Health related quality of life (HRQoL), or psychological-, social-, and physical functioning (1), has become an important outcome measure in medical care. A literature search in PubMed in July 2007 for ‘health related quality of life’ showed close to 14.000 hits. Until recently, HRQoL measurement has predominantly been restricted to a research environment, with most studies comparing HRQoL scores of specifi c patient populations with scores of healthy norm populations. Subsequently, impaired HRQoL has now been established for many patient populations. However, this information does not give insight in the HRQoL of individual patients. Therefore, a useful next step in HRQoL measurement seems to be its application in clinical practice, with the goal of improving individual patients’ well-being. The conclusion of a recent thesis on the HRQoL of patients with chronic liver disease subscribes this move from using HRQoL in a research environment to clinical practice (2). In that thesis, it was concluded that “During consultations, besides attention for physical impairments of patients with chronic liver disease (CLD), attention should be given to psychological impairment…” (2). With the application of HRQoL measurement in clinical practice, both physical and psychological impairment will be addressed. Considering the reduced HRQoL that has been found in patients with CLD and the large prevalence and severity of CLD, patients with this disease were included in the present thesis on the application of HRQoL measurement in clinical practice. The fi rst aim of this thesis was to assess the effectiveness of computerized measurement of HRQoL in clinical practice. To that end, we performed a prospective, randomised controlled study on the use of HRQoL data in a large sample of patients with CLD recruited from the recruited from the outpatient clinic of hepatology of a single academic centre in the Netherlands. The results are described in the fi rst part of this thesis (chapter 2 and 3). The second aim of the study was to identify predictors of HRQoL in patients with CLD. In order for the identifi cation of impairment, as described in the fi rst part of the thesis, to lead to an adjustment in treatment it is imperative to know which factors infl uence HRQoL of patients with CLD. With knowledge of these factors, physicians can be assisted in further management of patients presenting with impaired HRQoL. Despite the many studies that have shown a reduced HRQoL in hepatology, relatively few studies have investigated which factors infl uence liver patients’ HRQoL. Therefore, second aim of this thesis was to determine physical and psychological factors that are closely related to HRQoL in patients with chronic liver disease. The results of this investigation are addressed in the second part of the thesis (chapter 4 - 6). The last chapter describes the development of a liver diseas

Additional Metadata
Keywords chronic diseases, gastroenterology, liver diseases, quality of life
Promotor H.L.A. Janssen (Harry)
Publisher Erasmus University Rotterdam
Persistent URL hdl.handle.net/1765/18615
Citation
Gutteling, J.J. (2008, June 4). Implementing Health Related Quality of Life Measurement in Clinical Practice: A prospective study in patients with chronic liver disease. Erasmus University Rotterdam. Retrieved from http://hdl.handle.net/1765/18615