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Quality of life burden on United States infants and caregivers due to lower respiratory tract infection and adjusting for selective testing: Pilot prospective observational study.
Hariharan, Dhwani; Kumar, V S Senthil; Glaser, Elizabeth L; Crown, William H; Wolf, Zachary A; Fisher, Kimberley A; Wood, Charles T; Malcolm, William F; Nelson, Christopher B; Shepard, Donald S.
Afiliación
  • Hariharan D; Heller School for Social Policy and Management Brandeis University Waltham Massachusetts USA.
  • Kumar VSS; Heller School for Social Policy and Management Brandeis University Waltham Massachusetts USA.
  • Glaser EL; Heller School for Social Policy and Management Brandeis University Waltham Massachusetts USA.
  • Crown WH; Heller School for Social Policy and Management Brandeis University Waltham Massachusetts USA.
  • Wolf ZA; Clinetic Durham North Carolina USA.
  • Fisher KA; Duke University School of Medicine Duke University Durham North Carolina USA.
  • Wood CT; Duke University School of Medicine Duke University Durham North Carolina USA.
  • Malcolm WF; Duke University School of Medicine Duke University Durham North Carolina USA.
  • Nelson CB; Medical Evidence Generation Sanofi Swiftwater Pennsylvania USA.
  • Shepard DS; Heller School for Social Policy and Management Brandeis University Waltham Massachusetts USA.
Health Sci Rep ; 6(6): e1338, 2023 Jun.
Article en En | MEDLINE | ID: mdl-37334041
Background and Aims: Policymakers need data about the burden of respiratory syncytial virus (RSV) lower respiratory tract infections (LRTI) among infants. This study estimates quality of life (QoL) for otherwise healthy term US infants with RSV-LRTI and their caregivers, previously limited to premature and hospitalized infants, and corrects for selective testing. Methods: The study enrolled infants <1 year with a clinically diagnosed LRTI encounter between January and May 2021. Using an established 0-100 scale, the 36 infants' and caregivers' QoL at enrollment and quality-adjusted life year losses per 1000 LRTI episodes (quality-adjusted life years [QALYs]/1000) were validated and analyzed. Regression analyses examined predictors of RSV-testing and RSV-positivity, creating modeled positives. Results: Mean QoL at enrollment in outpatient (n = 11) LRTI-tested infants (66.4) was lower than that in not-tested LRTI infants (79.6, p = 0.096). For outpatient LRTI infants (n = 23), median QALYs/1000 losses were 9.8 and 0.25 for their caregivers. RSV-positive outpatient LRTI infants (n = 6) had significantly milder QALYs/1000 losses (7.0) than other LRTI-tested infants (n = 5)(21.8, p = 0.030). Visits earlier in the year were more likely to be RSV-positive than later visits (p = 0.023). Modeled RSV-positivity (51.9%) was lower than the observed rate (55.0%). Infants' and caregivers' QALYs/1000 loss were positively correlated (rho = 0.34, p = 0.046), indicating that infants perceived as sicker imposed greater burdens on caregivers. Conclusions: The overall median QALYs/1000 losses for LRTI (9.0) and RSV-LRTI (5.6) in US infants are substantial, with additional losses for their caregivers (0.25 and 0.20, respectively). These losses extend equally to outpatient episodes. This study is the first reporting QALY losses for infants with LRTI born at term or presenting in nonhospitalized settings, and their caregivers.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Idioma: En Revista: Health Sci Rep Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Idioma: En Revista: Health Sci Rep Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos