Health-related quality of life (HRQoL) from HIV patients' perspective: comparison of patient-reported outcome (PRO) measures among people living with hiv (PLWH) and other chronic clinical conditions.

Chronic illness HIV HRQoL PLWH PRO

Journal

Journal of patient-reported outcomes
ISSN: 2509-8020
Titre abrégé: J Patient Rep Outcomes
Pays: Germany
ID NLM: 101722688

Informations de publication

Date de publication:
26 Mar 2022
Historique:
received: 29 09 2021
accepted: 13 02 2022
entrez: 29 3 2022
pubmed: 30 3 2022
medline: 30 3 2022
Statut: epublish

Résumé

People living with HIV (PLWH) are generally known to suffer from a lower quality of life compared to the one of general population, but still very few is known about the self-perception of quality of life when comparing HIV to non-communicable diseases. We performed a comprehensive assessment of patient's reported outcomes measures (PROMs) among PLWH and patients affected by other chronic conditions (OC) such as diabetes mellitus type 1, rheumatoid arthritis, breast cancer in hormonal therapy, in order to investigate differences in PROMs outcomes between PLWH and other pathologies. A cross-sectional observational study was performed by using questionnaires investigating health-related quality of life (Medical Outcomes Study Short Form 36-item Health Survey), work productivity (WPI), and global health status (EQ-5D-3L). They were administered to patients affected by chronic diseases consecutively observed at a single University Hospital during a 10 months period, with comparable disease related aspects. Logistic regression analysis was used to analyze the association between disease group (HIV vs OC) and PROMs. 230 patients were enrolled (89 PLWH, 143 OC). Mean age: 49 years (SD 10), mean time of disease 12 years (10), 96% were Caucasian, 35% assumed polypharmacy, 42% of male were PLWH versus 16% OC (p < 0.001), 19% PLWH versus 6% OC had clinical complications (p < 0.001). HIV infection was independently associated to a better health-related quality of life in several domains compared with the other conditions, except in mental health, whereas a worst health-related quality of life in most domains was reported by older patients and those experiencing polypharmacy. In this cohort of patients with chronic conditions followed within the same health setting, PLWH showed better self-reported health outcomes compared to other chronic conditions with comparable characteristics of chronicity. The potential detrimental role of older age and polypharmacy in most outcomes suggests the need of longitudinal assessment of PROMs in clinical practice.

Sections du résumé

BACKGROUND BACKGROUND
People living with HIV (PLWH) are generally known to suffer from a lower quality of life compared to the one of general population, but still very few is known about the self-perception of quality of life when comparing HIV to non-communicable diseases. We performed a comprehensive assessment of patient's reported outcomes measures (PROMs) among PLWH and patients affected by other chronic conditions (OC) such as diabetes mellitus type 1, rheumatoid arthritis, breast cancer in hormonal therapy, in order to investigate differences in PROMs outcomes between PLWH and other pathologies.
METHODS METHODS
A cross-sectional observational study was performed by using questionnaires investigating health-related quality of life (Medical Outcomes Study Short Form 36-item Health Survey), work productivity (WPI), and global health status (EQ-5D-3L). They were administered to patients affected by chronic diseases consecutively observed at a single University Hospital during a 10 months period, with comparable disease related aspects. Logistic regression analysis was used to analyze the association between disease group (HIV vs OC) and PROMs.
RESULTS RESULTS
230 patients were enrolled (89 PLWH, 143 OC). Mean age: 49 years (SD 10), mean time of disease 12 years (10), 96% were Caucasian, 35% assumed polypharmacy, 42% of male were PLWH versus 16% OC (p < 0.001), 19% PLWH versus 6% OC had clinical complications (p < 0.001). HIV infection was independently associated to a better health-related quality of life in several domains compared with the other conditions, except in mental health, whereas a worst health-related quality of life in most domains was reported by older patients and those experiencing polypharmacy.
CONCLUSIONS CONCLUSIONS
In this cohort of patients with chronic conditions followed within the same health setting, PLWH showed better self-reported health outcomes compared to other chronic conditions with comparable characteristics of chronicity. The potential detrimental role of older age and polypharmacy in most outcomes suggests the need of longitudinal assessment of PROMs in clinical practice.

Identifiants

DOI: 10.1186/s41687-022-00423-4 PMID: 35347476 PMC: PMC8960483
pubmed: 35347476
doi: 10.1186/s41687-022-00423-4
pii: 10.1186/s41687-022-00423-4
pmc: PMC8960483
doi:

Types de publication

Journal Article

Langues

eng

Pagination

27

Informations de copyright

© 2022. The Author(s).

Références

Nakagawa F, Lodwick RK, Smith CJ et al (2012) Projected life expectancy of people with HIV according to timing of diagnosis. AIDS 26(3):335–343. https://doi.org/10.1097/QAD.0b013e32834dcec9
doi: 10.1097/QAD.0b013e32834dcec9 pubmed: 22089374
Bristowe K, Murtagh FEM, Clift P et al (2020) The development and cognitive testing of the positive outcomes HIV PROM: a brief novel patient-reported outcome measure for adults living with HIV. Health Qual Life Outcomes 18:214. https://doi.org/10.1186/s12955-020-01462-5
doi: 10.1186/s12955-020-01462-5 pubmed: 32631444 pmcid: 7336444
Simms VM, Higginson IJ, Harding R (2011) What palliative care-related problems do patients experience at HIV diagnosis? A systematic review of the evidence. J Pain Symptom Manag 42(5):734–753
doi: 10.1016/j.jpainsymman.2011.02.014
WHO: 1946, http://www.who.int/governance/eb/who_constitution_en.pdf/
Sherr L, Lampe F, Norwood S et al (2008) Adherence to antiretroviral treatment in patients with HIV in the UK: a study of complexity. AIDS Care 20:442–448
doi: 10.1080/09540120701867032 pubmed: 18449821
Stewart M, Brown J, Weston W, McWhinney I, McWilliam C, Freeman T (1995) Patient-centred medicine: transforming the clinical method. Sage, London
Lampe FC, Harding R, Smith CJ, Phillips AN, Johnson M, Sherr L (2010) Physical and psychological symptoms and risk of virologic rebound among patients with virologic suppression on antiretroviral therapy. J Acquir Immune Defic Syndr 54:500–505
doi: 10.1097/QAI.0b013e3181ce6afe pubmed: 20150819
Cooper V, Clatworthy J, Harding R, Whetham J, Emerge Consortium (2017) Measuring quality of life among people living with HIV: a systematic review of reviews. Health Qual Life Outcomes 15(1):220. https://doi.org/10.1186/s12955-017-0778-6
doi: 10.1186/s12955-017-0778-6 pubmed: 29141645 pmcid: 5688651
Health and Social Care Alliance Scotland. We've Got to Talk About Outcomes Report 1-Reconciling Patient Reported Outcome Measures And Personal Outcomes 2013.
Bristowe K, Clift P, James R et al (2019) Towards person-centred care for people living with HIV: What core outcomes matter, and how might we assess them? A cross-national multi-centre qualitative study with key stakeholders. HIV Med 20:542–554. https://doi.org/10.1111/hiv.12758
doi: 10.1111/hiv.12758 pubmed: 31162817
Miners A, Phillips A, Kreif N et al (2014) Health-related quality-of-life of people with HIV in the era of combination antiretroviral treatment: a cross-sectional comparison with the general population. The Lancet HIV 1(1):e32–e40. https://doi.org/10.1016/S2352-3018(14)70018-9
doi: 10.1016/S2352-3018(14)70018-9 pubmed: 26423814
Engelhard EA, Smit C et al (2018) Health-related quality of life of people with HIV. AIDS 32(1):103–112. https://doi.org/10.1097/QAD.0000000000001672
doi: 10.1097/QAD.0000000000001672 pubmed: 29112062
1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Recomm Rep. 1992;41(RR-17):1–19
Burstein HJ, Prestrud AA, Seidenfeld J et al (2010) American Society of Clinical Oncology. American Society of Clinical Oncology clinical practice guideline: update on adjuvant endocrine therapy for women with hormone receptor-positive breast cancer. J Clin Oncol. 28(23):3784–96. https://doi.org/10.1200/JCO.2009.26.3756
doi: 10.1200/JCO.2009.26.3756 pubmed: 20625130 pmcid: 5569672
Whelan TJ, Pritchard KI (2006) Managing patients on endocrine therapy: focus on quality-of-life issues. Clin Cancer Res 12(3 Pt 2):1056s–1060s. https://doi.org/10.1158/1078-0432.CCR-05-2185
doi: 10.1158/1078-0432.CCR-05-2185 pubmed: 16467124
Harris ED (2005) Clinical features of rheumatoid arthritis. In: Ruddy S, Harris ED, Sledge CB, Kelley WN (eds) Kelley’s textbook of rheumatology, 7th edn. WB Saunders, Philadelphia, pp 1043–1078
Position Statement of American Diabetes Association (2004) Diagnosis and classification of diabetes mellitus. Diabetes Care 27(suppl 1):s5–s10. https://doi.org/10.2337/diacare.27.2007.S5
doi: 10.2337/diacare.27.2007.S5
Solomon SD, Chew E, Duh EJ et al (2017) Diabetic retinopathy: a position statement by the American Diabetes Association. Diabetes Care 40(3):412–418. https://doi.org/10.2337/dc16-2641
doi: 10.2337/dc16-2641 pubmed: 28223445 pmcid: 5402875
The effect of intensive diabetes therapy on the development and progression of neuropathy. Ann Intern Med. 1995; 122(8):561–8. https://doi.org/10.7326/0003-4819-122-8-199504150-00001 .
American Diabetes Association (2009) Standards of medical care in diabetes-2009. Diabetes Care 32(Suppl 1):S13-61. https://doi.org/10.2337/dc09-S013
doi: 10.2337/dc09-S013 pmcid: 2613589
Cosentino F, Grant PJ, Aboyans V et al (2020) 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 41(2):255–323. https://doi.org/10.1093/eurheartj/ehz486
doi: 10.1093/eurheartj/ehz486 pubmed: 31497854
https://www.rand.org/health-care/surveys_tools/mos/36-item-short-form.html
Hays RD, Sherbourne CD, Mazel RM (1993) The RAND 36-Item Health Survey 1.0. Health Econ 2(3):217–27. https://doi.org/10.1002/hec.4730020305
doi: 10.1002/hec.4730020305 pubmed: 8275167
http://www.reillyassociates.net/WPAI-GH__Italian-Italy_.pdf
Reilly MC, Zbrozek AS, Dukes EM (1993) The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics 4(5):353–365. https://doi.org/10.2165/00019053-199304050-00006
doi: 10.2165/00019053-199304050-00006 pubmed: 10146874
Apolone G, Mosconi P, Ware J Jr. Questionario sullo stato di salute SF-36 – Manuale d’uso e guida all’interpretazione dei risultati. Milano: Guerini e Associati Editore; 1997
Thompson AJ, Turner AJ (2020) A comparison of the EQ-5D-3L and EQ-5D-5L. Pharmacoeconomics 38(6):575–591. https://doi.org/10.1007/s40273-020-00893-8
doi: 10.1007/s40273-020-00893-8 pubmed: 32180162
Nobre N, Pereira M, Roine RP, Sutinen J, Sintonen H (2018) HIV-related self-stigma and health-related quality of life of people living with HIV in Finland. J Assoc Nurses AIDS Care 29(2):254–265. https://doi.org/10.1016/j.jana.2017.08.006
doi: 10.1016/j.jana.2017.08.006 pubmed: 28935441
Astuti N, Maggiolo F (2014) Single-tablet regimens in HIV therapy. Infect Dis Ther 3:1–17. https://doi.org/10.1007/s40121-014-0024-z
doi: 10.1007/s40121-014-0024-z pubmed: 25134808 pmcid: 4108118
Pozniak A (2014) Quality of life in chronic HIV infection. The Lancet HIV 1(1):e6–e7. https://doi.org/10.1016/S2352-3018(14)70003-7
doi: 10.1016/S2352-3018(14)70003-7 pubmed: 26423817
Kaplan RM, Anderson JP, Wu AW, Mathews WC, Kozin F, Orenstein D (1989) The quality of well-being scale. Applications in AIDS, cystic fibrosis, and arthritis. Med Care 27(3 Suppl):S27-43. https://doi.org/10.1097/00005650-198903001-00003
doi: 10.1097/00005650-198903001-00003 pubmed: 2921885
Wu AW, Rubin HR, Mathews WC, Ware JE Jr, Brysk LT, Hardy WD, Bozzette SA, Spector SA, Richman DD (1991) A health status questionnaire using 30 items from the Medical Outcomes Study. Preliminary validation in persons with early HIV infection. Med Care. 29(8):786–98. https://doi.org/10.1097/00005650-199108000-00011
doi: 10.1097/00005650-199108000-00011 pubmed: 1875745
Hays RD, Cunningham WE, Sherbourne CD, Wilson IB, Wu AW, Cleary PD, McCaffrey DF, Fleishman JA, Crystal S, Collins R, Eggan F, Shapiro MF, Bozzette SA (2000) Health-related quality of life in patients with human immunodeficiency virus infection in the United States: results from the HIV Cost and Services Utilization Study. Am J Med 108(9):714–722. https://doi.org/10.1016/s0002-9343(00)00387-9
doi: 10.1016/s0002-9343(00)00387-9 pubmed: 10924648
Hart HE, Bilo HJ, Redekop WK et al (2003) Quality of life of patients with type 1 diabetes mellitus. Qual Life Res Int J Qual Life Aspects Treat Care Rehabil 12(8):1089–1097
doi: 10.1023/A:1026197119569
Van Dijk PR, Logtenberg SJ, Groenier KH et al (2014) Fifteen-year follow-up of quality of life in type 1 diabetes mellitus. World J Diabetes 5(4):569–576
doi: 10.4239/wjd.v5.i4.569 pubmed: 25126403 pmcid: 4127592
Wermeling PR, Van den Donk M, Gorter KJ et al (2010) Towards a more efficient diabetes control in primary care: six-monthly monitoring compared with three-monthly monitoring in type 2 diabetes—the EFFIMODI trial. Design of a randomised controlled patient-preference equivalence trial in primary care. BMC Fam Pract 11:35
doi: 10.1186/1471-2296-11-35 pubmed: 20459820 pmcid: 2885321
Claessen SJ, Hazes JM, Huisman MA et al (2009) Use of risk stratification to target therapies in patients with recent onset arthritis; design of a prospective randomized multicenter controlled trial. BMC Musculoskelet Disord 10:71
doi: 10.1186/1471-2474-10-71 pubmed: 19538718 pmcid: 2702315
Skevington SM, O’Connell KA (2003) Measuring quality of life in HIV and AIDS: a review of the recent literature. Psychol Health 18(3):331–350. https://doi.org/10.1080/0887044031000084030
doi: 10.1080/0887044031000084030
Weatherburn P, Keogh P, Reid D et al (2009) What do you need? 2007–2008: Findings from a national survey of people with diagnosed HIV. Sigma Research, London
Ebrahimi Belil F, Alhani F, Ebadi A, Kazemnejad A (2018) Self-efficacy of people with chronic conditions: a qualitative directed content analysis. J Clin Med 7(11):411. https://doi.org/10.3390/jcm7110411
doi: 10.3390/jcm7110411 pmcid: 6262549

Auteurs

C Seguiti (C)

Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy.
UOC Malattie Infettive, Infectious Disease Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy.

P F Salvo (PF)

Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy.

E Di Stasio (E)

UOC Chimica, Biochimica e Biologia Molecolare Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.

S Lamonica (S)

UOC Malattie Infettive, Infectious Disease Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy.

A L Fedele (AL)

Divisione Reumatologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.

S Manfrida (S)

Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.

N Ciccarelli (N)

Dipartimento di Psicologia, Università Cattolica, Milan, Italy.

B Corvari (B)

Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.

C De Luca (C)

UOC Chimica, Biochimica e Biologia Molecolare Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

L Tartaglione (L)

UOS Diabetologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.

D Pitocco (D)

UOS Diabetologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.

R Cauda (R)

Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy.
UOC Malattie Infettive, Infectious Disease Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy.

A Cingolani (A)

Malattie Infettive, Università Cattolica del Sacro Cuore, Rome, Italy. antonella.cingolani@unicatt.it.
UOC Malattie Infettive, Infectious Disease Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168, Rome, Italy. antonella.cingolani@unicatt.it.

Classifications MeSH