The health-related quality of life in patients with Chagas disease: the state of the art

Abstract

Chagas disease (CD) is a neglected tropical disease associated with poverty in which patients are surrounded by stigma. These factors can contribute to reducing health-related quality of life (HRQoL). Therefore, a broad discussion of HRQoL in the CD population is required. This study aimed to discuss the main findings of HRQoL in patients with CD, focusing on the association between sociodemographic and lifestyle factors, echocardiographic and functional determinants, and the effect of non-invasive interventions on HRQoL. A literature search of the MEDLINE, Web of Science, CINAHL, Scopus, and LILACS databases was performed with no data or language restrictions. Twenty-two articles were included in this meta-analysis. In general, HRQoL is worse in patients with CD than in healthy individuals, particularly in the presence of cardiovascular and/or gastrointestinal symptoms. Sex, age, functional class, level of physical activity, healthy habits, and medications received could affect HRQoL. Among the echocardiographic and functional determinants, decreased systolic function seems to negatively affect HRQoL. No association with the peak oxygen uptake was observed in the maximal tests. By contrast, well-tolerated field tests with submaximal intensities were associated with HRQoL. Both pharmaceutical care and exercise training have a positive effect on the HRQoL of patients with Chagas cardiomyopathy, and the mental component can be a prognostic marker in this population. In conclusion, assessment of HRQoL can provide important information about the health status of patients with CD, and its use in clinical practice is warranted.

Assessment of health‐related quality of life in patients with Chagas cardiomyopathy using Minnesota living with heart failure questionnaire: A validation study

“…In the present study, the MLwHFQ score correlated with almost all SF-36 domains. The SF-36 is the most used questionnaire in patients with Chagas disease [7]. Therefore, the present study demonstrated a high correlation between both questionnaires.…”

“…Structural and functional abnormalities, associated with stigma and fear of sudden death, can compromise the health-related quality of life (HRQoL) of these patients [7][8][9][10]. However, the assessment of HRQoL remains controversial, since there are no specific questionnaires for patients with Chagas disease, and it is usually evaluated using generic questionnaires.…”

Cost‐effectiveness of an exercise‐based cardiovascular rehabilitation program in patients with chronic Chagas cardiomyopathy in Brazil: An analysis from the PEACH study

“…Variation of VO 2peak during the follow‐up period was used as a measure of effect (clinical outcome) due to its significant prognostic value, whose increase of 1 ml kg −1 min −1 is associated with an approximate 10% reduction in the risk of death [19]. Moreover, VO 2peak is also associated with patient‐reported outcomes, including health‐related quality of life [16]. VO 2peak was measured by CPET on a treadmill (Inbramed, Brazil), using a ramp protocol, being considered the maximum value achieved 60 s before or after the peak workload.…”

“…Considering increased functional capacity is positively associated with quality of life and that CR programs may improve functional capacity and health‐related quality of life of patients with CCC [16], whose treatment costs are usually high in the context of scarce resources, studies evaluating the cost‐effectiveness of CR programs designed for CCC patients are required for better allocation of healthcare resources. Therefore, the present study aimed to perform an economic evaluation of a CR program designed for patients with CCC, considering the overall healthcare costs and the cost‐effectiveness evaluation.…”

Health-Related Quality of Life Reported by Patients With Chagas Disease: A Systematic Review of Qualitative Evidence With GRADE Recommendations

“…In the setting of CD, many studies have quantitatively evaluated the HRQoL of patients [9][10][11][12][13] . A recent state-of-the-art study 14 summarized the current findings and postulated that HRQoL is worse in patients with CD compared with that in healthy individuals. Moreover, HRQoL is more compromised in women with cardiovascular and gastrointestinal symptoms among patients with worse functional class, lower levels of physical activity, and worse cardiac function.…”