Assessment of Health-Related Quality of Life Among Patients Infected With HIV Receiving Care in a Nigerian Tertiary Hospital.

OBJECTIVES: Globally, an appropriate estimate of the health-related quality of life (HRQoL) of people living with HIV/AIDS (PLWHA) is essential for the economic evaluation of antiretroviral therapy (ART) programs to ensure optimal value for money. Therefore, this article aimed to evaluate the HRQoL of PLWHA on ART and to explore its predictors. METHODS: A cross-sectional study was conducted among PLWHA in an ART clinic of a Nigerian tertiary hospital. The participants were selected through a computer-based simple random sampling technique. The study instrument used for data collection was the English-language version of the European Quality of Life (EQ-5D-5L). The participants completed the questionnaire in the waiting room of the clinic, and the patients' clinical data were retrieved from their medical records. Descriptive statistics and multivariate linear regression were used for data analysis. P<.05 was considered statistically significant. RESULTS: Out of the 352 participants, the majority were female (66.5%), and more than half (56.2%) had a CD4 count fewer than 500 cells/mm3. The EQ-5D index and utility score of the study population were 0.72 ± 4.18 and 73.05 ± 10.36, respectively. The significant predictors of EQ-5D index were the number of children (ß = -0.215, P=.026), CD4 count (ß = 0.171, P=.030), and duration on ART (ß = -0.144, P=.011). CONCLUSIONS: Our findings suggest that PLWHA receiving ART in Nigeria had good HRQoL. However, concerted efforts targeted at improving CD4 cell count and reducing the family burden of PLWHA would enhance their HRQoL.

Satisfaction of Nigerian patients with health services: a protocol for a systematic review.

BACKGROUND: Patient-based assessment of health services is becoming popular in measuring the standard of care. Both quantitative and qualitative methods are available. Patient satisfaction surveys are commonly used to record the experiences of patients in hospitals, whereas qualitative designs (e.g., interviews and focus group discussions) are used less frequently. To date, there has been no systematic review published devoted to patient satisfaction with health services in Nigeria. We aim to (1) systematically analyze relevant quantitative studies to pinpoint excellent procedures in measuring patient satisfaction with health services, (2) to investigate if a reference method (gold standard method) exists, and (3) to identify relevant topics which are recognized by patients as important for the delivery of a high-quality health service in Nigeria. METHODS: Searches of eight electronic journal databases, including MEDLINE, EMBASE, CINAHL, PsycINFO, AJOL, CDSR, DARE, and HTA will be conducted to identify studies assessing patient satisfaction with health services in Nigeria. The searches will be supported by manual searches in reference lists of relevant primary studies and systematic reviews. The review will be limited to studies published since 2007. After a stepwise screening process by two reviewers, data from included studies will be extracted and reviewed. The COSMIN RoB checklist will be used to critically appraise included studies. We will carry out an extensive data synthesis to answer the review questions. DISCUSSION: The intended systematic review will provide information on how the satisfaction of patients with health services has earlier been described and assessed in Nigerian studies. It will establish if a gold standard method exists and synthesize information on topics which might be of special interest to patients. Review findings will enrich the debate on patient-centered care and overall performance of health quality standards in Nigeria. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018108140.