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Title: coment


1
  • Tools Validation and Assessment of Health-Related
    Quality of Life with Chronic Obstructive
    Pulmonary Disease at three selected tertiary Care
    Hospitals in Addis Ababa, Ethiopia
  • By Shimelis Engida
  • advisor Oumer Sada (assistance professor)
  • Co advisor Girma Tekle(associated professor)
  • March 15, 2023
  • Addis Abeba, Ethiopia

2
Presentation Outline
  • Introduction
  • Statement of the problem
  • Significance of the study
  • Objectives
  • Method
  • Other supplementary docx
  • References

3
Introduction
3
  • COPD is airway (bronchitis, bronchiolitis) and/or
    alveolar (emphysema) abnormalities result in
    resistance and frequently progressive airflow
    obstruction. it is characterized by chronic
    respiratory symptoms (dyspnoea, cough, sputum,
    sputum production). (GOLD , 2023)
  • According to different systemic review done in
    USA (R.J. Halbert et al.,2015) and China (Zhu et
    al., 2018) The prevalence of COPD is increase
    and one of non-communicable diseases public
    health problem

4
  • WHO predicts copd became the 3rd leading cause
    of deaths in 2030 (World Health
    Organization(WHO), 2019 ).
  • Nearly 90 of COPD deaths occur in low- and
    middle-income countries(WHO,2019 ).
  • among noncommunicable diseases in Ethiopia,
    chronic obstructive pulmonary disease accounts
    for 2.7-4.3 of cases and causes 3 of death
    Patients with COPD showed a significantly reduced
    health-related quality of life(awokola, B.L et
    al,2022)

5
Cont.
5
  • COPD and its associated symptoms impair the
    functional capacity of individuals to perform
    normal activities of daily living, thus affecting
    their quality of life(Marin JM.et.al.2011)
  • (HRQoL) is a subjective and multidimensional
    measure of physical and psychosocial factors in
    the context of everyday quality life.(Pati S et
    al., 2018)
  • Many disease-specific HRQL instruments with
    proven validity and reliability are now available
    to assess HRQL in patients with COPD

6
Cont..
  • Health measures available for specific diseases,
    such as the St. George's (SGRQ) and COPD Clinical
    Questionnaire (CCQ), are reliable, valid, and
    widely used in clinical research or clinical
    practice
  • There is a new assessment tool called chronic
    obstructive pulmonary disease assessment test
    (CAT) which widely used and recommended by GOLD
    Guideline in clinical practices(Gupta N et
    al.,2014)
  • such disease-specific instrument designed to
    measure the impact of COPD on overall health and
    perceived well-being among COPD patients and this
    has been validated and translated into various
    languages

7
Statement of Problem
7
  • COPD is a neglected disease in LMIC countries.it
    is even unknown in public perception and opinion
    Health Planning COPD management programs are
    underdeveloped( Finney LJ et al., 2013)
  • In spite of COPD treatment and its management is
    mainly focused on lung function assessments.
    There is increasing evidence that conventional
    lung function measures alone do not correlate
    with COPD symptoms.(Troosters et al., 2013)

8
Conti..
  • Study conducted in India(Ibrahim S.et al., 2021,
    Barani S et al., 2022) and Nepal (Adhikari TB et
    al., 2022) HRQOL of life reduced
  • A growing number of questionnaires or measurement
    tools are now available to assess psychosocial
    characteristics and various health outcomes that
    can be used in research, clinical practice and
    population health assessment. (Dekker J, et al.,
    2007)

9
Cont..
  • many tools have been developed, many have not yet
    been properly validated
  • carefully choose which tools are appropriate and
    accurate to ensure the quality of their
    results.(Souza et al.,2017)
  • among those assessment tools there is no any
    validated, reliable and responsive tools in
    Ethiopia. it is critical to explore the
    applicability of easily accessible and
    cost-effective tools like CAT in low-resource
    countries like Ethiopia.

10
Cont..
  • Despite the establishment of the validity and
    reliability of the tool in different countries,
  • there are no previous studies that have
    investigated the applicability of the CAT tool
    among COPD patients in Ethiopia. Therefore, this
    study will carried out to validate
  • CAT instrument in the context of the Ethiopia
    healthcare setting. and used to assess health
    related quality of life.

11
Significance of the Study
11
  • Assessment of health-related quality of life is
    important for A COPD patient according to
    different literature suggests HRQOL assessment is
    important for COPD patients
  • that listed frontal and most of its symptoms
    affect QOL of COPD patient.
  • To measure the HRQOL it needs validated tools
    which adaption according the situation of country

12
Cont..
  • request exacerbations, multiple comorbidities,
    and smoking were associated with a lower HRQoL.
    train more physical activities and a better
    6-minute walk were associated with better
    HRQoL.(Fazekas-Pongor . V et al.,2021)
  • researcher and these also important for health
    care workers to monitor patients disease
    response to the treatment as well as guideline
    developer and policymakers(Guyatt GH et al.,1993)

13
Cont..
  • the difficulty in accessing copyright-free HRQL
    assessment tools having freely available but also
    valid and reliable tools in Amharic version.
  • which is the official language in Ethiopia would
    have great importance to assess health-related
    quality of life in the Ethiopian context.
  • there is no study on the HRQoL and factors
    affecting It among patients with COPD.

14
Objective
14
  • General objective
  • to validate the Amharic version of the COPD
    assessment test (CAT) tools
  • assessment of the health-related quality of life
    in COPD
  • Specific Objective
  • To assess the validity of the CAT -Amharic
    version among COPD patients
  • To assess health-related quality of life in COPD
    by using CAT- Amharic version
  • To assess factors affecting health related
    quality of life

15
Method
  • Study Setting
  • The study will be conducted at the adult chest
    clinics of
  • TASHis the biggest tertiary care and teaching
    hospital in the country with many outpatient
    services On average, around 59 patients are
    expected to attend care at the clinic per day.
    Over four months of the study period around 80
    patients will have a follow-up

16
Method
  • St. Peters Specialized Hospital, has chest
    clinic with about patients follow-up over four
    months
  • SPHMMC, third largest tertiary teaching and
    referral hospital with chest clinic that serves
    for about patients per day for two days per
    week. Over the study period of four months the
    hospital will have patients on follow-up

17
Method
  • Study design and study period
  • A hospital based cross-sectional study design
    will be carried out
  • The study will be conducted from January 1 to
    October 2023
  • Source and study population
  • All patients who attended the adult chest clinics
    of TASH, St. Peter Specialized Hospital and
    SPHMMC.
  • All COPD patients who have a follow up during the
    study period and who fulfilled the inclusion
    criteria

18
Method
  • Inclusion and Exclusion Criteria
  • Inclusion Criteria
  • All patients (age gt18 years) with a diagnosis of
    COPD A patient on follows up Out Patient
    Department
  • Patients who were taking COPD medication for at
    least 6 months before enrolment.

19
Method
  • Exclusion Criteria
  • Patients who are critically ill during the period
    of data collection
  • patient with newly diagnosed
  • patient is not willing to participate
  • Patient with under 18 years

20
Study Variables
20
  • Dependant variable
  • health-related quality of life
  • Validity and reliability
  • Independent Variables
  • Sociodemographic characteristics of the
    participant
  • Medical characteristics like family history of
    COPD, current COPD treatment
  • the presence of comorbid disease, presence or
    absence of poly-pharmacy, and disease duration.
  • Factors affecting HRQOL

21
Method
  • Sample size determination
  • Calculated by using single population proportion
    formula considering 16.2 proportion of COPD
    patient from previous study 95 confidence level,
    5 margin of error(van Gemert, F. et al., 2015)
  • n (Z a /2) 2 p (1-p)
  • (d)2
  • n (1.96) 2 0.162(1-0.162 209
  • (0.05)2
  • 5 contingency, final sample size is 220 COPD
    patients

22
Method
  • Sampling technique
  • A systematic random sampling technique will be
    used
  • The sample size (n) will be proportionally
    allocated to each hospital depending on the
    number of patients on follow-up (N) care in each
    hospital during the study period from
  • N500/four months TASH (N120, n30), SPSH
    (N200, n50) and SPHMMC (N150, n35).
  • Sampling interval (Kth) will be determined by
    total number of source population, K N/n3

23
Method
  • Data collection procedures and instruments
  • The data collection tool will have two parts
  • Questionnaire and data abstraction format
    prepared by reviewing different various
    literatures for important variables to extract
    all necessary information
  • Socio-demographic data will be obtained by
    interviewing
  • Trained Pharmacists will involve in data
    collection

24
Method
  • Data quality assurance
  • Training will be given for data collectors
    focusing on the purpose of the study, how to fill
    the questionnaire
  • The data collection tool will be validated
  • During data collection supervision will be
    carried out daily to ensure the completeness of
    the collected data

25
Method
  • Data interpretation and data analysis

26
Method
26
27
Ethical consideration
27
  • Letter of ethical clearance will be obtained from
    Ethical Review Committee
  • Patient data will be accessed upon the approval
    of the clinical director of each hospitals
  • Each participant will be requested for informed
    consent
  • Clear description of the study objective will be
    given before starting the data collection process
  • Patient confidentiality will be ensured

28
Dissemination of the Result
28
  • The final result of the study will be submitted
    to School of Pharmacy College of Health Science,
    Addis Ababa University
  • The final manuscript will be sent for publication

29
Supplementary document references
  • Study timeline
  • Budget plan
  • References
  • Appendixes

30


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