere used to explore comprehension problems of items, response choices,instructions/formats and other problems. A Rasch model was used toquantitatively identify problems of items and scale layout. Results:According to cognitive interviews, indecision about the cause of impacts ofmedicines and side-effects was the most found problem of PROMPT-QoL.Domain about getting drug information from health care providers wasfound the most found problem, followed by question comprehensionproblem. Eight of 42 questions had infit mean-squares and/or outfit meansquaresbelow 0.7 or above 1.3. Of nine domains, 5 domains had personreliability coefficients below 0.80. Conclusion: Most items of PROMPT-QoLhad favorable fit to the Rasch model. Further studies in large patientgroups are required to test its complete psychometric properties.Keywords: patient-reported outcomes, pretesting, cognitive interviews,Rasch mode

ผลของโปรแกรมการเปลี่ยนแปลงจิตสำนึกเพื่อคลายเครียดต่อผู้ป่วยติดเชื้อเอชไอวีและผู้ป่วยเอดส์ Effects if the Consciousness Transformation Program on Patients with HIV/AIDS

บทคัดย่อวัตถุประสงค์: เพ

ผลลัพธ์ของการจัดการด้านยาในผู้ป่วยนอกโรคเบาหวาน Outcomes of Medication Therapy Management in Diabetic Outpatients

บทคัดย่อวัตถุประสงค์:เพื่อศึกษาผลของการจัดการด้านยาในผู้ป่วยเบาหวาน ในแง่ผลลัพธ์ทางคลินิก ได้แก่ ผลการควบคุมระดับน

Item Analysis, Validity and Reliability of the Patient–Reported Outcome Measure of Pharmaceutical Therapy for Quality of Life (PROMPT-QoL) at Ramathibodi Hospital

Objective: To conduct item analysis and investigate validity and reliabilityof the Patient-Reported Outcome Measure of Pharmaceutical Therapy forQuality of Life (PROMPT-QoL) questionnaire by using classical test theory.Method: In this study, data were collected from 400 outpatients who hadbeen using medications for at least 3 months at Ramathibodi hospital.Participants completed PROMPT-QoL, Medication Taking Behaviorquestionnaire (MTB), WHOQOL-BREF-THAI and EQ-5D-5L Thai version bythemselves and retested these questionnaires in one week later. Classicaltest theory was used to analyze item and test construct validity, criterionvalidity, internal consistency reliability and test-retest reliability. Results:Among 9 PROMPT-QoL domains, 7 domains were correlated with overallquality of life domain significantly. Different sex, age, levels of education,number of medicines per day, disease control level and incidence ofadverse drug reaction affected PROMPT-QoL scores in each domaindifferently. For criterion validity, PROMPT-QoL moderately correlated withWHOQOL–BREF-THAI and EQ-5D-5L (r = 0.25 – 0.50). Every domain inPROMPT-QoL showed excellent test-retest reliability (ICCs 0.75). Mostdomains revealed acceptable internal consistency reliability (Cronbach’salpha 0.7) except availability/accessibility domain. However this domainshowed acceptable corrected item-total correlations. Conclusion:PROMPT-QoL consists of 9 domains (43 items) that reveal acceptablevalidity and reliability. Further studies about responsiveness are required tocomplete psychometric properties.Keywords: item analysis, validity, reliability, Patient–Reported OutcomeMeasure of Pharmaceutical Therapy for Quality of Life,PROMPT-Qo

Health Utility Measured with EQ-5D in Thai Patients Undergoing Peritoneal Dialysis

AbstractObjectivesTo measure health utility by using the EuroQol five-dimensional questionnaire (EQ-5D) in Thai patients undergoing peritoneal dialysis (PD) and to examine the relationship between the EQ-5D and patient characteristics including sociodemographic and clinical data and end-stage renal disease symptoms.MethodsThis was a cross-sectional study. About 10 to 12 patients undergoing PD were randomly selected from each of the 10 hospitals located in every part of Thailand. Face-to-face interviews were conducted from October 2008 to February 2009. Patients assessed their health status by using five domains and a visual analogue scale. The EQ-5D score was calculated on the basis of responses to five domains by using the Thai value set. Multiple regression analyses using a stepwise method were employed to model the associations between the EQ-5D score, the VAS score, and patient characteristics.ResultsThe patients' mean age was 42.2 ± 13.8 years; 53% were male. The mean PD duration was 7.4 ± 6.0 months. The mean EQ-5D and visual analogue scale scores were 0.65 ± 0.23 and 0.65 ± 0.26, respectively. The EQ-5D score was higher than that obtained from a meta-analysis study (0.58). The multivariate regression model showed that education, work status, diabetes, and end-stage renal disease symptoms were significant predictors of the EQ-5D score. The significant predictors of the VAS score included work status, albumin level, use of erythropoietin, and end-stage renal disease symptoms.ConclusionsThis Thai PD sample yielded higher EQ-5D scores than did other PD populations. To improve the health utility of Thai patients undergoing PD, the significant factors should be addressed. Because our PD sample had a short PD duration, their long-term health utility should be evaluated in future research

A comparison of EQ-5D index scores using the UK, US, and Japan preference weights in a Thai sample with type 2 diabetes

Abstract Background Data are scarce on the comparison of EQ-5D index scores using the UK, US, and Japan preference weights in other populations. This study was aimed to examine the differences and agreements between these three weights, psychometric properties including test-retest reliability, convergent and known-groups validity, and the impact of differences in the EQ-5D scores on the outcome of cost-utility analysis in Thai people. Methods A convenience sample of 303 type 2 diabetic outpatients (18 years or older) from a cross-sectional study was examined. ANOVA and pos-hoc Bonferroni tests were used to determine the differences among the three EQ-5D scores. The agreements among the EQ-5D scores were assessed employing intraclass correlations coefficients (ICCs) and Bland-Altman plots. The ICCs were utilized to examine the test-retest reliability. Spearman's rho correlation coefficients were used to assess the convergent validity between the EQ-5D scores and sociodemographic & clinical data, and health status. Mann-Whitney U tests were used to test the differences in EQ-5D scores between the known groups including HbA1c level (cut point of 7%), and the presence of diabetic complications namely neuropathy, retinopathy, nephropathy and cardiovascular diseases. Seven hypothetical decision trees were created to evaluate the impact of differences in the EQ-5D scores on the incremental cost-utility ratio (ICUR). Results The US weights yielded higher scores than those of the UK and the Japan weights (p p > 0.05). Both UK and US scores had more agreement with each other than with the Japan scores. Regarding psychometric properties, the Japan scheme provided better test-retest reliability, convergent and known-groups validity than both UK and US schemes. The variation in EQ-5D scores estimated from UK, US, and Japan preference weights had a marginal impact on ICUR (range: 1.23–6.32%). Conclusion Since the Japan model showed more preferable psychometric properties than the UK and the US models and the differences in these EQ-5D scores had a small impact on ICUR, we recommended that for both clinical and policy purposes the Japan scheme should be used in Thai people. However, more research needs to be done.</p

Usefulness of Patient-Generated Index for HIV to Measure Individual Quality of Life: A Study from Thailand

AbstractObjectivesTo 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.MethodsIn 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.ResultsA total of 210 patients completed the study. They were mostly women (69.5%), with a mean age of 39.2 ± 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 ± 0.8, highly reliable (intraclass correlation coefficient = 0.75; P < 0.001), and responsive to HRQOL changes (effect size = 0.81; standardized response mean = 0.99), but not valid when compared with CD4 levels and viral loads (all Pearson’ r < 0.2; P > 0.05).ConclusionsThe 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