An assessment of health-related quality of life using generic and HIV-specific instruments among patients receiving antiretroviral therapy at a general hospital in central Thailand
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Published:
Apr 29, 2018
Keywords:
antiretroviral therapy EQ-5D-5L HIV HRQoL WHOQOL-HIV BREF
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Abstract
This cross-sectional study aimed to assess the health-related quality of life (HRQoL) among 210 HIV-positive patients receiving antiretroviral therapy (ART) at a general hospital in Central Thailand, and to analyze correlations between scores from HIV-specific and generic HRQoL instruments. A small majority of the participants were female (56.2%) with a mean (SD) age of 43.3 (7.9) years. An assessment using the World Health Organization Quality of Life-HIV Brief Version (WHOQOL-HIV BREF) demonstrated that most participants reported moderate levels for overall HRQoL (71.9%) and general health (40.5%). The mean scores of the six domains ranged from 12.64 to 16.20 out of a total score of 20, with the lowest and highest scores being reported for ‘social relationships’ and ‘spiritual/personal beliefs/religion’. For the 5-level EuroQol-5 dimension (EQ-5D-5L), most participants reported ‘no problems’ in any of the five health dimensions, with mean (SD) EQ-5D-5L utility and EQ VAS scores of 0.93 (0.08) and 81.43 (15.75) respectively. All the general items and domain scores of the WHOQOL-HIV BREF significantly correlated with both the EQ-5D-5L utility and EQ VAS scores (p < 0.05), but the correlations were considered either weak or moderate. Our results provided a better understanding of the HRQoL of these patients and suggested certain important aspects concerning the patients’ HRQoL that should be integrated into patient counseling and education.
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Pongmesa, T., Luckanajantachote, P., Kositchaiwat, K., Waewpunyasin, J., Trongtrakarn, P., & Oransuwanchai, A. (2018). An assessment of health-related quality of life using generic and HIV-specific instruments among patients receiving antiretroviral therapy at a general hospital in central Thailand. Science, Engineering and Health Studies, 12(1), 33–45. https://doi.org/10.14456/sehs.2018.1
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Research Articles
References
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Battaglioli-DeNero, A. M. (2007). Strategies for improving patient adherence to therapy and long-term patient outcomes. Journal of the Association of Nurses in AIDS Care, 18(1 Suppl), S17-22.
Belak, K. S., Vurusic, T., Duvanic, K., and Macek, M. (2006). Quality of life of HIV-infected persons in Croatia. Collegium Antropologicum, 30 Suppl 2, 79-84.
Briongos-Figuero, L. S., Bachiller-Luque, P., Palacios-Martin, T., De Luis-Roman, D., and Eiros-Bouza, J. M. (2011). Depression and health related quality of life among HIV-infected people. European Review for Medical and Pharmacological Sciences, 15(8), 855-862.
Bunjoungmanee, P., Chunloy, K.,Tangsathapornpong, A., Khawcharoenporn, T., and Apisarnthanarak, A. (2014). Quality of life assessment among patients living with HIV/AIDS at a tertiary care hospital in Thailand. The Southeast Asian Journal of Tropical Medicine and Public Health, 45(4), 834-842.
Campsmith, M. L., Nakashima, A. K., and Davidson, A. J. (2003). Self-reported health-related quality of life in persons with HIV infection: results from a multi-site interview project. Health and Quality of Life Outcomes, 1, 12.
da Cunha, J., Maselli, L. M., Stern, A. C., Spada, C., and Bydlowski, S. P. (2015). Impact of antiretroviral therapy on lipid metabolism of human immunodeficiency virus-infected patients: old and new drugs. World Journal of Virology, 4(2), 56-77.
Daniel, W. W. (1999). Biostatistics: a Foundation for Analysis in the Health Sciences, 7th ed., John Willey & Sons, New York, pp. 180-184.
Degroote, S., Vogelaers, D., and Vandijck, D. M. (2014). What determines health-related quality of life among people living with HIV: an updated review of the literature.Archives of Public Health, 72(1), 40.
Department of Mental Health and Substance Dependence. World Health Organization. (2002). WHOQOL-HIV BREF. [Online URL:www.who.int/mental_health/publications/who qol_hiv_bref.pdf] accessed on Mar 30, 2017.
De Ryck, I., Van Laeken, D., Nostlinger, C., Platteau, T., and Colebunders, R. (2012). Sexual satisfaction among men living with HIV in Europe. AIDS and Behavior, 16(1), 225-230.
De Vries, J. (2001). Quality of life assessment. In Assessment in Behavioral Medicine (Vingerhoets, A., ed.), pp. 353-370. Taylor & Francis Inc., New York.
Fayers, P. M., and Machin, D. (2007). Quality of life: the Assessment, Analysis, and Interpretation of Patient-Reported Outcomes, 2nd ed., John Wiley & Sons, Chichester, pp. 209-222.
Gilbert, L., and Walker, L. (2010). ‘My biggest fear was that people would reject me once they knew of my status...’: stigma as experienced by patients in an HIV/AIDS clinic in Johannesburg, South Africa. Health & Social Care in the Community, 18(2), 139-146.
Ichikawa, M., and Natpratan, C. (2004). Quality of life among people living with HIV/AIDS in northern Thailand: MOS-HIV Health Survey. Quality of Life Research, 13(3), 601-610.
Imam, M. H., Karim, M. R., Ferdous, C., and Akhter, S. (2011). Health related quality of life among the people living with HIV. Bangladesh Medical Research Council Bulletin, 37(1), 1-6.
Keaei, M., Kuhlmann, J., Conde, R., Evers, S. M., Gonzalez, J., Govers, M., and Hiligsmann, M. (2016). Health-related quality of life of patients with HIV/AIDS in Bogota, Colombia. Value in Health Regional Issues, 11, 68-72.
Kunawaradisai, N., Dawnvongyad, N., Wannnathong, K., Moonsrikaew, N., and Thaiyanan, S. (2016). Quality of life of HIV infected and AIDS patients in Ubon Ratchathani. Isan Journal of Pharmaceutical Sciences, 12, 21-32. [in Thai]
Lema, V. M. (2013). Sexual dysfunction among HIV patients: three case reports and review of literature. African Journal of Reproductive Health 17,(4 Spec No), 161-170.
Liping, M., Peng, X., Haijiang, L., Lahong, J., and Fan, L. (2015). Quality of life of people living with HIV/AIDS: a cross-sectional study in Zhejiang province, China. PLoS One, 10, e0135705.
Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien,R. H., Ortiz, D., Szekeres, G., and Coates, T. J. (2008). Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. AIDS, 22(Suppl 2), S67-79.
Mall, S., Middelkoop, K., Mark, D., Wood, R., and Bekker, L. G. (2013). Changing patterns in HIV/AIDS stigma and uptake of voluntary counseling and testing services: the results of two consecutive community surveys conducted in the Western Cape, South Africa. AIDS Care, 25(2), 194-201.
Mavandadi, S., Zanjani, F., Ten Have, T. R., and Oslin, D. W. (2009). Psychological well-being among individuals aging with HIV: the value of social relationships. Journal of Acquired Immune Deficiency Syndromes, 51(1), 91-98.
McSweeny, A. J., and Creer, T. L. (1995). Health-related quality-of-life assessment in medical care. Disease-A-Month, 41(1), 1-71.
Meemon, N., Paek, S. C., Yenchai, D., and Wan, T. T. (2016). Application of the WHOQOL-HIV-BREF Questionnaire in HIV-infected Thai patients: reliability and validity of the instrument. Journal of the Association of Nurses in AIDS Care, 27(5), 698-708.
Moir, S., and Fauci, A. S. (2009). B cells in HIV infection and disease. Nature Reviews Immunology, 9(4), 235-245.
Munchey, R., and Pongmesa, T. (2016). Health-related quality of life in patients with rheumatoid arthritis at Uttaradit Hospital, Thailand. Value in Health, 19(7), A917.
Oguntibeju, O. O. (2012). Quality of life of people living with HIV and AIDS and antiretroviral therapy. HIV/AIDS: Research and Palliative Care, 4, 117-124.
Pattanaphesaj, J. (2014). Health-related Quality of Life Measure (EQ-5D-5L): Measurement Property Testing and Its Preference-based Score in Thai Population [Doctoral dissertation], Mahidol University, Bangkok, Thailand.
Pattanaphesaj, J., and Thavorncharoensap, M. (2015). Measurement properties of the EQ-5D-5L compared to EQ-5D-3L in the Thai diabetes patients. Health and Quality of Life Outcomes, 13, 14.
Qiao, S., Nie, J. B., Tucker, J., Rennie, S., and Li, X. M. (2015). The role of social relationship in HIV healing and its implications in HIV cure in China. Health Psychology and Behavioral Medicine, 3(1), 115-127.
Sakthong, P., and Kasemsup, V. (2012). Health utility measured with EQ-5D in Thai patients undergoing peritoneal dialysis. Value in Health, 15(1 Suppl), S79-84.
Sakthong, P., Kamemsup, V., and Winit-Watjana, W. (2015). Assessment of health-related quality of life in Thai patients after heart surgery. Asian Biomedicine, 9(2), 203-210.
Sakthong, P., Schommer, J. C., Gross, C. R., Prasithsirikul, W., and Sakulbumrungsil, R. (2009). Health utilities in patients with HIV/AIDS in Thailand. Value in Health, 12(2), 377-384.
Sakthong, P., Winit-Watjana, W., and Choopan, K. (2014). Usefulness of patient-generated index for HIV to measure individual quality of life: a study from Thailand. Value in Health Regional Issues, 3, 101-107.
Siegel, K., Schrimshaw, E. W., and Lekas, H. M. (2006). Diminished sexual activity, interest, and feelings of attractiveness among HIV-infected women in two eras of the AIDS epidemic. Archives of Sexual Behavior, 35(4), 437-449.
Thomas, B. E., Rehman, F., Suryanrayanan, D., Josephine, K., Dillip, M., Dorairaj, V. S., and Swaminathan, S. (2005). How stigmatizing is stigma in the life of people living with HIV: a study on HIV positive individuals from Chennai, South India. AIDS Care, 17(7), 795-801.
Tran, B. X. (2012). Quality of life outcomes of antiretroviral treatment for HIV/AIDS patients in Vietnam. PLoS One, 7(7), e41062.
Tran, B. X., Ohinmaa, A., and Nguyen, L. T. (2012). Quality of life profile and psychometric properties of the EQ-5D-5L in HIV/AIDS patients. Health and Quality of Life Outcomes, 10, 132.
Van Reenen, M., and Janssen, B. (2015). EQ-5D-5L User Guide: Basic Information on How to Use the EQ-5D-5L Instrument, EuroQoL Group, Rotterdam, Netherlands.
World Health Organization. (2002). WHOQOL-HIV Instrument Users Manual: Scoring and Coding for the WHOQOL-HIV Instruments, Department of Mental Health and Substance, Geneva, Switzerland.
World Health Organization. (2016). WHO fact sheet. HIV/AIDS. [Online URL:www.who.int/mediacentre/factsheets/fs360/en/] accessed on Mar 30, 2017.
Wu, A. W., and Rubin, H. R. (1992). Measuring health status and quality of life in HIV and AIDS. Psychology & Health, 6(4), 251-264.
Battaglioli-DeNero, A. M. (2007). Strategies for improving patient adherence to therapy and long-term patient outcomes. Journal of the Association of Nurses in AIDS Care, 18(1 Suppl), S17-22.
Belak, K. S., Vurusic, T., Duvanic, K., and Macek, M. (2006). Quality of life of HIV-infected persons in Croatia. Collegium Antropologicum, 30 Suppl 2, 79-84.
Briongos-Figuero, L. S., Bachiller-Luque, P., Palacios-Martin, T., De Luis-Roman, D., and Eiros-Bouza, J. M. (2011). Depression and health related quality of life among HIV-infected people. European Review for Medical and Pharmacological Sciences, 15(8), 855-862.
Bunjoungmanee, P., Chunloy, K.,Tangsathapornpong, A., Khawcharoenporn, T., and Apisarnthanarak, A. (2014). Quality of life assessment among patients living with HIV/AIDS at a tertiary care hospital in Thailand. The Southeast Asian Journal of Tropical Medicine and Public Health, 45(4), 834-842.
Campsmith, M. L., Nakashima, A. K., and Davidson, A. J. (2003). Self-reported health-related quality of life in persons with HIV infection: results from a multi-site interview project. Health and Quality of Life Outcomes, 1, 12.
da Cunha, J., Maselli, L. M., Stern, A. C., Spada, C., and Bydlowski, S. P. (2015). Impact of antiretroviral therapy on lipid metabolism of human immunodeficiency virus-infected patients: old and new drugs. World Journal of Virology, 4(2), 56-77.
Daniel, W. W. (1999). Biostatistics: a Foundation for Analysis in the Health Sciences, 7th ed., John Willey & Sons, New York, pp. 180-184.
Degroote, S., Vogelaers, D., and Vandijck, D. M. (2014). What determines health-related quality of life among people living with HIV: an updated review of the literature.Archives of Public Health, 72(1), 40.
Department of Mental Health and Substance Dependence. World Health Organization. (2002). WHOQOL-HIV BREF. [Online URL:www.who.int/mental_health/publications/who qol_hiv_bref.pdf] accessed on Mar 30, 2017.
De Ryck, I., Van Laeken, D., Nostlinger, C., Platteau, T., and Colebunders, R. (2012). Sexual satisfaction among men living with HIV in Europe. AIDS and Behavior, 16(1), 225-230.
De Vries, J. (2001). Quality of life assessment. In Assessment in Behavioral Medicine (Vingerhoets, A., ed.), pp. 353-370. Taylor & Francis Inc., New York.
Fayers, P. M., and Machin, D. (2007). Quality of life: the Assessment, Analysis, and Interpretation of Patient-Reported Outcomes, 2nd ed., John Wiley & Sons, Chichester, pp. 209-222.
Gilbert, L., and Walker, L. (2010). ‘My biggest fear was that people would reject me once they knew of my status...’: stigma as experienced by patients in an HIV/AIDS clinic in Johannesburg, South Africa. Health & Social Care in the Community, 18(2), 139-146.
Ichikawa, M., and Natpratan, C. (2004). Quality of life among people living with HIV/AIDS in northern Thailand: MOS-HIV Health Survey. Quality of Life Research, 13(3), 601-610.
Imam, M. H., Karim, M. R., Ferdous, C., and Akhter, S. (2011). Health related quality of life among the people living with HIV. Bangladesh Medical Research Council Bulletin, 37(1), 1-6.
Keaei, M., Kuhlmann, J., Conde, R., Evers, S. M., Gonzalez, J., Govers, M., and Hiligsmann, M. (2016). Health-related quality of life of patients with HIV/AIDS in Bogota, Colombia. Value in Health Regional Issues, 11, 68-72.
Kunawaradisai, N., Dawnvongyad, N., Wannnathong, K., Moonsrikaew, N., and Thaiyanan, S. (2016). Quality of life of HIV infected and AIDS patients in Ubon Ratchathani. Isan Journal of Pharmaceutical Sciences, 12, 21-32. [in Thai]
Lema, V. M. (2013). Sexual dysfunction among HIV patients: three case reports and review of literature. African Journal of Reproductive Health 17,(4 Spec No), 161-170.
Liping, M., Peng, X., Haijiang, L., Lahong, J., and Fan, L. (2015). Quality of life of people living with HIV/AIDS: a cross-sectional study in Zhejiang province, China. PLoS One, 10, e0135705.
Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien,R. H., Ortiz, D., Szekeres, G., and Coates, T. J. (2008). Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. AIDS, 22(Suppl 2), S67-79.
Mall, S., Middelkoop, K., Mark, D., Wood, R., and Bekker, L. G. (2013). Changing patterns in HIV/AIDS stigma and uptake of voluntary counseling and testing services: the results of two consecutive community surveys conducted in the Western Cape, South Africa. AIDS Care, 25(2), 194-201.
Mavandadi, S., Zanjani, F., Ten Have, T. R., and Oslin, D. W. (2009). Psychological well-being among individuals aging with HIV: the value of social relationships. Journal of Acquired Immune Deficiency Syndromes, 51(1), 91-98.
McSweeny, A. J., and Creer, T. L. (1995). Health-related quality-of-life assessment in medical care. Disease-A-Month, 41(1), 1-71.
Meemon, N., Paek, S. C., Yenchai, D., and Wan, T. T. (2016). Application of the WHOQOL-HIV-BREF Questionnaire in HIV-infected Thai patients: reliability and validity of the instrument. Journal of the Association of Nurses in AIDS Care, 27(5), 698-708.
Moir, S., and Fauci, A. S. (2009). B cells in HIV infection and disease. Nature Reviews Immunology, 9(4), 235-245.
Munchey, R., and Pongmesa, T. (2016). Health-related quality of life in patients with rheumatoid arthritis at Uttaradit Hospital, Thailand. Value in Health, 19(7), A917.
Oguntibeju, O. O. (2012). Quality of life of people living with HIV and AIDS and antiretroviral therapy. HIV/AIDS: Research and Palliative Care, 4, 117-124.
Pattanaphesaj, J. (2014). Health-related Quality of Life Measure (EQ-5D-5L): Measurement Property Testing and Its Preference-based Score in Thai Population [Doctoral dissertation], Mahidol University, Bangkok, Thailand.
Pattanaphesaj, J., and Thavorncharoensap, M. (2015). Measurement properties of the EQ-5D-5L compared to EQ-5D-3L in the Thai diabetes patients. Health and Quality of Life Outcomes, 13, 14.
Qiao, S., Nie, J. B., Tucker, J., Rennie, S., and Li, X. M. (2015). The role of social relationship in HIV healing and its implications in HIV cure in China. Health Psychology and Behavioral Medicine, 3(1), 115-127.
Sakthong, P., and Kasemsup, V. (2012). Health utility measured with EQ-5D in Thai patients undergoing peritoneal dialysis. Value in Health, 15(1 Suppl), S79-84.
Sakthong, P., Kamemsup, V., and Winit-Watjana, W. (2015). Assessment of health-related quality of life in Thai patients after heart surgery. Asian Biomedicine, 9(2), 203-210.
Sakthong, P., Schommer, J. C., Gross, C. R., Prasithsirikul, W., and Sakulbumrungsil, R. (2009). Health utilities in patients with HIV/AIDS in Thailand. Value in Health, 12(2), 377-384.
Sakthong, P., Winit-Watjana, W., and Choopan, K. (2014). Usefulness of patient-generated index for HIV to measure individual quality of life: a study from Thailand. Value in Health Regional Issues, 3, 101-107.
Siegel, K., Schrimshaw, E. W., and Lekas, H. M. (2006). Diminished sexual activity, interest, and feelings of attractiveness among HIV-infected women in two eras of the AIDS epidemic. Archives of Sexual Behavior, 35(4), 437-449.
Thomas, B. E., Rehman, F., Suryanrayanan, D., Josephine, K., Dillip, M., Dorairaj, V. S., and Swaminathan, S. (2005). How stigmatizing is stigma in the life of people living with HIV: a study on HIV positive individuals from Chennai, South India. AIDS Care, 17(7), 795-801.
Tran, B. X. (2012). Quality of life outcomes of antiretroviral treatment for HIV/AIDS patients in Vietnam. PLoS One, 7(7), e41062.
Tran, B. X., Ohinmaa, A., and Nguyen, L. T. (2012). Quality of life profile and psychometric properties of the EQ-5D-5L in HIV/AIDS patients. Health and Quality of Life Outcomes, 10, 132.
Van Reenen, M., and Janssen, B. (2015). EQ-5D-5L User Guide: Basic Information on How to Use the EQ-5D-5L Instrument, EuroQoL Group, Rotterdam, Netherlands.
World Health Organization. (2002). WHOQOL-HIV Instrument Users Manual: Scoring and Coding for the WHOQOL-HIV Instruments, Department of Mental Health and Substance, Geneva, Switzerland.
World Health Organization. (2016). WHO fact sheet. HIV/AIDS. [Online URL:www.who.int/mediacentre/factsheets/fs360/en/] accessed on Mar 30, 2017.
Wu, A. W., and Rubin, H. R. (1992). Measuring health status and quality of life in HIV and AIDS. Psychology & Health, 6(4), 251-264.