Health outcomes research in medicine最新文献

{"title":"The Relationship of Opioid Analgesia to Quality of Life in an Adult Sickle Cell Population","authors":"Soheir S. Adam MD,&nbsp;Marilyn J. Telen MD,&nbsp;Charles R. Jonassaint PhD,&nbsp;Laura M. De Castro MD,&nbsp;Jude C. Jonassaint RN","doi":"10.1016/j.ehrm.2010.04.002","DOIUrl":"10.1016/j.ehrm.2010.04.002","url":null,"abstract":"<div><h3>Background</h3><p>Pain is a limiting factor in the daily life activities<span><span> of sickle cell disease (SCD) patients. Although </span>opioid analgesics are widely used, to date there have been no studies on the relationship of daily opioid use to quality of life (QoL) measures in this population.</span></p></div><div><h3>Objective</h3><p>To determine the relationship of opioid analgesia to QoL in adults with SCD.</p></div><div><h3>Design</h3><p>There were 185 outpatients with various SCD genotypes evaluated. Data were collected by patient interviews as well as review of medical records. QoL as determined by the Medical Outcome Study 36-item Short Form Survey (SF-36) was the main outcome measured.</p></div><div><h3>Results</h3><p>QoL outcomes were not lower in the classically more severe homozygous SS individuals when compared with the heterozygous SC patients. However, SF-36 scores were significantly lower in individuals using opioids daily compared with those who did not, in all age groups and for all diagnoses. When controlling for hydroxyurea use, the negative association between opioid use and QoL scores remained unchanged. QoL scores were significantly higher in those who were either on no medications or on hydroxyurea alone, as compared with those who were on opioids alone or on hydroxyurea and opioids concurrently. Disease severity scores were not different between medication groups.</p></div><div><h3>Conclusions</h3><p><span>SCD patients on daily opioids had poorer QoL scores than those who were not on opioids, independent of disease severity. Hydroxyurea had a positive impact on QoL, although that effect was not observed in patients also using chronic opioids. Prospective studies are needed to define the relationship of opioid use to QoL and the significance of the interaction of both </span>drugs in SCD.</p></div>","PeriodicalId":88882,"journal":{"name":"Health outcomes research in medicine","volume":"1 1","pages":"Pages e29-e37"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehrm.2010.04.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54245321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COPD and Asthma Fatigue Scale (CAFS): Development and Psychometric Assessment","authors":"Dennis A. Revicki PhD ,&nbsp;David M. Meads MSc ,&nbsp;Stephen P. McKenna PhD ,&nbsp;Rupert Gale MA ,&nbsp;G. Alistair Glendenning MSc ,&nbsp;Robin F. Pokrzywinski MHA","doi":"10.1016/j.ehrm.2010.06.001","DOIUrl":"10.1016/j.ehrm.2010.06.001","url":null,"abstract":"<div><h3>Objectives</h3><p>Patients with respiratory diseases report significant fatigue, but few measures have been developed to assess respiratory disease-related fatigue in patients<span> with either asthma or chronic obstructive pulmonary disease<span> (COPD). This study developed and evaluated the psychometric characteristics of the COPD and Asthma Fatigue Scale (CAFS), a respiratory disease-targeted scale.</span></span></p></div><div><h3>Study Design</h3><p>Patient qualitative data (focus groups and individual interviews) with COPD and asthma patients were used to generate the CAFS. An observational study involving patients with asthma or COPD from the US and UK was then conducted to assess the psychometric qualities of the CAFS. COPD patients completed the St. George’s Respiratory Questionnaire, asthma patients completed the Asthma Quality of Life Questionnaire, and selected clinical severity measures were collected for all patients.</p></div><div><h3>Results</h3><p>Qualitative data were obtained from 78 patients with COPD and 84 with asthma. The observational study included 311 patients with COPD and 324 with asthma. The final 12-item CAFS was confirmed based on factor and item analyses. Internal consistency was 0.95 (both groups) and test-retest reliability was 0.82 and 0.84 (COPD and asthma, respectively). In COPD patients, CAFS scores were significantly correlated with St. George’s Respiratory Questionnaire scores (<em>P</em> &lt;.0001); mean CAFS scores varied significantly by disease severity, exacerbations, and health status (<em>P</em> ≤.0014). In asthma patients, CAFS scores were significantly correlated with Asthma Quality of Life Questionnaire scores (<em>P</em> &lt;.0001); mean CAFS scores varied significantly by disease severity, exacerbations, and health status (all <em>P</em> ≤.0024).</p></div><div><h3>Conclusions</h3><p>The CAFS was developed using systematic qualitative and psychometric methods and is a reliable and valid measure of fatigue in asthma or COPD patients.</p></div>","PeriodicalId":88882,"journal":{"name":"Health outcomes research in medicine","volume":"1 1","pages":"Pages e5-e16"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehrm.2010.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54245333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Modified Brief Pain Inventory-Exploratory Form in Surgery Patients","authors":"Wen-Hung Chen PhD ,&nbsp;Kitty S. Chan PhD ,&nbsp;Tong J. Gan MD ,&nbsp;Connie Chen PharmD ,&nbsp;Mani Lakshminarayanan PhD ,&nbsp;Dennis A. Revicki PhD","doi":"10.1016/j.ehrm.2010.04.001","DOIUrl":"10.1016/j.ehrm.2010.04.001","url":null,"abstract":"<div><h3>Objective</h3><p>An exploratory version of the Modified Brief Pain Inventory (mBPI-e) to measure acute post-operative pain, with new items on coughing, breathing, and concentration, was examined for their measurement properties.</p></div><div><h3>Study Design</h3><p><span>This is a secondary study using data from two randomized clinical trials<span>: general surgery trial (N=1050) and coronary artery bypass graft (CABG) surgery trial (N=1636). The measurements used in the two trials were: 1) mBPI-e; 2) clinician and patient global evaluations of medications; and 3) pain intensity diary. The mBPI-e and pain intensity were collected for 10 days. Clinician and patient global evaluations of medication were collected twice. The analyses conducted were: 1) exploratory factor analysis (EFA); 2) </span></span>confirmatory factor analysis<span> (CFA); 3) item response theory (IRT); 4) internal consistency; 5) test-retest reliability; 6) concurrent validity; 7) known-group validity; and 8) responsiveness.</span></p></div><div><h3>Results</h3><p>Pain severity, pain interference, and coughing and breathing factors were identified. Pain severity and pain interference subscale scores were constructed for mBPI-e. IRT analyses showed all items exhibited good item characteristics. Internal consistency was 0.85 for severity and 0.87 for interference. Test-retest reliability was 0.81 for severity and 0.71 for interference. Both severity and interference scores were correlated with diary-based pain intensity ratings (<em>P</em> &lt;.0001). Mean severity and interference scores varied by physician and patient global ratings (<em>P</em> &lt;.05). Severity and interference scores were responsive to changes in pain diary scores and physician global ratings (<em>P</em> &lt;.001). There were no substantive differences in reliability or validity for sub-samples of surgery patients.</p></div><div><h3>Conclusions</h3><p>The original BPI has been used in clinical studies, and the mBPI has demonstrated good reliability and validity in CABG patients. Based on this study, the mBPI-e has also demonstrated good reliability and validity for assessing postoperative acute pain in CABG and general surgery patients.</p></div>","PeriodicalId":88882,"journal":{"name":"Health outcomes research in medicine","volume":"1 1","pages":"Pages e17-e28"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ehrm.2010.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54245288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}