Advertisement

Quality of Life Research

, Volume 1, Issue 6, pp 359–366 | Cite as

Changes in quality of life among persons with HIV infection

  • D. P. Lubeck
  • J. F. Fries
Research Papers

Abstract

Health-related quality of life (QOL) is an important component of the evaluation of patient outcome in HIV infection where disease is progressive and debilitating. This paper compares patient-reported QOL obtained from questionnaires which cover functional ability, social functioning, cognition, mental health, disability days, disease symptoms, and overall health in the previous 3 months. These scales have been validated on HIV populations. We compared changes in health status over 12 months for 669 patients with varying HIV disease severity: 134 asymptomatic, 416 symptomatic (previously termed ARC), and 119 AIDS. Groups were evaluated at baseline for demographic and health status differences (i.e., age, CD4+). Declines in health status and psychosocial status were found over the year for all persons. Individuals with symptomatic disease or AIDS had significant declines of 10–20% (p<0.001) in all aspects of role functioning (social, daily activities, energy, and global health) and increased disease symptoms, but no significant declines in cognition or mental health. Persons with AIDS had greater declines than those with symptomatic disease. AIDS and symptomatic patients also reported significantly fewer hours at work and more disability days than asymptomatic patients. The impact that HIV disease has on the health status of non-AIDS symptomatic patients is especially striking.

Key words

AIDS health status HIV infection quality of life 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    World Health Organization.International classification of impairments, disabilities and handicaps: a manual classification relating to the consequences of disease. Geneva: World Health Organization, 1980.Google Scholar
  2. 2.
    FriesJF, SpitzPW, YoungDY. The dimensions of health outcomes: the health assessment questionnaire, disability and pain scales.J Rheumatol 1982;9: 789–793.Google Scholar
  3. 3.
    PincusT, CallahanLF, BradleyLA, et al. Elevated MMPI scores for hypochondrias, depression and hysteria scores in RA reflect disease rather than psychological status.Arthritis Rheum 1986;29: 1456–1466.Google Scholar
  4. 4.
    LubeckDP, YelinEH. A question of value: measuring the impact of chronic disease.Milbank Quarterly 1988;66(3): 444–464.Google Scholar
  5. 5.
    FriesJF. The chronic disease data bank: first principles to future directions.J Med Philosophy 1984;9: 161–180.Google Scholar
  6. 6.
    BrookRH, WareJE, Davies-AveryA, et al. Conceptualization and measurement of health for adults in the Health Insurance Study Vol. 8: overview. Santa Monica: The RAND Corporation. (pub. #R-1987/8-HEW) 1979.Google Scholar
  7. 7.
    StewartAL, GreenfieldS, HaysRD, et al. Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study.JAMA 1989;262(7): 907–913.Google Scholar
  8. 8.
    StewartAL, HaysRD, WareJEJr. The MOS short-form general health survey.Medical Care 1988;26(7): 724–735.Google Scholar
  9. 9.
    TarlovAR, WareJEJr, GreenfieldS, et al. The Medical Outcomes Study: an application of methods for monitoring the results of medical care.JAMA 1989;262: 925–930.Google Scholar
  10. 10.
    WuAW, RubinHR, MathewsWC, et al. A health status questionnaire using 30 items from the Medical Outcomes Study.Med Care 1991;29: 786–798.Google Scholar
  11. 11.
    WachtelT, PietteJ, MorV, et al. Quality of life in persons with human immunodeficiency virus infection: measurement by the Medical Outcomes Study instrument.Ann Intern Med 1992;116: 129–137.Google Scholar
  12. 12.
    FriesJF, SpitzP, KrainesRG, HolmanHR. Measurement of patient outcome in arthritis.Arthritis Rheum 1980;23: 137–145.Google Scholar
  13. 13.
    WellsKB, StewartA, HaysRD, et al. The functioning and well-being of depressed patients: results from the Medical Outcomes Study.JAMA 1989;262: 914–919.Google Scholar
  14. 14.
    Lubeck DP, Lenker SL, Vosler A. Demand for HIV services by insurance status and disease stage. Presented at American Public Health Association, Annual Meeting, November 11, 1991.Google Scholar
  15. 15.
    WuAW, MathewsWC, BryskLT, et al. Quality of life in a placebo-controlled trial of zidovudine in patients with AIDS and AIDS-related complex.J Acquir Immune Defic Syndr 1990;3: 683–690.Google Scholar

Copyright information

© Rapid Communications of Oxford Ltd 1992

Authors and Affiliations

  • D. P. Lubeck
    • 1
  • J. F. Fries
    • 1
  1. 1.Department of Medicine, Division of ImmunologyStanford UniversityStanfordUSA

Personalised recommendations