title: Comparison of Blood Transfusion Plus Chelation Therapy and Bone Marrow Transplantation in Patients with β-Thalassemia: Application of SF-36, EQ-5D, and Visual Analogue Scale Measures.
abstract: BACKGROUND
  β-Thalassemia is a prevalent genetic disease in Mediterranean countries. The most common treatments for this disease are blood transfusion plus iron chelation (BTIC) therapy and bone marrow transplantation (BMT). Patients using these procedures experience different health-related quality of life (HRQoL). The purpose of the present study was to measure HRQoL in these patients using 2 different multiattribute quality of life (QoL) scales.
  
  
  METHODS
  In this cross-sectional study, data were gathered using 3 instruments: a socio-demographic questionnaire, EQ-5D, and SF-36. A total of 196 patients with β-thalassemia were randomly selected from 2 hospitals in Shiraz (Southern Iran). Data were analyzed using logistic regression and multiple regression models to identify factors that affect the patients' HRQoL.
  
  
  RESULTS
  The average EQ-5D index and EQ visual analog scale (VAS) scores were 0.86 (95% CI: 0.83-0.89) and 71.85 (95% CI: 69.13-74.58), respectively. Patients with BMT reported significantly higher EQ VAS scores (83.27 vs 68.55, respectively). The results showed that patients who lived in rural area and patients with BMT reported higher EQ VAS scores (rural; β= 10.25, P = .006 and BMT; β= 11.88, P = .000). As well, SF-36 between 2 groups of patients were statistically significant in physical component scale (PCS).
  
  
  CONCLUSIONS
  Patients in the BMT group experienced higher HRQoL in both physical and mental aspects compared to those in the BTIC group. More studies are needed to assess the relative cost-effectiveness of these methods in developing countries.
authors.affiliation: Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Javanbakht
authors.affiliation: Health Economics Department, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Keshtkaran
authors.affiliation: Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.|Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Hossien
authors.initials: H
authors.lastname: Shabaninejad
authors.affiliation: Health Economics Department, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Karami
authors.affiliation: Department of Internal Medicine, BMT Unit, Hematology Research Center, and Organ Transplant Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Zakerinia
authors.affiliation: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Sajad
authors.initials: S
authors.lastname: Delavari
mesh_terms: D000293:Adolescent; D000328:Adult; D001803:Blood Transfusion; D016026:Bone Marrow Transplantation; D015913:Chelation Therapy; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007492:Iran; D008297:Male; D010147:Pain Measurement; D011788:Quality of Life; D011795:Surveys and Questionnaires; D064232:Visual Analog Scale; D055815:Young Adult; D017086:beta-Thalassemia / Q000628:therapy*
keywords: Blood Transfusion; Bone Marrow Transplantation (BMT); Health Related Quality of Life (HRQoL); β-Thalassemia