Health related quality of life in chronic liver diseases

Abstract

Background & Aims: The impact of chronic liver diseases (CLDs) on health-related quality of life (HRQoL) is relevant to understand the burden of these conditions and inform decision-making processes related to their care. Studies simultaneously comparing the HRQoL of patients affected by the major CLDs to that of the general population are still lacking and are the subject of this study. Methods: Using the EQ-5D-3L questionnaire, we analysed and compared HRQoL data from 2962 Italian patients affected by CLDs and forming a representative sample of the general Italian population (6800 individuals). Exploratory analyses were conducted to investigate the effects of each CLD on HRQoL, using the general population as reference and adjusting for possible confounders. Results: Patients with CLDs (HBV, HCV, PSC, PBC, AIH, NAFLD/NASH) in the chronic hepatitis stage and with compensated cirrhosis (CC) showed HRQoL similar to the general population. However, AIH were more likely to report problems in self-care and lower EQ-5D VAS score, while NAFLD/NASH and HCV showed an increased risk of anxiety/depression. On the other hand, with progression to more advanced | 2631 CORTESI ET al.

Health-related quality of life in autoimmune hepatitis

“…The majority of the AIH patients in that cohort had cirrhosis (55%), and as in the previously mentioned study, that did not have a significant effect on well-being. A recent Italian multicenter study of chronic liver disease reported that of a total of seven different chronic liver diseases without cirrhosis, patients with AIH had a lower quality of life measured with the EQ-5D VAS score, and experienced difficulties in the self-care domain, even after adjusting for multiple possible confounders, including age, sex, education, and professional status[ 10 ]. That was confirmed in a Cuban study in which AIH patients had lower quality of life scores than hepatitis B patients using the disease-specific Chronic Liver Disease Questionnaire (CLDQ)[ 7 ].…”

“…Patients with AIH are more often diagnosed with symptoms of depression and anxiety compared with the general population or healthy controls[ 7 , 9 , 10 , 12 , 15 ]. Studies by Schramm and Janik et al [ 15 ] showed a significantly higher percentage of depression and anxiety symptoms, measured with the PHQ-9, GAD-7, or State-Trait Anxiety Inventory[ 12 , 15 ].…”

“…Despite biochemical remission in 77% of the patients ( n = 103), the occurrence of severe depressive symptoms within the German cohort appeared to be five times as frequent compared with the general population. 12 In addition, even AIH patients without cirrhosis revealed more problems with regard to depression and anxiety compared with the general population[ 10 ]. It is interesting to note that psychological stress was also associated with relapses in patients with AIH type 1[ 20 ].…”

Do Drug Accessibility and OOP Burden Affect Health-Related Quality of Life of Patients With Chronic Diseases? — EQ-5D-5L Evaluation Evidence From Five Districts in China

“…Many scholars such as Addis and Cortesi have studied HRQoL through demographic characteristics variables (21,22). In 1997, the life course framework proposed by Kuh and Schlomo explained that health was a dynamic process, which was affected by the combined effect of biological and social factors, which inspired us to understand a wider range of determinants of health, including the impact of health resource exposure and economic pressure (23).…”

Practice Guidelines of the Central European Hepatologic Collaboration (CEHC) on the Use of Thrombopoietin Receptor Agonists in Patients with Chronic Liver Disease Undergoing Invasive Procedures

“…Worldwide, 844 million people have a CLD, which has a mortality rate of two million deaths per year [1]. Progression of CLD to fibrosis and end-stage cirrhosis, liver failure and hepatocellular carcinoma is associated with increased patient morbidity, hospitalization frequency and deteriorating quality of life [2,3]. Reduced hepatic production of thrombopoietin (TPO) together with direct bone marrow suppression are key factors in the development of thrombocytopenia (TCP) in liver cirrhosis, resulting in decreased megakaryocyte stimulation and platelet production [4].…”