Comorbidities associated with reduced HRQoL in elderly CML patients
medwireNews: Italian researchers find that health-related quality of life (HRQoL) is impaired in the presence of comorbidities in elderly patients with chronic myeloid leukaemia (CML).
“Therefore, assessing comorbidity in elderly patients is important to facilitate identification of those most in need of HRQOL improvements”, says the team led by Fabio Efficace, from GIMEMA Data Center and Health Outcomes Research Unit in Rome.
For the purpose of this study, 174 CML patients aged 60 years or older previously enrolled in a study assessing the long-term effects of first-line imatinib treatment completed the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Charlson Comorbidity Index.
Thirty-six percent of the cohort was comorbidity free, while 32% reported the presence of one comorbidity and the remaining 32% reported two or more comorbidities, such as osteoarthritis or rheumatism, vascular pathology or diabetes.
Multivariable analysis adjusting for various sociodemographic and disease-related factors showed that four of the eight SF-36 scales were significantly lower in patients with than in those without comorbidities. The affected domains included those related to physical health (bodily pain, general health, physical functioning) as well as to mental health (vitality).
And analysis of variance showed that the presence of comorbidities was the most substantial contributor in determining the general health and bodily pain scales of the SF-36, explaining more variance than either sociodemographic or disease-related factors.
Our findings imply that elderly patients with comorbidities should be monitored more closely due to their worse HRQoL outcomes, say the researchers. “They might represent a specific population who can benefit the most from supportive care programs.”
Another implication pertains to the “better designing and interpreting” of future HRQoL research in this patient population, they write in the Annals of Hematology.
“Our results indicate that comorbidity should be considered as a key variable to adjust for, in order to increase robustness of study results and outcome interpretation. Therefore, routinely collecting and quantifying comorbid conditions possibly using well-validated indices in clinical practice and research is strongly recommended.”
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