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T. Mills, J. Walt, S. Law; Quality of Life Impact of Glaucoma versus other Chronic Diseases. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4471.
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Chronic diseases have a long-term negative impact on quality of life (QoL). Decreased QoL is associated with increased financial burden on healthcare systems and society. Few studies have investigated the impact of glaucoma on patients’ QoL in comparison to other chronic diseases observed in patients with similar demographics.
We performed a systematic literature search to assess QoL in glaucoma and 3 chronic diseases: osteoporosis, type 2 diabetes mellitus, and dementia. Results from studies employing the most frequently used and widely-known generic instruments (Short-Form Health Survey [SF]-36, -12 and -20, EuroQol EQ-5D, and Sickness Impact Profile [SIP]) are reported here.
Of 146 total QoL publications identified, SF-36 was used in 77 (glaucoma=8; osteoporosis=25; diabetes=40; dementia=4), SF-12 in 19 (glaucoma=1, osteoporosis=5, diabetes=9, dementia=4), SF-20 in 7 (glaucoma=1, diabetes=6). EQ-5D in 29 (glaucoma=2; osteoporosis=9; diabetes=9; dementia=9), and SIP in 6 (glaucoma=2; osteoporosis=1; diabetes=3, dementia=0). Similar trends were observed across studies using SF-36, -12 or -20: social functioning domains were affected least, and physical domains affected most in glaucoma; in general, QoL was affected to a similar degree in all diseases. By EQ-5D, in glaucoma, utility decreased with increasing glaucomatous damage (0.84 for mild, to 0.72 for severe damage). The highest mean values using the EQ-5D instrument were similar across all four diseases. Mean overall utility scores were 0.80 and 0.89 in the two glaucoma studies, and ranged from 0.06-0.86 (note the 0.06 score was based on a sample of one patient) in osteoporosis, from 0.31-0.86, and from 0.34-0.86, in diabetes and dementia, respectively. Mean SIP scores increased (QoL decreased) with severity of the glaucoma, ranging from 3.4 (mild) to 5.2 (severe). Total SIP scores for glaucoma were similar to those for patients with diabetes (range, 3.4-5.6).
QoL in glaucoma decreases with increasing disease severity; physical domains are affected more than social domains. Although there are limited published QoL studies in glaucoma, its impact on QoL appears to be broadly consistent with other serious chronic diseases. Further efforts towards diagnosing and treating glaucoma, to reduce financial burden on healthcare systems and society, are warranted.
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