Ngo Chau Quy, Phan Phuong Thu, Vu Giap Van, Pham Quyen Le Thi, Nguyen Long Hoang, Vu Giang Thu, Tran Tung Thanh, Nguyen Huong Lan Thi, Tran Bach Xuan, Latkin Carl A, Ho Cyrus S H, Ho Roger C M
Department of Internal Medicine, Hanoi Medical University, Hanoi 100000, Vietnam.
Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh city, 700000, Vietnam.
J Clin Med. 2019 Feb 7;8(2):214. doi: 10.3390/jcm8020214.
Comorbidities are common in respiratory disease patients and have been well-known to impact their quality of life. The objective of this study is to estimate the minimal clinically important difference (MCID) of the health-related quality of life (HRQOL) among respiratory disease patients with different comorbidities in a Vietnamese tertiary hospital. We performed a cross-sectional study from October to November 2016 at the Respiratory Center of Bach Mai Hospital, Hanoi, with a total of 508 participants. Information about socio-economic characteristics, HRQOL and comorbidities of participants was collected. ANOVA was used to identify MCID between patients with and without specific comorbid conditions. Tobit regression was used to explore the associations between comorbidities and the HRQOL. Results showed that the prevalence of cardiovascular comorbidities was 23.8%, followed by musculoskeletal diseases (12.0%), digestive diseases (11.8%), endocrine diseases (10.0%), kidney diseases (5.1%) and ear, nose, and throat diseases (4.5%). Regarding HRQOL, having a problem in pain/discomfort was observed in 61.0% of participants, followed by anxiety/depression (48.2%). Mean EQ-5D index was 0.66 (SD (Standard Deviation) = 0.31). The significant MCID ( < 0.05) was found between patients with and without cardiovascular diseases, musculoskeletal diseases, kidney diseases, and endocrine diseases. The multivariate regression model showed that only musculoskeletal diseases were found to be related with the marked decrement of EQ-5D index score (Coef. = -0.13; 95% CI (Confident Interval) = -0.23; -0.02). Suffering at least one chronic illness was correlated to the marked decrease of EQ-5D index score (Coef. = -0.09; 95%CI = -0.17; -0.01). These results underline the importance of appropriate pain management as well as the provision of an interprofessional care approach to patients in order to alleviate the burden of comorbidities to their treatment outcomes and HRQOL.
合并症在呼吸系统疾病患者中很常见，并且众所周知会影响他们的生活质量。本研究的目的是评估越南一家三级医院中患有不同合并症的呼吸系统疾病患者健康相关生活质量（HRQOL）的最小临床重要差异（MCID）。2016年10月至11月，我们在河内白梅医院呼吸中心进行了一项横断面研究，共有508名参与者。收集了参与者的社会经济特征、HRQOL和合并症信息。采用方差分析确定有特定合并症和无特定合并症患者之间的MCID。采用 Tobit 回归探讨合并症与HRQOL之间的关联。结果显示，心血管合并症的患病率为23.8%，其次是肌肉骨骼疾病（12.0%）、消化系统疾病（11.8%）、内分泌疾病（10.0%）、肾脏疾病（5.1%）以及耳鼻喉疾病（4.5%）。关于HRQOL，61.0%的参与者存在疼痛/不适问题，其次是焦虑/抑郁（48.2%）。EQ-5D指数的平均值为0.66（标准差（SD）=0.31）。在有和没有心血管疾病、肌肉骨骼疾病、肾脏疾病和内分泌疾病的患者之间发现了显著的MCID（<0.05）。多变量回归模型显示，仅发现肌肉骨骼疾病与EQ-5D指数评分的显著降低有关（系数=-0.13；95%置信区间（CI）=-0.23；-0.02）。患有至少一种慢性病与EQ-5D指数评分的显著降低相关（系数=-0.09；95%CI=-0.17；-0.01）。这些结果强调了适当疼痛管理的重要性，以及为患者提供跨专业护理方法以减轻合并症对其治疗结果和HRQOL的负担的重要性。
