Patients with multiple myeloma (MM) report high symptom burden and functional disabilities resulting in impaired health-related quality of life (HRQoL). Effective evidence-based rehabilitation guidelines are needed for patients with MM to improve HRQoL. The primary aim of this study was to investigate HRQoL in patients with rehabilitation needs living their everyday life. Patients with MM in remission attended a 12-week multidisciplinary rehabilitation program including a 5-day residential course, home-based exercise and a 2-day follow-up course. The patients were referred by the treating haematologist and completed a booklet of validated HRQoL questionnaires at baseline and before arriving for the 2-day follow-up course. The proportion of participants with moderate to severe symptoms and functional problems were assessed at the two time points and multivariate logistic regression was used to investigate explaining factors of impaired HRQoL at baseline. Ninety-two patients participated with a follow-up compliance rate of 90%. Median age was 67 years and median time since diagnosis was 26 months (ranged 5 months to 15.6 years). The most frequently reported symptoms were global quality of life, role functioning, fatigue, pain, peripheral neuropathy and physical functioning. Pain and fatigue were both highly coherent with impairment in physical functioning and those two symptoms explained most HRQoL impairments. Overall, the participants reported no change in HRQoL after the 12-week rehabilitation program. The study supports the need for an evidence-based guideline for rehabilitation and palliative care to patients with MM in remission living their everyday life.
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http://dx.doi.org/10.1007/s00277-020-04356-0 | DOI Listing |
J Neurosurg
January 2025
8Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung.
Objective: This study focuses on epidermal growth factor receptor-mutated lung adenocarcinoma, known for frequent brain metastasis. It aimed to compare the clinical outcomes and cost-effectiveness of combining Gamma Knife radiosurgery (GKRS) with tyrosine kinase inhibitors (TKIs) (GKRS+TKI group) versus TKIs alone (TKI group) for the treatment of patients with newly diagnosed brain metastasis in this condition.
Methods: Study characteristics of the two groups were matched using inverse probability of treatment weighting (IPTW).
J Med Internet Res
January 2025
Virginia Commonwealth University, Richmond, VA, United States.
Health care is undergoing a "revolution," where patients are becoming consumers and armed with apps, consumer review scores, and, in some countries, high out-of-pocket costs. Although economic analyses and health technology assessment (HTA) have come a long way in their evaluation of the clinical, economic, ethical, legal, and societal perspectives that may be impacted by new technologies and procedures, these approaches do not reflect underlying patient preferences that may be important in the assessment of "value" in the current value-based health care transition. The major challenges that come with the transformation to a value-based health care system lead to questions such as "How are economic analyses, often the basis for policy and reimbursement decisions, going to switch from a societal to an individual perspective?" and "How do we then assess (economic) value, considering individual preference heterogeneity, as well as varying heuristics and decision rules?" These challenges, related to including the individual perspective in cost-effectiveness analysis (CEA), have been widely debated.
View Article and Find Full Text PDFJMIR Res Protoc
January 2025
UK Health Security Agency, London, United Kingdom.
Background: Due to advances in treatment, HIV is now a chronic condition with near-normal life expectancy. However, people with HIV continue to have a higher burden of mental and physical health conditions and are impacted by wider socioeconomic issues. Positive Voices is a nationally representative series of surveys of people with HIV in the United Kingdom.
View Article and Find Full Text PDFBackground: Young adults (15-24 years old) living with HIV may experience pressure both from HIV infection and social role change problems, resulting in a series of psychological problems such as depression and anxiety. Effective psychological intervention can improve their mental health and quality of life.
Objective: The study aims to explore the effectiveness of VR-based mental intervention on young adults living with HIV.
J Neurosurg Spine
January 2025
15Department of Neurological Surgery, University of California, San Francisco, California.
Objective: The goal of this study was to compare the impact of using a lower thoracic (LT) versus upper lumbar (UL) level as the upper instrumented vertebra (UIV) on clinical and radiographic outcomes following minimally invasive surgery for adult spinal deformity.
Methods: A multicenter retrospective study design was used. Inclusion criteria were age ≥ 18 years, and one of the following: coronal Cobb angle > 20°, sagittal vertical axis > 50 mm, pelvic tilt > 20°, pelvic incidence-lumbar lordosis mismatch > 10°.
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