Browsing by Author "Gedif, Teferi (BPharm,MSc, PhD)"

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    Health Related Quality of Life, Predictors and Utility of Cervical Cancer Patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
    (Addis Ababa Universty, 2018-09) Teklu, Liya; Gedif, Teferi (BPharm,MSc, PhD)
    Background: Cervical cancer is the second most prevalent malignancy in Ethiopia associated with high mortality and morbidity. It is costly to manage the disease and it severely affects women’s health-related quality of life (HRQOL). Nonetheless, few efforts have been made to assess the patients’ HRQOL, its predictive factors and their utility values set in Ethiopia. As a result, decisions on cost-effective interventions still remains on personal experiences and evidences from other countries, without doing a formal economic Assessment locally. Objective: To validate the Amharic version of European Organization for Research and Treatment of Cancer-Cervical Module (EORTC QLQ-CX24), assess Health Related Quality of Life, its associated factors and utility of cervical cancer patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: An institutional based cross-sectional study was conducted in Tikur Anbessa Specialized Hospital from January to June, 2018. A total of 404 cervical cancer patients were interviewed using the Amharic version of; European Organization for Research and Treatment of Cancer module (EORTC QLQ-C30), EORTC QLQ-CX24 and Euro Quality of Life Group’s 5-Domain Questionnaires 5 Levels (EQ 5D 5L) and Euro Quality of Life Group’s visual scale analog instruments (EQ-VAS) tools. The Amharic versions of all Instruments were previously validated except for the Amharic version of EORTC QLQ-CX24 which was used in the present study through forward and backward translation approach and validated by interviewing 171 cervical cancer patients prior the data collection for the main study. The data was analyzed using SPSS version 23 and Microsoft Office Excel 2010. Pearson correlation, Cronbach's alpha and independent t-test, were employed to assess the reliability and validity of EORTC QLQ-CX24 while; ANOVA and stepwise multivariable logistic regression were employed to determine mean difference and significant associations. Results: The EORTC QLQ-CX24 was found to be acceptable with high compliance and low missing response. The Cronbach’s alpha ranged from 0.70-0.837, indicating reliability of the scale. Convergent and discriminant validity in multi-trait scaling analyses was adequate. The tool also confirmed its clinical validity by differentiating among groups and concurrent validity by the weak to strong correlation with EORTC QLQ-C30. viii In the HRQOL assessment, the mean age of patients was 52.092±0.50 years and majority (93.8%) of the patients were treated as outpatients. The highest proportion (35%) of patients, were on FIGO stage IV of cervical cancer. The Mean ±SD Global quality of life of patients (GQOL) was 48.3 ± 23.77, while the EQ VAS mean score was found to be 65.7 ± 20.83. Social functioning and sexual activity scored the lowest mean from the functioning scales, while financial difficulty, pain and fatigue scored the highest mean from the symptom scales. Physical functioning (AOR=4.98, 95%CI=2.16-11.49), emotional functioning (AOR=5.25, 95%CI=2.2612.17), pain (AOR=5.79, 95%CI=2.30-14.57) and symptom experience (AOR=4.58, 95%CI=1.95-10.79) had a strong association with the GQOL of patients. The utility value was found to be 0.7. Conclusions: Cervical cancer patients reported poor HRQOL and above average utility score. Hence, strong psychological support, pain management and awareness creation including their care takers and partners should be included in the management of this patient group. The Amharic version of the EORTC QLQ-CX24 questionnaire can be used as an acceptable, reliable and efficient tool in clinical use and clinical research to assess the HRQOL of cervical cancer in Ethiopia.
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    Valuing health-state: an eq-5d-5l value set for Ethiopians
    (Addis Ababa Universty, 2018-11) Gebregziabiher, Abraham; Gedif, Teferi (BPharm,MSc, PhD)
    Background: There is a growing interest in health technology assessment and economic evaluations in developing countries using measures such as EQ-5D-5L (European quality 5 dimension- 5 level). However, the main challenge is lack of local population value sets which are recommended in most countries as they reflect local preferences. Objective: To obtain social preference and establish an EQ-5D-5L value set from the Ethiopian general population. Methods: A sample reflecting urban, and rural population (n= 1,050) was recruited using stratified multi-stage quota sampling technique. Face-to-face, computer-assisted interviews using the EuroQol Portable Valuation Technology (EQ-PVT) software of composite time trade-off(c-TTO) and discrete choice experiments (DCE) were undertaken to elicit preference score. The feasibility of EQ-PVT was pilot tested in a sample of the population (n=110). A hybrid regression model combining c-TTO and DCE data was used to estimate the final value set. Results: The pilot study revealed that the feasibility of EQ-PVT protocol was good and there were no special concerns with undertaking TTO task. The predicted value for the EQ-5D-5L ranged from-0.7186 to 1. The coefficients generated from a hybrid model were logically consistent. Anxiety/depression showed the most impact to utility decrement of 0.4578, and self-care influenced the least 0.2224. The maximum predicted value beyond full health was 0.9741 for the ‘11112’ (health state of slight problem in anxiety/depression dimension). Conclusions: This study established Ethiopian value set for EQ-5D-5L on the basis of c-TTO and DCE. It is expected to facilitate health economic evaluations, health-related quality of life research and to inform decision making in Ethiopia.