A Path Analysis of Effects of Patients' Underlying Conditions, Treatment Satisfaction, and Adherence on Quality of Life Among Korea Glaucoma Patients
PRéCIS:: This observed patient-specific features and treatment-driven conditions that were significantly associated with the impairment of health-related quality of life (HRQOL) among glaucoma patients. The results suggest that more systematic strategies should be implemented to improve an HRQOL. To...
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| Published in: | Journal of glaucoma Vol. 28; no. 9; p. 785 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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01.09.2019
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| ISSN: | 1536-481X, 1536-481X |
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| Abstract | PRéCIS:: This observed patient-specific features and treatment-driven conditions that were significantly associated with the impairment of health-related quality of life (HRQOL) among glaucoma patients. The results suggest that more systematic strategies should be implemented to improve an HRQOL.
To determine factors contributing to an HRQOL and assess total, direct and indirect, effects that may exist between the determinants using path analysis.
Data were derived from previous Korea glaucoma outcomes research. A total of 847 glaucoma outpatients with ≤2 years of eye-drop use were included in the present study. Including factors and their hypothetical pathways to an HRQOL were based on the literature review and consultation with specialists. Age, sex, comorbidities, and education levels were included as underlying conditions and treatment patterns were defined by the number of daily instillations of prescribed eye-drops. Treatment satisfaction and adherence were estimated using a Treatment Satisfaction Questionnaire for Medication, which assessed side-effects, effectiveness, convenience, global satisfaction, and pill count. An HRQOL was assessed by EQ-5D and EQ-visual analogue scale (EQ-VAS).
In EQ-5D analysis, male individuals showed total effects (β=0.102, P=0.0026), including both direct (β=0.076, P=0.0095) and indirect effects (β=0.0253, P=0.0020), which were mediated by treatment satisfaction in the side effects and global satisfaction categories. Higher education (β=0.197, P=0.0020) and satisfaction in the side effect (β=0.095, P=0.0076) and global satisfaction (β=0.075, P=0.0414) categories were found to have direct effects on EQ-5D. For EQ-VAS, higher education levels had significant total effects (β=0.153, P=0.0020) accounting for direct effects (β=0.131, P=0.0030) and indirect effects (β=0.0223, P=0.0531) through global satisfaction. In addition, male individuals had indirect effects (β=0.274, P=0.0165), which was indirectly mediated by satisfaction in the global satisfaction category. Comorbidity (β=-0.096, P=0.0090) and satisfaction in the effectiveness (β=0.094, P=0.0302), convenience (β=0.076, P=0.0390), and global satisfaction (β =0.144, P=0.0020) categories showed indirect effect on EQ-VAS.
Higher education and better treatment satisfaction had positive effects on HRQOL both in direct and indirect ways whereas comorbidities indirectly showed negative associations with HRQOL. |
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| AbstractList | PRéCIS:: This observed patient-specific features and treatment-driven conditions that were significantly associated with the impairment of health-related quality of life (HRQOL) among glaucoma patients. The results suggest that more systematic strategies should be implemented to improve an HRQOL.PRéCIS:: This observed patient-specific features and treatment-driven conditions that were significantly associated with the impairment of health-related quality of life (HRQOL) among glaucoma patients. The results suggest that more systematic strategies should be implemented to improve an HRQOL.To determine factors contributing to an HRQOL and assess total, direct and indirect, effects that may exist between the determinants using path analysis.PURPOSETo determine factors contributing to an HRQOL and assess total, direct and indirect, effects that may exist between the determinants using path analysis.Data were derived from previous Korea glaucoma outcomes research. A total of 847 glaucoma outpatients with ≤2 years of eye-drop use were included in the present study. Including factors and their hypothetical pathways to an HRQOL were based on the literature review and consultation with specialists. Age, sex, comorbidities, and education levels were included as underlying conditions and treatment patterns were defined by the number of daily instillations of prescribed eye-drops. Treatment satisfaction and adherence were estimated using a Treatment Satisfaction Questionnaire for Medication, which assessed side-effects, effectiveness, convenience, global satisfaction, and pill count. An HRQOL was assessed by EQ-5D and EQ-visual analogue scale (EQ-VAS).MATERIALS AND METHODSData were derived from previous Korea glaucoma outcomes research. A total of 847 glaucoma outpatients with ≤2 years of eye-drop use were included in the present study. Including factors and their hypothetical pathways to an HRQOL were based on the literature review and consultation with specialists. Age, sex, comorbidities, and education levels were included as underlying conditions and treatment patterns were defined by the number of daily instillations of prescribed eye-drops. Treatment satisfaction and adherence were estimated using a Treatment Satisfaction Questionnaire for Medication, which assessed side-effects, effectiveness, convenience, global satisfaction, and pill count. An HRQOL was assessed by EQ-5D and EQ-visual analogue scale (EQ-VAS).In EQ-5D analysis, male individuals showed total effects (β=0.102, P=0.0026), including both direct (β=0.076, P=0.0095) and indirect effects (β=0.0253, P=0.0020), which were mediated by treatment satisfaction in the side effects and global satisfaction categories. Higher education (β=0.197, P=0.0020) and satisfaction in the side effect (β=0.095, P=0.0076) and global satisfaction (β=0.075, P=0.0414) categories were found to have direct effects on EQ-5D. For EQ-VAS, higher education levels had significant total effects (β=0.153, P=0.0020) accounting for direct effects (β=0.131, P=0.0030) and indirect effects (β=0.0223, P=0.0531) through global satisfaction. In addition, male individuals had indirect effects (β=0.274, P=0.0165), which was indirectly mediated by satisfaction in the global satisfaction category. Comorbidity (β=-0.096, P=0.0090) and satisfaction in the effectiveness (β=0.094, P=0.0302), convenience (β=0.076, P=0.0390), and global satisfaction (β =0.144, P=0.0020) categories showed indirect effect on EQ-VAS.RESULTSIn EQ-5D analysis, male individuals showed total effects (β=0.102, P=0.0026), including both direct (β=0.076, P=0.0095) and indirect effects (β=0.0253, P=0.0020), which were mediated by treatment satisfaction in the side effects and global satisfaction categories. Higher education (β=0.197, P=0.0020) and satisfaction in the side effect (β=0.095, P=0.0076) and global satisfaction (β=0.075, P=0.0414) categories were found to have direct effects on EQ-5D. For EQ-VAS, higher education levels had significant total effects (β=0.153, P=0.0020) accounting for direct effects (β=0.131, P=0.0030) and indirect effects (β=0.0223, P=0.0531) through global satisfaction. In addition, male individuals had indirect effects (β=0.274, P=0.0165), which was indirectly mediated by satisfaction in the global satisfaction category. Comorbidity (β=-0.096, P=0.0090) and satisfaction in the effectiveness (β=0.094, P=0.0302), convenience (β=0.076, P=0.0390), and global satisfaction (β =0.144, P=0.0020) categories showed indirect effect on EQ-VAS.Higher education and better treatment satisfaction had positive effects on HRQOL both in direct and indirect ways whereas comorbidities indirectly showed negative associations with HRQOL.CONCLUSIONHigher education and better treatment satisfaction had positive effects on HRQOL both in direct and indirect ways whereas comorbidities indirectly showed negative associations with HRQOL. PRéCIS:: This observed patient-specific features and treatment-driven conditions that were significantly associated with the impairment of health-related quality of life (HRQOL) among glaucoma patients. The results suggest that more systematic strategies should be implemented to improve an HRQOL. To determine factors contributing to an HRQOL and assess total, direct and indirect, effects that may exist between the determinants using path analysis. Data were derived from previous Korea glaucoma outcomes research. A total of 847 glaucoma outpatients with ≤2 years of eye-drop use were included in the present study. Including factors and their hypothetical pathways to an HRQOL were based on the literature review and consultation with specialists. Age, sex, comorbidities, and education levels were included as underlying conditions and treatment patterns were defined by the number of daily instillations of prescribed eye-drops. Treatment satisfaction and adherence were estimated using a Treatment Satisfaction Questionnaire for Medication, which assessed side-effects, effectiveness, convenience, global satisfaction, and pill count. An HRQOL was assessed by EQ-5D and EQ-visual analogue scale (EQ-VAS). In EQ-5D analysis, male individuals showed total effects (β=0.102, P=0.0026), including both direct (β=0.076, P=0.0095) and indirect effects (β=0.0253, P=0.0020), which were mediated by treatment satisfaction in the side effects and global satisfaction categories. Higher education (β=0.197, P=0.0020) and satisfaction in the side effect (β=0.095, P=0.0076) and global satisfaction (β=0.075, P=0.0414) categories were found to have direct effects on EQ-5D. For EQ-VAS, higher education levels had significant total effects (β=0.153, P=0.0020) accounting for direct effects (β=0.131, P=0.0030) and indirect effects (β=0.0223, P=0.0531) through global satisfaction. In addition, male individuals had indirect effects (β=0.274, P=0.0165), which was indirectly mediated by satisfaction in the global satisfaction category. Comorbidity (β=-0.096, P=0.0090) and satisfaction in the effectiveness (β=0.094, P=0.0302), convenience (β=0.076, P=0.0390), and global satisfaction (β =0.144, P=0.0020) categories showed indirect effect on EQ-VAS. Higher education and better treatment satisfaction had positive effects on HRQOL both in direct and indirect ways whereas comorbidities indirectly showed negative associations with HRQOL. |
| Author | Sung, Kyung Rim Kim, Tae-Woo Kim, Young-Joo Park, Sang-Woo Cha, Jin-Hye Park, Ki Ho Kim, Ho-Soong Lee, Ji Woong Kim, Chan Yun Sohn, Yong Ho Lee, Junyoung Kim, Joon Mo Ahn, Myung-Douk Cha, Soon Cheol Yoo, Chungkwon Kim, Yong Yeon Ahn, Jaehong Kim, Moon Jung Choi, Jimi |
| Author_xml | – sequence: 1 givenname: Chan Yun surname: Kim fullname: Kim, Chan Yun organization: Department of Ophthalmology, Institute of Vision Research, Yonsei University, College of Medicine – sequence: 2 givenname: Ki Ho surname: Park fullname: Park, Ki Ho organization: Department of Ophthalmology, Seoul National University Hospital – sequence: 3 givenname: Jaehong surname: Ahn fullname: Ahn, Jaehong organization: Ajou University, School of Medicine, Suwon – sequence: 4 givenname: Myung-Douk surname: Ahn fullname: Ahn, Myung-Douk organization: The Catholic University of Korea, Seoul St. Mary's Hospital – sequence: 5 givenname: Soon Cheol surname: Cha fullname: Cha, Soon Cheol organization: Yeungnam University Medical Center, Daegu – sequence: 6 givenname: Ho-Soong surname: Kim fullname: Kim, Ho-Soong organization: Sungmo Eye Hospital – sequence: 7 givenname: Joon Mo surname: Kim fullname: Kim, Joon Mo organization: Department of Ophthalmology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital – sequence: 8 givenname: Moon Jung surname: Kim fullname: Kim, Moon Jung organization: Kong Eye Clinic – sequence: 9 givenname: Tae-Woo surname: Kim fullname: Kim, Tae-Woo organization: Seoul National University Bundang Hospital, Gyeonggi-do – sequence: 10 givenname: Yong Yeon surname: Kim fullname: Kim, Yong Yeon organization: Korea University Guro Hospital – sequence: 11 givenname: Ji Woong surname: Lee fullname: Lee, Ji Woong organization: Pusan National University Hospital, Busan – sequence: 12 givenname: Sang-Woo surname: Park fullname: Park, Sang-Woo organization: Chonnam National University Medical School & Hospital, Gwangju, Republic of Korea – sequence: 13 givenname: Yong Ho surname: Sohn fullname: Sohn, Yong Ho organization: Kim's Eye Hospital – sequence: 14 givenname: Kyung Rim surname: Sung fullname: Sung, Kyung Rim organization: Asan Medical Center, University of Ulsan College of Medicine – sequence: 15 givenname: Chungkwon surname: Yoo fullname: Yoo, Chungkwon organization: Korea University Anam Hospital – sequence: 16 givenname: Jin-Hye surname: Cha fullname: Cha, Jin-Hye organization: Outcomes Research/Real World Data Team, Corporate Affairs and Health & Value Division, Pfizer Pharmaceuticals Korea Ltd – sequence: 17 givenname: Young-Joo surname: Kim fullname: Kim, Young-Joo organization: Outcomes Research/Real World Data Team, Corporate Affairs and Health & Value Division, Pfizer Pharmaceuticals Korea Ltd – sequence: 18 givenname: Junyoung surname: Lee fullname: Lee, Junyoung organization: Department of Biostatistics, Korea University College of Medicine, Seoul – sequence: 19 givenname: Jimi surname: Choi fullname: Choi, Jimi organization: Department of Biostatistics, Korea University College of Medicine, Seoul |
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| Title | A Path Analysis of Effects of Patients' Underlying Conditions, Treatment Satisfaction, and Adherence on Quality of Life Among Korea Glaucoma Patients |
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