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Kiadó: The Royal Society of Medicine Press
New Directions in Chronic Pain 5
The multidimensional, subjective phenomenon of health related quality of life (HRQOL) is difficult to define. In one of the simpler definitions, this concept is described as an individual's satisfaction with domains of life that affect, or are affected by, health. One point that is clear among the confusion, however, is that chronic pain has a detrimental effect on almost all aspects of HRQOL, limiting the ability of patients to work, maintain social relationships and role functions, and to lead a productive life.
HRQOL is increasingly being recognized as the single most important outcome to be measured in the evaluation of medical therapies. It is a more subtle indicator than the usual outcomes of efficacy and safety, but is probably a better indicator of treatment value, patient satisfaction and likely compliance. By incorporating the assessment of HRQOL into medical research, healthcare providers are encouraged to focus on the patient's perspective on health, disease and medical treatments. However, HRQOL is complex to understand and to study and substantial barriers to its assessment exist. Even those clinicians who view HRQOL as important have difficulty finding the time to assess it and there is a lack of clarity about which instruments to use.
This fifth publication in the New Directions in Cbronic Pain series explores the assessment of HRQOL. The numerous definitions of HRQOL are discussed and the multidimensional, subjective nature of this phenomenon is outlined. Choosing an appropriate instrument to assess HRQOL from the many available is not easy; this choice is helped by understanding the psychometric properties of the instruments, and the different approaches taken in assessing HRQOL. The difference between the evaluation of HRQOL and the evaluation of utility or health status is highlighted. The impact of chronic pain on HRQOL is reviewed, and the assessment of HRQOL in studies of sustained release opioid analgesics is outlined.
Earlier publications in this series explored the pharmacokinetics, tolerability and efficacy of sustained release opioids in chronic pain, the use of sustained release opiolds in special populations (eg the elderly), the association of sleep disorders with chronic pain, and pain assessment. A future publication will explore the myths and misconceptions surrounding the use of oploids for pain relief.