D'Uva, F

Mear, I

Mollon, P

Wu, AW

Elsevier - Publisher Connector 

PIN31 USE OF THE SYMPTOMS DISTRESS MODULE IN AN INTERNATIONAL STUDY 

314 Abstracts
OBJECTIVES: To understand the current extent of anemia in
HIV/AIDS patients and its impact on health-related quality of
life (HRQL). METHODS: HIV/AIDS patients >18 years of age
were recruited from STD/HIV clinics across the US throughout
2003 to complete self-administered questionnaires. Clinical
status was assessed with questions on medical history and HIV
disease and treatment, while HRQL was quantiﬁed using the SF-
8. RESULTS: In total, 2044 patients were recruited; 498 (24%)
reported that they experienced anemia (as indicated by a health
care provider) as a side effect of medication within the previous
month. Although anemic and non-anemic individuals were
similar in age, gender, HIV viral load, and use of AZT, NRTI
and NNRTI treatment, anemic patients were more likely to be
non-Caucasian, have a lower CD4 count, and more likely to be
on PIs. Similarly, anemic patients were signiﬁcantly more likely
to have anxiety, depression, and cardiovascular comorbidities 
(p < 0.0001). Further, anemic patients had signiﬁcantly lower
scores vs. non-anemic patients on the mental and physical com-
ponent summary scores of the SF-8 (mental: 38.2 + 11.6 anemic
vs. 42.9 + 11.9 non-anemic p < 0.0001; physical: 40.1 + 10.0
anemic vs. 45.5 + 10.4 non-anemic p < 0.0001). There was a sig-
niﬁcantly higher prevalence of great difﬁculty or inability to
perform daily work among the anemic patients (33% anemic vs.
19% non-anemic, p < 0.0001). In a multivariate logistic regres-
sion model controlling for relevant demographic, disease and
treatment characteristics, anemic patients experienced signiﬁ-
cantly lower levels of mental (-4.1 SF-8 MCS score, p < 0.001)
and physical (-4.9 SF-8 PCS score, p < 0.001) well-being than
non-anemic patients. CONCLUSION: Independent of AZT use,
anemia is prevalent in the HIV/AIDS population in the HAART
era. Controlling for relevant confounders, anemia is indepen-
dently associated with a diminished HRQL.
PIN31
USE OF THE SYMPTOMS DISTRESS MODULE IN AN
INTERNATIONAL STUDY
Mear I1, D’Uva F1,Wu AW2, Mollon P3
1Mapi Research Institute, Lyon, Rhône, France; 2Johns Hopkins
Bloomberg School of Public Health, Baltimore, MD, USA; 3Pﬁzer, Kent,
Sandwich, UK
OBJECTIVES: Prior to use in an international study involving
HIV patients, the original 20-item Symptoms Distress Module
(SDM), underwent linguistic validation in 25 languages. The
original scale was developed in US English by the Adult AIDS
Clinical Trials Group to assess the impact of common HIV-
related symptoms (either due to HIV disease or its treatments).
A rigorous methodology was required to ensure conceptual
equivalence and cultural relevance across different languages.
METHODS: The translation process was conducted by a spe-
cialist in each target country using the following standardized
methodology: 1) two forward translations by professional trans-
lators who were native speakers of the target language and ﬂuent
in English; 2) comparison and reconciliation of the translations
by the specialist in the target country and the translators; 3)
back-translation by a native English speaker; 4) comparison of
source and backward version; 5) review by a clinician; and 
6) comprehension test on ﬁve individuals with HIV/AIDS.
RESULTS: The translation process revealed two major chal-
lenges. First, for items which contain two different terms to
describe one single concept, some languages only have one word
that suitably conveys the concept. Second, the comprehension
tests revealed that in countries where people are less used to com-
pleting questionnaires, the instructions “The questionnaire . . .
should take no more than ﬁve minutes to complete” were per-
ceived as stressful. This required alternative wording. CON-
CLUSION: The 25 language versions of the SDM were estab-
lished according to a rigorous standardized translation method-
ology. The process aims to ensure conceptual equivalence across
language versions to facilitate international comparison and
pooling of data. The linguistic validation process as a whole sup-
ports the integration of international feedback on concepts and
wording during the development of questionnaires.
NEUROLOGICAL DISORDERS—Alzheimer’s Disease
PNL1
ASSESSMENT OF COMORBIDITY AND INCIDENCE RATE OF
ALZHEIMER’S DISEASE IN THE CALIFORNIA MEDICAID
(MEDI-CAL) PROGRAM
Yu YF1,Yu AP2, Lee LJ2, Nichol MB3
1HealthCore, Inc, Wilmington, DE, USA; 2University of Southern
California, Los Angeles, CA, USA; 3University of Southern California,
School of Pharmacy, Los Angeles, CA, USA
OBJECTIVES: First, to investigate comorbidities associated with
Alzheimer’s disease (AD) and second, to report eligibility and the
yearly trend of incidence rate of AD in Medi-Cal from 1995 to
2002. METHODS: A retrospective case-control study was con-
ducted using 20% sample of Medi-Cal administrative claims
data from 1995 to 2002. The cases were patients with a diag-
nosis of AD, and were 1 :10 matched to a cohort without AD
based on age and gender. Eligibility was measured by the number
of eligible months. Relative risk (RR) was calculated to estimate
the risk of AD patients developing a proﬁle of 24 common
comorbidities set forth by AHRQ. RESULTS: In total, 6,494
cases and 64,940 controls were identiﬁed. The average age was
84 and 69% were female. During the eight-year study period,
both groups had around 50 eligible months with no signiﬁcant
difference. Hispanics and other minorities (primarily Asians) had
lower risk of having AD (p < 0.0001). In addition to depression
(RR = 1.67) and psychoses (RR = 2.63), which are the known
comorbidities of AD, peripheral vascular disorder (RR = 1.49)
and other neurological disorders (RR = 1.82) were associated
with the AD diagnosis. Interestingly, AD patients had signiﬁ-
cantly lower risk for many other chronic diseases such as CHF
(RR = 0.82), valvular disease (RR = 0.85), hypertension (RR =
0.84), COPD (RR = 0.85), diabetes (RR = 0.85), renal failure
(RR = 0.86), peptic ulcer (RR = 0.86), cancer (RR = 0.69), and
rheumatoid arthritis (RR = 0.80). The yearly incidence rate for
AD slightly declined from 5.8 per 10,000 person-years in 1995
to 4.8 per 10,000 person-years in 2002. Average annual inci-
dence rate was 5.3 per 10,000 person-years. CONCLUSIONS:
The present study demonstrated that patients with AD had
increased risk of some diseases, yet were less likely to experience
many chronic disorders common to elderly patients.
PNL2
THE COST-EFFECTIVENESS OF DONEPEZIL AND
RIVASTIGMINE IN THE TREATMENT OF ALZHEIMER’S
DISEASE IN THAILAND PRIVATE HOSPITAL
Pattanaprateep O, Phongchareonsuk P, Chaikledkaew U
Mahidol University, Payathai, Bangkok,Thailand
OBJECTIVES: To evaluate the cost-effectiveness of donepezil 10
mg per day, rivastigmine 6–12mg per day (high dose), and
rivastigmine 1–4mg per day (low dose) compared with no treat-
ment in the management of mild to moderate Alzheimer’s
Disease in Thailand. METHODS: Using the decision tree analy-
sis, the cost-effectiveness model was developed to compare
donepezil, low dose-rivastigmine and high dose-rivastigmine
with no treatment in patients with mild to moderate Alzheimer’s
Disease. Direct medical costs (i.e., the costs of drugs) and direct


file:///data/remote/core/dit/data/elsevier/pdf/1ca/aHR0cDovL2FwaS5lbHNldmllci5jb20vY29udGVudC9hcnRpY2xlL3BpaS9zMTA5ODMwMTUxMDYyODE0OA==.pdf

PIN31 USE OF THE SYMPTOMS DISTRESS MODULE IN AN INTERNATIONAL STUDY

Abstract

Similar works

Full text

Available Versions

Elsevier - Publisher Connector

Elsevier - Publisher Connector