title: Development and validation of a questionnaire evaluating the impact of hepatitis B immune globulin prophylaxis on the quality of life of liver transplant recipients.
abstract: To date, there is still a lack of instruments for specifically assessing the impact of anti-hepatitis B virus prophylaxis after liver transplantation (LT) on health-related quality of life (HRQOL) and treatment satisfaction. Focusing on the use of hepatitis B immune globulin (HBIG), we developed and validated the Immunoglobulin Therapy After Liver Transplantation Questionnaire (ITaLi-Q), which includes 41 items and covers 5 domains (side effects, positive and negative feelings, impact on the flexibility of daily activities, support, and satisfaction). The questionnaire was tested by 177 consecutive LT patients [71.8% were male, 38.4% were more than 60 years old, 58.8% were on intramuscular (IM) HBIG, and 41.2% were on intravenous (IV) HBIG]. A factor analysis confirmed the hypothesized structure, and a multitrait, multi-item analysis showed favorable psychometric characteristics for ITaLi-Q: item-scale correlations > 0.40 for all items but 1, high scaling success rates (>90% for all scales but 1), excellent internal consistency (Cronbach's α ≥ 0.8 for all scales), and good reproducibility (test-retest coefficient > 0.70 for all scales but 2). ITaLi-Q was able to discriminate between subgroups of patients according to their clinical and sociodemographic characteristics. In comparison with patients on IV HBIG, patients on IM HBIG reported significantly better HRQOL scores on the Flexibility (81.5 ± 21.4 versus 73.1 ± 24.2, P = 0.01) and Negative Feelings scales (90.1 ± 17.3 versus 85.4 ± 20.7, P = 0.04), but they reported worse HRQOL scores on the Side Effects scale (81.8 ± 22.8 versus 95.6 ± 7.4, P < 0.001). No differences were found between the route of HBIG administration and the Satisfaction, Positive Feelings, Impact, and Support scales. In conclusion, ITaLi-Q showed adequate psychometric characteristics and revealed that the route of HBIG administration has a significant impact on specific HRQOL domains beyond a patient's satisfaction.
authors.affiliation: Department of Clinical Pharmacology and Epidemiology, Mario Negri Sud Consortium, Via Nazionale 8A, Santa Maria Imbaro, Italy. franciosi@negrisud.it
authors.forename: Monica
authors.initials: M
authors.lastname: Franciosi
authors.forename: Lucio
authors.initials: L
authors.lastname: Caccamo
authors.forename: Paolo
authors.initials: P
authors.lastname: De Simone
authors.forename: Antonio Daniele
authors.initials: AD
authors.lastname: Pinna
authors.forename: Giovanni Giuseppe
authors.initials: GG
authors.lastname: Di Costanzo
authors.forename: Riccardo
authors.initials: R
authors.lastname: Volpes
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Scuderi
authors.forename: Paolo
authors.initials: P
authors.lastname: Strignano
authors.forename: Patrizia
authors.initials: P
authors.lastname: Boccagni
authors.forename: Patrizia
authors.initials: P
authors.lastname: Burra
authors.forename: Antonio
authors.initials: A
authors.lastname: Nicolucci
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006509:Hepatitis B / Q000517:prevention & control*; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000009:adverse effects / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
chemical_list: D007136:Immunoglobulins; C045213:hepatitis B hyperimmune globulin