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      Resultados en calidad de vida comunicados por pacientes en tratamiento antirretroviral Translated title: Health-related quality of life among people living with human immunodeficiency virus infection

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          Abstract

          RESUMEN Objetivo: Conocer las impresiones de los pacientes con terapia antirretroviral acerca de su calidad de vida relacionada con la salud (CVRS), salud y bienestar general respecto a la infección por VIH. Material y métodos: Estudio observacional, descriptivo, prospectivo y transversal. Se incluyeron pacientes mayores de edad VIH positivos que recogiesen tratamiento en el Servicio de Farmacia durante 3 meses. Como medida de la CVRS, se utilizó el World Health Organization Quality of Life in HIV-infected Persons instrument (WHOQOL-HIV-BREF) versión castellano. Se midieron seis dominios: capacidad física, factores psicológicos, nivel de independencia, relaciones sociales, entorno y creencias personales/religiosas/espirituales más 5 preguntas específicas de infección por VIH/SIDA. El cuestionario fue anónimo y auto-administrado. Se recogieron edad, sexo, estado civil y nivel de educación máximo alcanzado. Se calcularon medianas y rangos intercuartílicos (IQR) para cada dominio, así como los posibles factores influyentes. Resultados: Se incluyeron 69 pacientes. 72,5% varones. Edad (mediana [IQR])=50,4 [55,1-43] años. Nivel de educación: ninguno 5,8%; educación primaria 37,7%; secundaria 47,8%; terciaria 8,7%. Estado civil: casado/a 21,9%; en pareja 15,9%; divorciado/a 7,2%; soltero/a 47,8%; viudo/a 7,2%. Resultados para cada dominio: capacidad física (mediana [IQR])=75 [65-80]; factores psicológicos=68 [57-76]; nivel de independencia=70 [59-80]; relaciones sociales=65 [58-80]; entorno=70 [64-80] y creencias personales/religiosas/espirituales=63 [55-75]. Resultado global=67 [71-78]. La edad (≤50 años) se relacionó con la CVRS (diferencia de medias IC95%; p) en el dominio de capacidad física (11,41 IC95% 4,12-18,69; p=0,03), nivel de independencia (10,47 IC95% 1,85-19,08; p=0,018) y en el resultado global (8,33 IC95% 1,99-14,67; p=0,011). Conclusiones: La CVRS fue inferior en el dominio de creencias personales, seguida por las relaciones sociales. La edad superior a 50 años se relacionó con una peor CVRS.

          Translated abstract

          SUMMARY Purpose: To know about quality of life, health and general well-being among people living with HIV who take antiretroviral therapy. Material and methods: Cross-sectional descriptive prospective observational study. Adults with HIV's infection and antiretroviral therapy dispensed by our Pharmacy Service during 3 months were included. World Health Organization Quality of Life in HIV-infected Persons instrument (WHOQOL-HIV-BREF) was used to explore the quality of life (QoL). The scores denote an individual's perception of QoL in six domains: physical, psychological, level of independence, social relationships, environment and spirituality. Items are rated on a 5-point Likert scale with a transformed maximum score of 100 points per item. Five questions are specific to HIV/AIDS (Q:4,8-10,17). The questionnaire was self-administered. Age (≤50 years), gender, civil status and level of studies was also collected. The questionnaire, anonymous and voluntary, was returned in the next visit to our centre. Median and interquartile range was calculated for each domain. Relationship among scores and demographic variables was explored. Results: 69 patients were included (response rate 45.1%), 72.5% male. Age (median [IQR])=50.4 [55.1-43] years. Education received: none 5.8%; primary school 37.7%; secondary 47.8%; tertiary 8.7%. Civil status: married 21.9%; living as married 15.9%; divorced 7.2%; single 47.8%; widowed 7.2%. Results of domains transformed score: physical (median [IQR])=75 [65-80], psychological=68 [57-76]; level of independence=70 [59-80]; social relationships=65 [58-80], environment= 70 [64-80]; and spirituality=63 [55-75]. Global score=67 [71-78]. Age (≤50 years) was the only variable related with test score (mean difference (IC95%; p); physical domain (11.41 (4.12-18.69); 0.03), level of independence (10.47 (1.85-19.08); 0.018) and global score (8.33 (1.99-14.67); 0.011). Conclusions: QoL score was lower regarding spirituality domain followed by social relationships. Age over 50 was statistically associated with a worse self-reported QoL.

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          Most cited references15

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          The WHO quality of life (WHOQOL) questionnaire: Spanish development and validation studies.

          In the 1990s, the World Health Organization (WHO) undertook a project to develop an instrument (the WHOQOL) for measuring quality of life (QoL). The WHOQOL was developed in the framework of a collaborative project involving numerous centers in different cultural settings. This paper describes the psychometric properties of the Spanish WHOQOL during its development. One thousand and eighty-two patients with physical health conditions, persons without any health condition, patients with schizophrenia, and family caregivers of patients with schizophrenia participated on the WHOQOL-100 and WHOQOL-BREF field trials. QoL self-assessment was completed, together with sociodemographic and health status questions. Analysis was performed using classical psychometric methods. Both versions of the WHOQOL showed satisfactory psychometric properties as follows: acceptability, internal consistency, and evidence of convergent and discriminant validity. The WHOQOL-100 and WHOQOL-BREF are suitable to use in patients with different health conditions, including schizophrenia, and in different populations, including caregivers. Spanish field trials are the first to report on use of the WHOQOL in persons with schizophrenia and caregivers. These results indicate that both versions are useful tools in assessing these groups, as the WHOQOL includes important dimensions commonly omitted from other generic QoL measures.
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            Measuring quality of life among people living with HIV: a systematic review of reviews

            Aim A systematic review of reviews was conducted to identify and appraise brief measures of health-related quality of life (HRQoL) that have been used in peer-reviewed research with people living with HIV. Methods The review was conducted in two stages: 1) search of electronic databases to identify systematic reviews of tools used to measure HRQoL in adults living with HIV, published since the year 2000; 2) selection of HRQol scales from those identified in the reviews. Inclusion criteria included scales that could be self-administered in 10 min or less, covering at least 3 domains of quality of life (physical function, social/role function and mental/emotional function). For generic scales, inclusion criteria included the availability of normative data while for HIV-specific scales, patient input into the development of the scale was required. Results Ten reviews met the inclusion criteria. Nine generic scales met the inclusion criteria: the EuroQol five dimensions questionnaire (EQ-5D); Health Utilities Index; McGill Quality of Life questionnaire; Medical Outcomes Study (MOS) Short Form (SF)-12; SF-36; World Health Organisation Quality of Life (WHOQOL- BREF), Questions of Life Satisfaction (FLZM) and SF-20. Available psychometric data supported the EQ-5D and SF-36. Seven HIV-specific scales met the inclusion criteria: the AIDS Clinical Trials Group (ACTG)-21; HIV-QL-31; MOS-HIV; Multidimensional Quality of Life Questionnaire for Persons with HIV/AIDS (MQOL-HIV), PROQOL-HIV, Symptom Quality of Life Adherence (HIV-SQUAD) and the WHOQOL-HIV BREF. Of the HIV -specific measures, the MOS-HIV was considered to have the most well-established psychometric properties, however limitations identified in the reviews included insufficient input from people living with HIV in the development of the scale, cross-cultural relevance and continued applicability. Two relatively new measures, the WHOQOL-HIV BREF and PROQOL-HIV, were considered to have promising psychometric properties and may have more relevance to people living with HIV. Conclusion The findings highlight the need for further validation of HRQoL measures in people living with HIV. The choice of one measure over another is likely to be influenced by the purpose of the quality of life assessment and the domains of HRQoL that are most relevant to the specific research or clinical question.
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              Patient reported outcomes in rheumatoid arthritis clinical trials.

              Patient reported outcomes (PRO) are at the core of assessing RA treatment response with patient assessments of global health or disease activity, pain, and physical function included in the calculation of American College of Rheumatology (ACR) responses. Progress has been made in assessing PROs that include additional patient-valued aspects of disease in recent RA randomized clinical trials (RCTs), particularly fatigue. Importantly, the National Institute of Health (NIH)--Patient Reported Outcomes Measurement Information System (PROMIS) development of psychometrically advanced generic health measures that span the range of symptoms potentially affected in RA, with high precision across the entire range of a symptom are undergoing additional study in RA and other rheumatologic diseases to establish their construct validity, responsiveness, and clinically meaningful cutoffs. PRO measures that are currently used and widely available can provide important perspectives not captured in composite clinical response criteria with the potential of better informing treatment decisions in clinical practice.
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                Author and article information

                Journal
                ofil
                Revista de la OFIL
                Rev. OFIL·ILAPHAR
                Organización de Farmacéuticos Ibero-Latinoamericanos (Madrid, Madrid, Spain )
                1131-9429
                1699-714X
                2020
                : 30
                : 2
                : 105-107
                Affiliations
                [1] Getafe Madrid orgnameHospital Universitario de Getafe orgdiv1Servicio de Farmacia España
                [2] Getafe Madrid orgnameHospital Universitario de Getafe orgdiv1Servicio de Medicina Interna España
                Article
                S1699-714X2020000200105 S1699-714X(20)03000200105
                10.4321/s1699-714x2020000200008
                e966f206-591d-44c2-b4f6-a44ce3c01248

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 27 June 2019
                : 06 May 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 3
                Product

                SciELO Spain

                Categories
                Originales

                HIV,hospital pharmacy,farmacia hospitalaria,VIH,calidad de vida relacionada con la salud,quality of life

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