Health related quality of life in chronic liver diseases

• DOI: 10.1111/liv.14647
• Publication Date: 2020-09-02T16:59:29Z
• Authors: Paolo A. Cortesi; Sara Conti; Luciana Scalone; Ariel Jaffe; Antonio Ciaccio; Stefano Okolicsanyi; Matteo Rota; Luca Fabris; Michele Colledan; Stefano Fagiuoli; Luca S. Belli; Giancarlo Cesana; Mario Strazzabosco; Lorenzo G. Mantovani
• Keywords: 0301 basic medicine; 03 medical and health sciences; Carcinoma, Hepatocellular; Health Status; Surveys and Questionnaires; Liver Neoplasms; Quality of Life; Chronic Liver Diseases; General population; Health-Related Quality of Life; Humans; chronic liver diseases; general population; health-related quality of life;; 3. Good health

AbstractBackground & AimsThe impact of chronic liver diseases (CLDs) on health‐related quality of life (HRQoL) is relevant to understand the burden of these conditions and inform decision‐making processes related to their care. Studies simultaneously comparing the HRQoL of patients affected by the major CLDs to that of the general population are still lacking and are the subject of this study.MethodsUsing the EQ‐5D‐3L questionnaire, we analysed and compared HRQoL data from 2962 Italian patients affected by CLDs and forming a representative sample of the general Italian population (6800 individuals). Exploratory analyses were conducted to investigate the effects of each CLD on HRQoL, using the general population as reference and adjusting for possible confounders.ResultsPatients with CLDs (HBV, HCV, PSC, PBC, AIH, NAFLD/NASH) in the chronic hepatitis stage and with compensated cirrhosis (CC) showed HRQoL similar to the general population. However, AIH were more likely to report problems in self‐care and lower EQ‐5D VAS score, while NAFLD/NASH and HCV showed an increased risk of anxiety/depression. On the other hand, with progression to more advanced stages of liver disease (DC or HCC), HRQoL decreased significantly with higher risk of reporting problems in the physical domains, and significant reductions in the VAS and utility index scores.ConclusionsDifferent subtypes of CLD affected different QoL domains. This study therefore provides a real estimate of the impact of CLDs on patients’ HRQoL, and represents a much needed tool to inform decision‐making while assessing the effectiveness and cost‐effectiveness of the care of these patients.