Health-related quality of life impact of cobimetinib in combination with vemurafenib in patients with advanced or metastatic BRAFV600 mutation-positive melanoma

Background: In the coBRIM study, cobimetinib plus vemurafenib (C+V) significantly improved survival outcomes vs placebo and vemurafenib (P+V) in patients with advanced/metastatic BRAF(V600)-mutated melanoma. An analysis of health-related quality of life (HRQOL) from coBRIM is reported.Methods: Patients completing the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (QLQ-C30) at baseline and >= 1 time point thereafter constituted the analysis population. Change from baseline >= 10 points was considered clinically meaningful.Results: Mean baseline scores for all QLQ-C30 domains were similar between arms. Most on-treatment scores for QLQ-C30 domains were also comparable between arms. A transient deterioration in role function in cycle 1 day 15 (C1D15; -14.7 points) in the P+V arm and improvement in insomnia in the C+V arm at C2D15 (-12.4 points) was observed. Among patients who experienced a >= 10-point change from baseline (responders), between-group differences were greatest for insomnia (16%), social functioning (10%), fatigue (9%) and pain (7%), all favouring C+V. Diarrhoea, photosensitivity reaction, pyrexia, and rash did not meaningfully affect global health status (GHS). Serous retinopathy was associated with a transient decrease in GHS at C1D15 assessment.Conclusions: In patients with advanced/metastatic BRAFV600-mutated melanoma, treatment with C+V maintained HRQOL compared with P+V, with superior efficacy

Health related quality of life in ANCA associated vasculitis and item generation for a disease specific patient reported outcome measure

ABSTRACTObjective: The anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) are multisystem diseases of the small blood vessels. Patients experience irreversible damage and psychological effects from AAV and its treatment. An international collaboration was created to investigate the impact of AAV on health-related quality of life (HRQoL), and develop a disease-specific patient-reported outcome measure to assess outcomes of importance to patients.Methods: Patients with AAV from the UK, US, and Canada were interviewed to identify salient aspects of HRQoL affected by AAV. The study was overseen by a steering committee including four patient research partners. Purposive sampling of interviewees ensured representation of a range of disease manifestations and demographics. Inductive analysis was used to identify themes of importance to patients; these were further confirmed by a free-listing exercise in the US. Individual themes were recast into candidate items, which were scrutinized by patients, piloted through cognitive interviews and received a linguistic and translatability evaluation. Results: Fifty interviews, conducted to saturation, with patients from the UK, US and Canada, identified 55 individual themes of interest within seven broad domains: general health perceptions, impact on function, psychological perceptions, social perceptions, social contact, social role and symptoms. Individual themes were constructed into >100 candidate questionnaire items which were then reduced and refined to 35 candidate items.Conclusion: This is the largest international qualitative analysis of health related quality of life in ANCA associated vasculitis to date, the results have underpinned the development of 35 candidate items for a disease-specific, patient-reported outcome questionnaire

Oral Health-related Quality of Life Among Pregnant Women at Hospital Universiti Sains Malaysia

This cross sectional study aimed to determine oral health-related quality of life in pregnant women. A total of 100 pregnant women seen at the Obstetrics and Gynaecology Clinic at Hospital Universiti Sains Malaysia participated in this study. The short version of the Malaysian Oral Health Impact Profile (S-OHIP(M)) questionnaire with five-point ordinal scale that ranges from ‘never' to ‘very often' was used to assess the frequency of oral impacts during the previous 12 months. The majority of the respondents were Malay (96.0%), with a mean age of 29.9 years (SD 5.78). The highest education level attained by most respondents was post-secondary qualification or Diploma (39.0%). Some had formal tertiary education (27.0%). The majority of them were income earners (74.0%) and contributed to the household income. Half of the respondents were in their third trimester of pregnancy while the remaining half was either in the first or second trimester. The severity of impact experienced by the women, which is the mean S-OHIP(M) score was high at 10.43 (95% CI = 8.96, 11.90). The prevalence of impact, which is the percentage of respondents reporting ‘fairly often' or ‘very often' to one or more impacts, was 36.0%. Common impacts experienced by the respondents include feeling uncomfortable because food got stuck in between teeth or dentures (22.0%), feeling that oral health problems had caused bad breath (13.0%), and feeling shy because of problems with teeth, mouth or dentures (9.0%). The results also demonstrated that neither the severity nor the prevalence of impact was influenced by the women's socio-demographic background. This study concluded that pregnant women suffered from high impact of oral diseases that could affect their quality of lif

Moderate-vigorous physical activity and health-related quality of life among Hispanic/Latino adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

BackgroundPhysical activity is a modifiable healthy behavior that has been shown to positively influence health-related quality of life. However, research examining the link between physical activity and health-related quality of life among Hispanic/Latino adults is limited and inconsistent. The purpose of this study is to assess whether accelerometer-measured moderate-vigorous physical activity (MVPA) is associated with self-reported (a) mental health-related quality of life, and (b) physical health-related quality of life among diverse Hispanic/Latino adults in the US.MethodsCross-sectional data from 12,379 adults ages 18-74 years in 2008-2011, who participated in HCHS/SOL and had complete data were analyzed using complex survey design methods. Accelerometer data were categorized into no MVPA, low, moderate, and high MVPA. Health-related quality of life was assessed with the Short-Form 12 and we used the mental and physical component subscales where higher scores indicate better health-related quality of life. Multivariate linear regression models were used to derive adjusted means with 95% confidence intervals and linear trends.ResultsWe observed no significant linear trend between accelerometer-measured MVPA and mental health-related quality of life (ptrend = 0.73). There was a significant positive association between MVPA and physical health-related quality of life (ptrend < 0.001) where higher MVPA corresponded with higher scores in physical health-related quality of life. The adjusted means were 46.67 (44.85-48.48) for no MVPA, 49.33 (49.03-49.63) for low MVPA, 50.61 (50.09-51.13) for moderate MVPA, and 51.36 (50.86-51.86) for high MVPA.ConclusionsAmong diverse Hispanic/Latino adults in the US, accelerometer-measured MVPA was associated with physical health-related quality of life, but not mental health-related quality of life. Future interventions should evaluate if increases in MVPA lead to improvements in health-related quality of life

Physical activity and health related quality of life

Copyright @ 2012 Anokye et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.This article has been made available through the Brunel Open Access Publishing Fund.BACKGROUND: Research on the relationship between Health Related Quality of Life (HRQoL) and physical activity (PA), to date, have rarely investigated how this relationship differ across objective and subjective measures of PA. The aim of this paper is to explore the relationship between HRQoL and PA, and examine how this relationship differs across objective and subjective measures of PA, within the context of a large representative national survey from England. METHODS: Using a sample of 5,537 adults (40–60 years) from a representative national survey in England (Health Survey for England 2008), Tobit regressions with upper censoring was employed to model the association between HRQoL and objective, and subjective measures of PA controlling for potential confounders. We tested the robustness of this relationship across specific types of PA. HRQoL was assessed using the summary measure of health state utility value derived from the EuroQol-5 Dimensions (EQ-5D) whilst PA was assessed via subjective measure (questionnaire) and objective measure (accelerometer- actigraph model GT1M). The actigraph was worn (at the waist) for 7 days (during waking hours) by a randomly selected sub-sample of the HSE 2008 respondents (4,507 adults – 16 plus years), with a valid day constituting 10 hours. Analysis was conducted in 2010. RESULTS: Findings suggest that higher levels of PA are associated with better HRQoL (regression coefficient: 0.026 to 0.072). This relationship is consistent across different measures and types of PA although differences in the magnitude of HRQoL benefit associated with objective and subjective (regression coefficient: 0.047) measures of PA are noticeable, with the former measure being associated with a relatively better HRQoL (regression coefficient: 0.072). CONCLUSION: Higher levels of PA are associated with better HRQoL. Using an objective measure of PA compared with subjective shows a relatively better HRQoL.This project was funded by the NIHR Health Technology Assessment programme (project number 08/72/01)

Health Related Quality of Life in Coronary Patients.

The increase observed in the survival of patients with ischemic cardiopathy, together with the effect of the disease on the social, professional, and family life of those suffering from it, have led researchers to consider that the traditional ways of measuring morbidity and mortality are not adequate for assessing the potential benefits of health care interventions. For this reason, there is common agreement on the need to use an indicator of subjective assessment of health, and of health related quality of life (HRQL), as a complementary criterion for monitoring the results of medical interventions in these patients. The term "quality of life" (QoL) or health related quality of life (HRQL) came into use during the 1970s as a multidimensional concept reflecting the overall subjective condition of the physical and mental welfare of the individual, which is a consequence not only of the disease but also of the family and social conditions forming the patient’s environment. The assessment of these patients’ HRQL has been tackled by several authors using both disease-specific and generic instruments such as the Nottingham Health Profile, the Sickness Impact Profile, the SF-36 or the SF-12 health questionnaire. Both types of instrument have advantages and disadvantages, and they may provide additional information since they quantify the patient’s overall health. Using different multidimensional measures, poorer HRQL has been observed in patients with Acute Myocardial Infarction (AMI) and angina pectoris than in other populations, and these differences have been related to low social class, female sex, the presence of mental disorders and the severity of the clinical condition. Measuring changes in the HRQL of coronary patients is also important as a way of assessing interventions and predicting needs for social care, because it has been shown that the focus of attention in the immediate period following a cardiac attack is generally the physical functioning, but following discharge from hospital and in the longer term, general health, vitality, social and emotional functions could be at least as important. In this chapter, we aim to provide an overview of the concept of HRQL and the usefulness of this measure from the perspective of a coronary patient. Likewise, we intend to review the main instruments used to assess HRQL and we analyse the factors that have been seen to affect the quality of life of these patients

A bi-directional relationship between obesity and health-related quality of life : evidence from the longitudinal AusDiab study

Objective: To assess the prospective relationship between obesity and health-related quality of life, including a novel assessment of the impact of health-related quality of life on weight gain.Design and setting: Longitudinal, national, population-based Australian Diabetes, Obesity and Lifestyle (AusDiab) study, with surveys conducted in 1999/2000 and 2004/2005.Participants: A total of 5985 men and women aged 25 years at study entry.Main outcome measure(s): At both time points, height, weight and waist circumference were measured and self-report data on health-related quality of life from the SF-36 questionnaire were obtained. Cross-sectional and bi-directional, prospective associations between obesity categories and health-related quality of life were assessed.Results: Higher body mass index (BMI) at baseline was associated with deterioration in health-related quality of life over 5 years for seven of the eight health-related quality of life domains in women (all P0.01, with the exception of mental health, P&gt;0.05), and six out of eight in men (all P&lt;0.05, with the exception of role-emotional, P=0.055, and mental health, P&gt;0.05). Each of the quality-of-life domains related to mental health as well as the mental component summary were inversely associated with BMI change (all P&lt;0.0001 for women and P0.01 for men), with the exception of vitality, which was significant in women only (P=0.008). For the physical domains, change in BMI was inversely associated with baseline general health in women only (P=0.023).Conclusions: Obesity was associated with a deterioration in health-related quality of life (including both physical and mental health domains) in this cohort of Australian adults followed over 5 years. Health-related quality of life was also a predictor of weight gain over 5 years, indicating a bi-directional association between obesity and health-related quality of life. The identification of those with poor health-related quality of life may be important in assessing the risk of future weight gain, and a focus on health-related quality of life may be beneficial in weight management strategies.<br /

Do we understand health-related- quality-of-life outcomes?

Last year I was afforded the opportunity of investigating Health Related Quality of Life (HRQoL) outcomes for patients with wounds, through a Florence Nightingale Travel Scholarship. Since my return from Australia, I have been thinking about how we identify and enhance HRQoL outcomes for the range of wound conditions that we see and treat in clinical practice

Health-Related Quality of Life

The concept of health-related quality of life (HRQoL) has evolved since the 1980s, with broad-based applications for clinical care, research, and health policy, as well as for individual and patient use. This book, Health-Related Quality of Life - Measurement Tools, Predictors and Modifiers, highlights measurement tools for HRQoL, as well as predictors and modifiers, examining HRQoL in various disease states, including psychological health. It also discusses ethical issues in the use of HRQoL measurements. The book is a compendium of original research, sharing perspectives from across developing and developed world settings. It is a useful text for researchers and students of academic disciplines in public health and clinical studies, extending to healthcare administrators and policymakers

Health-related quality of life in migrant preschool children

BACKGROUND: Minority groups have a lower health-related quality of life (HRQOL), but there is little information if this finding also applies to children. In this study, we compared HRQOL between young children with and without migrant parents. METHODS: Two cross-sectional studies of culturally diverse preschool populations in Switzerland: Ballabeina (40 preschools, 258 girls and 232 boys aged 4 to 6 years) and Youp'la Bouge (58 child care centers, 453 girls and 522 boys aged 2 to 4 years). Most children were born in Switzerland (Ballabeina: 92.3%; Youp'la Bouge: 93.7%). Number of migrant parents was considered as the main exposure. HRQOL was measured using the 23-item Pediatric Quality of Life Inventory. RESULTS: Children of migrant parents had a significantly lower HRQOL total score (mean +/- SD, Ballabeina: 84.2 +/- 9.1; 82.7 +/- 9.6 and 81.7 +/- 11.7 for children with none, one or two migrant parents, respectively; Youp'la Bouge: 83.8 +/- 8.6; 82.9 +/- 9.5; 80.7 +/- 11.7, all p > 0.05). Similar results were found in Ballabeina and Youp'la Bouge for social, school and physical functioning (all p > 0.05), but not for emotional functioning. The differences in HRQOL measures were partly mediated by children's place of birth, parental education, paternal occupational level, children's BMI, screen time and physical activity in one study (Ballabeina), but not in the other (Youp'la Bouge). CONCLUSION: In preschoolers, children of migrant parents have lower HRQOL than children of non-migrant parents. These differences are only partly mediated by other sociocultural characteristics or lifestyle behavior. These families may need assistance to prevent further inequalities