Health-Related Quality of Life Reported by Patients With Chagas Disease: A Systematic Review of Qualitative Evidence With GRADE Recommendations

Abstract

Patients with Chagas disease have reduced health-related quality of life (HRQoL). Hence, we aimed to identify the factors that mostly affected their HRQoL. This was a systematic review of qualitative studies. The Latin American and Caribbean Health Sciences Literature, Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, Web of Science, and SciVerse Scopus databases were searched for relevant studies without language or date restrictions. The search and data analysis were performed by independent reviewers; all qualitative studies that reported the factors that had an impact on the HRQoL of patients with Chagas disease were included. The risk of bias was assessed using the Critical Appraisal Skills Program Qualitative Study Checklist; confidence in the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative approach. Five studies were included in this review: four in Brazil and one in California, United States, with immigrants from Central and South America. The sample consisted of 207 patients with chronic Chagas disease. Stigma, physical limitations, work absenteeism, emotional or mental aspects, fear of treatment, and fear of the future had the strongest impact on the HRQoL. All items showed moderate confidence except for fear of treatment (low confidence). The physical, emotional, mental, and cultural aspects affected the HRQoL of patients with chronic Chagas disease. Identification of these factors is important in the development of strategies aimed at improving the HRQoL of this population.

Assessment of health‐related quality of life in patients with Chagas cardiomyopathy using Minnesota living with heart failure questionnaire: A validation study

“…Since the assessment of HRQoL reflects the patient's perception of the impact of the disease, an appropriate questionnaire must contain particular aspects of that disease to monitor its progression. Chagas disease is complex and involves many specific issues related to poverty, sanitary conditions, stigma, fear of the future and treatment, and absence from work [10]. Generic questionnaires, such as the SF-36, or specific for other diseases, such as the MLwHFQ, may neglect these peculiarities of Chagas disease.…”

“…Structural and functional abnormalities, associated with stigma and fear of sudden death, can compromise the health-related quality of life (HRQoL) of these patients [7][8][9][10]. However, the assessment of HRQoL remains controversial, since there are no specific questionnaires for patients with Chagas disease, and it is usually evaluated using generic questionnaires.…”