Health-Related Quality of Life and Functional Ability of Patients with Rheumatoid Arthritis: A Study from a Tertiary Care Hospital in Thailand.

OBJECTIVES: To assess the health-related quality of life and functional ability of patients with rheumatoid arthritis (RA) using the Thai EuroQol five-dimensional questionnaire (EQ-5D) and the Thai Health Assessment Questionnaire (HAQ), and to analyze correlations between the scores from both questionnaires. METHODS: This cross-sectional study was conducted among 221 patients with RA aged 18 years or older at a tertiary care hospital in Thailand. Data collection methods included individual patient interviews and data gathering from medical records. The correlations between the EQ-5D and HAQ scores were analyzed using Spearman's rank correlation coefficients. RESULTS: Most patients were female (78.3%), aged 41 to 60 years (57.0%), having had RA for 12 to 60 months (43.0%), and being in an active disease state (60.6%). From the EQ-5D, most patients reported no problems in each dimension, except for mobility and pain/discomfort. For the HAQ, most patients reported no difficulty for almost all activities, except for arising. The medians (interquartile ranges) for the EQ-5D utility, EuroQol visual analogue scale (EQ VAS), and HAQ scores were 0.65 (0.55-0.73), 70 (50-80), and 0.25 (0.00-0.81), respectively. The Spearman's rank correlation coefficients were 0.42 for the EQ-5D utility and EQ VAS scores (P = 0.01), -0.65 for the EQ-5D utility and HAQ scores (P < 0.001), and -0.39 for the EQ VAS and HAQ scores (P < 0.001). CONCLUSIONS: The health-related quality of life and functional ability of most patients in our study were partially affected by the disease. The EQ-5D and HAQ scores significantly correlated at a moderate to strong level.

Minimal Clinically Important Differences (MCIDs) of the Thai Version of the Leicester Cough Questionnaire for Subacute and Chronic Cough.

OBJECTIVES: To investigate the minimal clinically important differences (MCIDs) of the Thai version of the Leicester Cough Questionnaire (LCQ-T) in patients with subacute and chronic cough. METHODS: Patients with cough for 3 or more weeks were recruited from outpatient clinics. They self-completed the LCQ-T at an initial evaluation and repeated the LCQ-T with a Global Rating of Change scale at follow-up. For the anchor-based method, the MCID was defined as a change in the LCQ scores that corresponded to the smallest improvement in Global Rating of Change score (+2 to +3). For distribution-based methods, the MCIDs were estimated from the standard error of measurement and a half and one-third of the SD of the LCQ score changes from baseline to follow-up. RESULTS: A total of 107 patients were included. The causes of cough were postinfectious cough/bronchitis (35.5%), asthma (20.6%), rhinosinusitis (16.8%), bronchiectasis (17.8%), and chronic obstructive pulmonary disease (9.3%). The anchor-based method yielded MCIDs of 1.1, 0.4, 0.4, and 0.4 for the total, physical, psychological, and social domains, respectively. The distribution-based method using standard error qof measurement yielded MCIDs of 0.8, 0.3, 0.3, and 0.3, whereas those using a half SD yielded MCIDs of 2.0, 0.6, 0.8, and 0.8 and those using one-third SD yielded MCIDs of 1.4, 0.4, 0.5, and 0.5 for the total, physical, psychological, and social domains, respectively. CONCLUSIONS: The MCIDs of the LCQ-T for subacute and chronic cough are 1.1, 0.4, 0.4, and 0.4 for the total, physical, psychological, and social domains, respectively. These estimates should be useful in making meaningful interpretations of the changes in quality of life because of cough.

Opportunistic Risk Screening for Type 2 Diabetes: Exploring of Application of Diabetes Risk Assessment Tool in Community Pharmacy in Australia and Thailand.

OBJECTIVE: To evaluate the feasibility of providing diabetes risk assessment at community pharmacy level in Australia and Thailand from organizational aspects. METHODS: The intervention study was conducted in eight community pharmacies in New South Wales, Australia, and six community pharmacies in Central Thailand. Diabetes risk assessment tools were applied to determine the risk of developing type 2 diabetes. An open-ended question was asked to solicit the willingness-to-pay value for the service. A semistructured interview was conducted with participating pharmacists to solicit the perceived facilitators and barriers in providing the service. RESULTS: There were a total of 132 and 185 participants, with the ratio of participants in the three risk categories of low, intermediate, and high being 1:4:11 and 2:1:1.5 for Australia and Thailand, respectively. More Thai participants were willing to pay for the service (72.4% vs. 18.9%; P = 0.0001). Pharmacists from both countries agreed that providing risk assessment would increase health awareness and assist in dampening the burden of disease. A major barrier is time and staff shortage. Support from the government and collaboration among health care providers were major facilitators from Thai pharmacists' perspective, whereas remuneration was a major facilitator from Australian pharmacists' perspective. CONCLUSIONS: Pharmacists in both countries agreed that this intervention would contribute to produce positive health benefits. Differences in advantages and barriers as well as in the proportion of consumers willing to pay for the service demonstrated that it is essential for pharmacists (particularly in developing countries) to be aware of the pitfalls of copying practice initiatives in developed countries without any consideration of the local health care environment.

Validity and reliability of the Thai version of the leicester cough questionnaire in chronic cough.

BACKGROUND: Chronic cough is a common problem potentially disturbing the quality of life (QoL) of coughers. The Leicester Cough Questionnaire (LCQ), previously developed in England, is a validated, self-completed QoL instrument for assessment of chronic cough. This study aimed to develop a Thai version of the LCQ (LCQ-T) and assess its validity and reliability among adult Thai patients with subacute to chronic cough. METHODS: A total of 146 patients with a cough lasting for more than 3 weeks consented to participate in this study and self-administered the LCQ-T, together with the following 3 instruments: Borg Cough Scale (BCS), Short Form-36 (SF-36), and Hospital Anxiety Depression Scale (Thai-HADS). The LCQ-T was developed by applying a forward-backward translation approach. The LCQ-T comprises 19 items divided into 3 domains: physical (8 items), psychological (7 items), and social (4 items). To validate the LCQ-T, concurrent validity, internal consistency reliability, and test-retest reliability were assessed. RESULTS: Participants included 96 women and 50 men with a mean (SD) age of 59.6 (14.4) years. The concurrent validity comparing LCQ-T to BCS yielded statistically significant Pearson correlation coefficients (r= -0.74, P<0.05). The correlation coefficients for SF-36 and Thai-HADS were also significant. The LCQ-T demonstrated very good internal consistency in all domains and the overall scale, with the Cronbach's alpha coefficients ranging from 0.89 to 0.94. The 3-day repeatability of the LCQ-T in 25 clinically stable patients was high with the intra-class correlation coefficients ranging between 0.81 and 0.90. CONCLUSION: LCQ-T is a valid and reliable cough-specific instrument for assessing symptoms and QoL of adult Thai patients with subacute to chronic cough.

A survey of knowledge on diabetes in the central region of Thailand.

OBJECTIVES: The objectives of this study were to evaluate the level of knowledge of diabetes among the Thai general population, identify areas of deficiency for targeted health education effort, and identify respondent characteristics that may be associated with knowledge of diabetes. METHODS: A survey involving 1000 respondents (age > or = 15 years) was conducted in the central region of Thailand. A 42-item pre-tested questionnaire to assess general and specific knowledge of diabetes (e.g., risk factors, symptoms, treatment, etc.) was administered. Scores of <50%, > or =50% to <80%, and > or =80% were classified as "poor,""fair," and "good," respectively, according to expert consensus. RESULTS: Mean age of respondents was 33.8 years (SD 13.4), with 57.5% being female. Mean diabetes knowledge score was fair: 25.02 of 42 (59.6%), SD 8.35 (19.9%). Respondents performed best in the risk factor section: mean (%) score was 2.88 of 4 (72%), SD 1.11 (27.8%); and worst in the section on diabetes in women: mean (%) score was 0.82 of 3 (27.3%), SD 0.96 (32.0%). In multiple linear regression analyses, education level, older age, own self having diabetes, and having a family member/relative/friend with diabetes were significantly associated with knowledge of diabetes. CONCLUSIONS: Knowledge of diabetes among the Thai respondents was fair. Areas of deficiency and factors associated with knowledge of diabetes were identified. Our findings would be useful in informing targeted health education programs.