Quality of life in cardiovascular diseases. Emphasis on beta-blocker treatment.

In this article, the issues involved in the measurements of quality of life in clinical trials of cardiovascular drugs are discussed with emphasis on beta-blocker treatment. The extensive documentation available for beta-blockers makes it possible to evaluate different aspects of this class of drugs. Generally, beta-blockers have been shown to be safe with a low frequency of serious side effects.

Cross-cultural adaptation of health measures. European Group for Health Management and Quality of Life Assessment.

There is increasing interest throughout Europe in measuring health needs in the general population and in the 'quality of life' of patients. This has led to a demand for questionnaires capable of measuring health status in a reliable and valid manner. Most existing measures have, however, been standardised only in the U.

Evaluation of quality of life in clinical trials. Selecting quality-of-life measures.

The strategy for evaluating quality of life in clinical trials is an important and complex issue. By comparing the performance of different quality-of-life measures before and after estrogen replacement therapy, it was shown that disease-specific measures had obvious advantages. Although narrow in applicability to the particular patient group, they were the most responsive measures in detecting small, clinically important changes.

A comparison of quality of life before and after arthroplasty in patients who had arthrosis of the hip joint.

Quality of life before and one year after total hip arthroplasty was evaluated in fifty-six patients who had arthrosis of the hip joint. There were twenty-one men and thirty-five women, and the median age was sixty-five years (range, thirty to seventy-nine years). Before and after total hip arthroplasty, a functional assessment was done with the Charnley-Merle d'Aubigné scoring system.

Long-term follow-up of health-related quality of life in patients with suspected acute myocardial infarction when the diagnosis was not confirmed.

This study describes the outcome in terms of health-related quality of life (QL) five years after onset of symptoms in 397 patients with an initial suspicion of acute myocardial infarction (MI) but in whom the diagnosis was not confirmed. The patients were approached by means of a postal inquiry that comprised two questionnaires. The most pronounced impairment in health-related QL was expressed as decreased energy, whereas social life was the least affected area.

The relationship between exercise tolerance and quality of life in angina pectoris.

The relationship between exercise tolerance assessed by a conventional exercise stress test using a standard Bruce protocol and quality of life (QoL) was studied in 50 patients with stable angina pectoris (AP). Before the exercise test, patients completed three self-administered QoL questionnaires, the Psychological General Well-Being Index, an Angina-Specific QoL Questionnaire, and Jenkins' Sleep Dysfunction Scale. Total exercise time (r = -0.

Aspects of quality of life on treatment with felodipine.

Quality of life has been assessed in a double-blind four week study comparing felodipine 5, 10, 20 mg and placebo added to metoprolol by adding two self-administered questionnaires to the conventional procedure for the evaluation of adverse events. None of the aspects related to general well-being was affected by felodipine. The subjective symptoms reported were mostly dose-related and so here mainly observed at the highest dose.

Anti-anginal therapy and quality of life. A comparison of the effects of transdermal nitroglycerin and long-acting oral nitrates.

A total of 112 male patients with severe effort-induced angina pectoris (New York Heart Association functional classes II and III) participated in a randomized open trial consisting of a 6 month phase with 3 month treatment cross-overs. The aim of the study was to compare the effect of transdermal nitroglycerin (TN) patches and long-acting oral nitrates (LAON) on quality of life (QL). During the cross-over period 30 patients (20 on TN and 10 on LAON) withdrew from the study, over half of them within the first month.

A summary index for the assessment of quality of life in angina pectoris.

When exploring the effects of anti-anginal therapy on quality of life (QL), it is essential to use concise, reliable, outcome measures which focus on those aspects of the disease which are affected by the anginal pain, and which are expected to be responsive to medical intervention. Analysis based on a single comprehensive index is preferable to the use of several indexes as it avoids the potential for conflicting inferences from multiple comparisons. In this paper, we describe the development of a QL index which summarizes the three questionnaires used in the North Karelian Quality of Life (KarQuol) study.

Function of the hip after femoral neck fractures treated by fixation or secondary total hip replacement.

Two matched groups of 28 patients each, with femoral neck fractures treated by primary internal fixation or by secondary total hip replacement after a complication of primary treatment, were evaluated and compared five years or more after primary pin fixation or secondary total hip replacement. The Nottingham Health Profile questionnaire was sent and returned by mail and the patient groups were matched with regard to age, sex, health, and social situation. Patients with healed fractures had less problems with sleep, housework and hobbies, and thus functioned better than patients who had required a secondary total hip replacement.

Evaluation of three methods of symptom reporting in a clinical trial of felodipine.

251 patients from 23 primary health care centres were recruited to a clinical trial in which either felodipine or placebo was added to baseline metoprolol treatment. Three methods of symptom reporting were used in 191 patients, namely two previously documented self-administered questionnaires and an adverse event monitoring system (spontaneous reports to treating physician). Higher frequencies of symptoms were seen with the questionnaires compared to spontaneous reporting.

Factors of importance when evaluating quality of life in clinical trials.

Quality of life (QoL) has during recent years become recognized as an important outcome in clinical trials. But it is not sufficient just to incorporate QoL measures in a trial. Several factors have important repercussions on the results of clinical trials using QoL as an outcome measure.

Education of adult patients at an "asthma school": effects on quality of life, knowledge and need for nursing.

The effect of education of adult asthma patients at a special "asthma school" was studied with regard to knowledge of the disease and its treatment and quality of life measured by leisure activities, social interaction and psychological well being. We also studied if there were any differences in number of days in hospital and emergency visits before and one year after the asthma-school. Patients were randomised to an intervention group (7 men and 13 women) and a control group (7 men and 11 women).

What is it like to be a parent of twins?

A questionnaire was given to parents of twins concerning their perceptions of dependency and similarity in their twin children. Also, the parents were asked if they tried to influence their children to become more dissimilar. 70 same-sex twin pairs (35 MZ and 35 DZ) were included in the study and a questionnaire was sent both to the mother and the father of the twins.

Defining quality of life in medicine.

In recent years, there has been increasing interest in incorporating the concept of "Quality of Life" in the evaluation of medical interventions. The lack of a general definition which can function as a basis for the scientific evaluation of medical treatment is, however, a problem. The definition proposed in this paper contains three main factors: Subjective well-being, Health and Welfare.

The Nottingham Health Profile--a measure of health-related quality of life.

Assessment of quality of life has attracted increasing interest in recent years. A standardized way of evaluating quality of life is by using questionnaires. One such, the Nottingham Health Profile (NHP), measures health-related quality of life within the sections of energy, sleep, emotions, pain, mobility and social isolation as well as the frequency of health-related problems pertaining to paid employment, housework, hobbies, family life, social life, sex life and holidays.

Measuring quality of life in medicine.

Quality of life has emerged as an important outcome in evaluating medical care. With an increasing number of patients with chronic disease, it is necessary not only to assess an intervention regarding its ability to effect cures, but also regarding its ability to improve the quality of life. Self-administered patient questionnaires provide a reliable and valid means of assessing how patients respond to therapy.

Differences in the subjective well-being and symptoms of normotensives, borderline hypertensives and hypertensives.

In this study, previously untreated subjects were randomly recruited from a blood pressure screening programme. After repeated measurement of blood pressure levels, the subjects were divided into three major groups: normotensives (n = 95), borderline hypertensives (n = 69) and hypertensives (n = 30). Three self-administered standardized questionnaires were used to measure different aspects of subjective well-being and symptoms: the Nottingham Health Profile (NHP), the Subjective Symptoms Assessment Profile (SSAP) and the Minor Symptoms Evaluation Profile (MSEP).

CNS-related subjective symptoms during treatment with beta 1-adrenoceptor antagonists (atenolol, metoprolol): two double-blind placebo controlled studies.

1. Whilst a number of studies have investigated whether metoprolol and atenolol, the most widely used beta 1-adrenoceptor antagonists, differ with regard to CNS-related subjective symptoms, few placebo-controlled studies using standardised questionnaires have been performed. 2.

Quality of life five years after myocardial infarction.

In 539 patients 5 years after myocardial infarction (MI), quality of life and factors influencing life quality were studied. All patients originally participated in an early intervention trial with metoprolol. A cardiac follow-up questionnaire and the Nottingham Health Profile were answered by 82%.