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Systematic Review of Health-Related Quality of Life in Patients with Pulmonary Arterial Hypertension

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Abstract

Background

The increasing survival of patients with pulmonary arterial hypertension (PAH) has shifted attention towards the disease burden that PAH imposes on patients and healthcare systems. Most studies emphasize epidemiology and medications, while large observational studies reporting on the health-related quality of life (HRQOL) of patients with PAH are lacking.

Objective

Our objective was to study the HRQOL of patients with PAH and to summarize the factors that influence it.

Methods

We conducted systematic literature searches in English (PubMed, Web of Knowledge, ScienceDirect and OVID) and Chinese (China National Knowledge Infrastructure, Wanfang Data, Chongqing VIP and SinoMed) databases to identify studies published from 2000 to 2015 assessing the HRQOL of patients with PAH. Search results were independently reviewed and extracted by two reviewers.

Results

Of 3392 records identified in the initial search, 20 eligible papers (19 English, 1 Chinese) were finally included. Studies used a range of instruments; the generic 36-item Short Form Survey (SF-36) was the most widely used, and the disease-specific Cambridge Pulmonary Hypertension Outcome Survey (CAMPHOR) was the second mostly widely used. Mean HRQOL scores assessed via the SF-36 (physical component summary [PCS] 25.4–80.1; mental component summary [MCS] 33.2–76.0) and CAMPHOR (symptom scores 3.1–17; total HRQOL 2.8–12.6; activity scores 3.8–18.1) varied across studies, reporting decreased HRQOL in patients. Mental health (depression, anxiety, stress), physical health (exercise capacity, symptoms) and medical therapies were reported to affect HRQOL.

Conclusion

We found that PAH places a substantial burden on patients, particularly in terms of HRQOL; however, the paucity of large observational studies in this area requires the attention of researchers, especially in China.

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Acknowledgments

The authors thank Xiaofang Liu, Lin Gao, Xuemei Zhen, Yuhang Zeng and Xiaoqian Hu (Zhejiang University School of Public Health, Hangzhou, China) for their help in collecting data.

Author contributions

Shuyan Gu and Hengjin Dong conceived of and designed the study. Shuyan Gu and Huimei Hu carried out the database search and the literature selection, and extracted and interpreted the data. Shuyan Gu produced the first draft of the manuscript, and reviewed and revised the manuscript. Huimei Hu reviewed and revised the manuscript. Hengjin Dong oversaw the development of the work, reviewed and revised the manuscript and provided guidance. All authors reviewed and approved the final manuscript. Shuyan Gu and Hengjin Dong are the guarantors of the study.

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  1. Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou, Zhejiang Province, 310058, China

    Shuyan Gu, Huimei Hu & Hengjin Dong

  2. Department of Public Health, Zhejiang Medical College, Hangzhou, Zhejiang Province, China

    Huimei Hu

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Shuyan Gu, Huimei Hu and Hengjin Dong have no conflicts of interest that are directly relevant to the content of this review.

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Gu, S., Hu, H. & Dong, H. Systematic Review of Health-Related Quality of Life in Patients with Pulmonary Arterial Hypertension. PharmacoEconomics 34, 751–770 (2016). https://doi.org/10.1007/s40273-016-0395-y

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