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医学干预对慢性病患者健康相关生活质量的影响——19 种最常见诊断的系统评价和荟萃分析。

Effects of medical interventions on health-related quality of life in chronic disease - systematic review and meta-analysis of the 19 most common diagnoses.

机构信息

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), Ludwig-Maximilians-University (LMU) Hospital, Munich, Germany.

Department of Orthopaedics, University Hospital Jena, Campus Eisenberg, Waldkliniken Eisenberg, Eisenberg, Germany.

出版信息

Front Public Health. 2024 Feb 6;12:1313685. doi: 10.3389/fpubh.2024.1313685. eCollection 2024.

Abstract

INTRODUCTION

The demographic shift leads to a tremendous increase in age-related diseases, which are often chronic. Therefore, a focus of chronic disease management should be set on the maintenance or even improvement of the patients' quality of life (QoL). One indicator to objectively measure QoL is the EQ-5D questionnaire, which was validated in a disease- and world region-specific manner. The aim of this study was to conduct a systematic literature review and meta-analysis on the QoL across the most frequent chronic diseases that utilized the EQ-5D and performed a disease-specific meta-analysis for treatment-dependent QoL improvement.

MATERIALS AND METHODS

The most common chronic disease in Germany were identified by their ICD-10 codes, followed by a systematic literature review of these ICD-10 codes and the EQ-5D index values. Finally, out of 10,016 independently -screened studies by two persons, 538 studies were included in the systematic review and 216 studies in the meta-analysis, respectively.

RESULTS

We found significant medium to large effect sizes of treatment effects, i.e., effect size >0.5, in musculoskeletal conditions with the exception of fractures, for chronic depression and for stroke. The effect size did not differ significantly from zero for breast and lung cancer and were significantly negative for fractures.

CONCLUSION

Our analysis showed a large variation between baseline and post-treatment scores on the EQ-5D health index, depending on the health condition. We found large gains in health-related quality of life mainly for interventions for musculoskeletal disease.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020150936, PROSPERO identifier CRD42020150936.

摘要

简介

人口结构的转变导致与年龄相关的疾病患者数量大幅增加,而这些疾病往往是慢性的。因此,慢性病管理的重点应该放在维持甚至提高患者的生活质量(QoL)上。衡量 QoL 的一个指标是 EQ-5D 问卷,该问卷已经过疾病和特定区域的验证。本研究的目的是对使用 EQ-5D 进行评估的最常见慢性疾病的 QoL 进行系统的文献回顾和荟萃分析,并对依赖于治疗的 QoL 改善进行特定疾病的荟萃分析。

材料和方法

通过其 ICD-10 代码确定德国最常见的慢性疾病,然后对这些 ICD-10 代码和 EQ-5D 指数值进行系统的文献回顾。最后,通过两人独立筛选,从 10016 项研究中,分别有 538 项研究被纳入系统综述,216 项研究被纳入荟萃分析。

结果

我们发现,除骨折外,肌肉骨骼疾病、慢性抑郁症和中风的治疗效果具有显著的中到大效应量(即效应量>0.5),而乳腺癌和肺癌的效应量与零无显著差异,骨折的效应量显著为负。

结论

我们的分析表明,根据健康状况,EQ-5D 健康指数的基线和治疗后评分之间存在很大差异。我们发现,肌肉骨骼疾病的干预措施在健康相关生活质量方面有很大的改善。

系统评价注册

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020150936,PROSPERO 标识符 CRD42020150936。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1bb2/10878130/2bb398f490a4/fpubh-12-1313685-g001.jpg

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