Changes in health-related quality of life (EQ-5D) dimensions associated with community-based musculoskeletal physiotherapy: a multi-centre analysis.
Qual Life Res
; 27(9): 2373-2382, 2018 Sep.
Article
en En
| MEDLINE
| ID: mdl-29948600
ABSTRACT
PURPOSE:
To determine the changes in each of the five dimensions of the EuroQol 5-dimension index associated with community-based physiotherapy.METHODS:
Four thousand one hundred and thirty-six patients that received community-based musculoskeletal physiotherapy across five NHS centres completed the EQ-5D on entry into the service and upon discharge. Patients were categorised on symptom location and response to treatment based on their EQ-5D index improving by at least 0.1 ("EQ-5D responders"). For each symptom location, and for responders and non-responders to treatment, the mean (± SD) were calculated for each dimension pre- and post-treatment as well as the size of effect.RESULTS:
The mobility dimension improved (p < 0.05) in all symptom locations for EQ-5D responders (d = 0.26-1.58) and in ankle, knee, hip and lumbar symptoms for EQ-5D non-responders (d = 0.17-0.45). The self-care dimension improved (p < 0.05) in all symptom locations for EQ-5D responders (d = 0.49-1.16). The usual activities dimension improved (p < 0.05) across all symptom locations for EQ-5D responders (d = 1.00-1.75) and EQ-5D non-responders (d = 0.14-0.60). Despite the pain/discomfort dimension improving (p < 0.05) across all symptom locations for both EQ-5D responders (d = 1.07-1.43) and EQ-5D non-responders (d = 0.29-0.66), the anxiety/depression dimension improved (p < 0.05) from higher starting levels in EQ-5D responders (d = 0.76-1.05) with no change seen for EQ-5D non-responders (d = - 0.16 to 0.06).CONCLUSIONS:
Clinicians should not assume that a patient presenting with pain but expressing high anxiety/depression is unlikely to respond to treatment, as they may show the best HRQoL outcomes. For patients presenting with pain/discomfort and low levels of anxiety/depression, the EQ-5D index is perhaps not a suitable tool for sole use in patient management and service evaluation.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Calidad de Vida
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Modalidades de Fisioterapia
Tipo de estudio:
Clinical_trials
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Qualitative_research
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Risk_factors_studies
Límite:
Female
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Humans
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Male
Idioma:
En
Año:
2018
Tipo del documento:
Article