title: Health-Related Quality of Life and Health Utility Values in Beta Thalassemia Major Patients Receiving Different Types of Iron Chelators in Iran.
abstract: Background:Thalassemia is a chronic, inherited blood disorder, which in its most severe form, causes life-threatening anemia. Thalassemia patients not only engage with difficulties of blood transfusion and iron chelating therapy but also have some social challenges and health threatening factors. There are some reports on quality of life in thalassemia patients around the world from southeast of Asia to Italy in Europe and United States. In this study, we tried to evaluate and compare Health Related Quality of life (HRQoL) and the health utility in beta thalassemia major patients receiving different types of iron chelators and living in different socio-economical situations.Subjects and Methods:EQ-5D-3L accompanied by a Visual Analogue Scale (VAS) questionnaire was used. The respondents were patients with beta thalassemia major that were at least 12 years old selected from 3 provinces of Sistan-Blouchestan, Fars and Mazandaran. Comorbidities including heart complication, Diabetes Mellitus and Hepatitis and also types of iron chelators (oral, injection, combination of both) were also asked. Cross tab and ANOVA analysis conducted to evaluate each dimension score and health utility differences between provinces, iron chelation methods, comorbidities, age group and gender.Results:528 patients answered the questionnaires. The health utility of patients that received oral iron chelator were 0.87 ± .01 for oral iron chelators versus 0.81 ± .01 for injection dosage form (p<0.05). Increase in age was accompanied by decrease in health utility. Females faced more usual activity problems, anxiety and depression. Heart problems were more prevalent in males.Conclusion:This study suggests that the quality of life of beta thalassemia major patients is dependent on type of iron chelation treatment which they received, the gender they have, the comorbidities they suffer and socio-economical situations they live in.
authors.affiliation: Pharmaceutical Management and Economics Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Meysam
authors.initials: M
authors.lastname: Seyedifar
authors.affiliation: Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Farid Abedin
authors.initials: FA
authors.lastname: Dorkoosh
authors.affiliation: Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Amir Ali
authors.initials: AA
authors.lastname: Hamidieh
authors.affiliation: Department of Pediatrics Hematology-Oncology, Ali-Ebne Abitaleb Hospital Research Center for Children and Adolescent Health [RCCAH], Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Naderi
authors.affiliation: Thalassemia Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Karami
authors.affiliation: Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mehran
authors.initials: M
authors.lastname: Karimi
authors.affiliation: Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Fadaiyrayeny
authors.affiliation: Department of Pediatrics Hematology-Oncology, Ali-Ebne Abitaleb Hospital Research Center for Children and Adolescent Health [RCCAH], Zahedan University of Medical Sciences, Zahedan, Iran.
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Musavi
authors.affiliation: MSc Student of Nursing, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran.
authors.forename: Sanaz
authors.initials: S
authors.lastname: Safaei
authors.affiliation: Department of Traditional Medicine, Medicinal Plants Research Center of Barij, Kashan, Iran.
authors.forename: Mohammad Mahdi
authors.initials: MM
authors.lastname: Ahmadian-Attari
authors.affiliation: Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran; Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Molouk
authors.initials: M
authors.lastname: Hadjibabaie
authors.affiliation: Faculty of Pharmacy, University of Baqiyatallah Medical Sciences, Tehran, Iran.
authors.forename: Abdol Majid
authors.initials: AM
authors.lastname: Cheraghali
authors.affiliation: Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Akbari Sari
keywords: Health utility; Iran; Iron chelators; Quality of life; Thalassemia