Health Related Quality of Life of Chronic Liver Patients: A Dutch Population-Based Study

Abstract

Chronic illnesses form a spectrum of diseases. Some chronic illnesses are poorly understood and unpredictable, some are understood and manageable, some are progressively disabling and some are life threatening. Nevertheless, for all chronic patients chronic illnesses have one thing in common: The patient will never again return to the pre-illness state of invulnerability of obliviousness to the body’s functioning. In chronic patients, symptoms may interfere to varying degrees with the ability to work, to carry out family and social roles and to rest 1. It is in this light that a measure like Health Related Quality of Life (HRQoL) can be of great use. HRQoL is a psychosocial outcome that reflects a person’s health and how a disturbance of a person’s health influences his or her functioning in daily life 2. HRQoL provides information about the physical, social and mental burden of disease and is complementary to the clinical, biochemical and physiologic outcomes, which provide information about the pathological course of the disease 3. Although clinicians may be more concerned about the traditional biological outcomes, patients are more concerned about the impact of disease and related treatments on quality of life 4. Chronic liver disease is associated with significant morbidity and mortality. Patients may suffer from complications of cirrhosis like ascites, variceal bleedings and hepatic encephalopathy, which are easily evaluated by traditional clinical measures. Yet, many chronic liver patients are put up with non-specific symptoms like fatigue, abdominal discomfort, nausea and depression. These symptoms are hard to evaluate, however 5,6. Therefore, in clinical practice the severity of these symptoms may get less attention than required, although these symptoms may have a significant impact on HRQoL.