Health-state utility of patients with HER2-positive breast cancer in Vietnam: A multicenter cross-sectional study.

BACKGROUND: Patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer may have poor prognoses and short overall and disease-free survival. Most previous studies focused on assessing the quality of life and health-state utility of the general population of breast cancer patients. The number of studies for HER2-positive breast cancer patients is negligible. This study investigated the health-state utility and its associated factors among Vietnamese patients with HER2-positive breast cancer. METHODS: We conducted face-to-face interviews with 301 HER2-positive breast cancer patients to collect data. Their health-state utility was measured via the EQ-5D-5L instrument. The Mann-Whitney U and Kruskal-Wallis tests were employed to compare the differences in utility scores between two groups and among three groups or more, respectively. Factors associated with patients' heath-state utility were identified via Tobit regression models. RESULTS: Pain/discomfort (56.1%) and anxiety/depression (39.5%) were the two issues that patients suffered from the most, especially among metastatic breast cancer patients. The severity of distress (depression, anxiety, and stress) in patients was relatively mild. Of 301 patients, their average utility score was 0.86±0.17 (range: 0.03-1.00), and the average EQ-visual analogue scale (VAS) score was 69.12±12.60 (range: 30-100). These figures were 0.79±0.21 and 65.20±13.20 for 102 metastatic breast cancer patients, significantly lower than those of 199 non-metastatic cancer patients (0.89±0.13 and 71.13±11.78) (p<0.001), respectively. Lower health-state utility scores were significantly associated with older age (p = 0.002), lower education level (p = 0.006), lower monthly income (p = 0.036), metastatic cancer (p = 0.001), lower EQ-VAS score (p<0.001), and more severe level of distress (p<0.001). CONCLUSIONS: Our findings showed a significant decrement in utility scores among metastatic breast cancer patients. Patients' health-state utility differed by their demographic characteristics (age, education level, and income) and clinical characteristics (stage of cancer and distress). Their utility scores may support further cost-effectiveness analysis in Vietnam.

Determining the factors impacting the quality of life among the general population in coastal communities in central Vietnam.

People living in coastal areas are frequently affected by natural disasters, such as floods and storms. This study aimed to assess the quality of life (QoL) of people living in disadvantaged coastal communes (subdivision of Vietnam) and identify their associated factors by using the World Health Organization's quality of life instrument (WHOQOL-BREF). To achieve this, a cross-sectional descriptive study was conducted on 595 individuals aged 18 years and above living in the coastal communes in Thua Thien Hue province, Vietnam, from October 2022 to February 2023. The results showed that the mean overall QoL (mean ± SD) was 61.1 ± 10.8. Among the four domains of QoL, the physical health (57.2 ± 12.3) domain had a lower score than the psychological health (61.9 ± 13.0), social relations (63.4 ± 13.4), and environment (61.9 ± 13.3) domains. The QoL score of the domains for participants affected by flooding was significantly lower than that of those not affected, except for social relations. Multivariable logistic regression showed that subjects with not good QoL had the educational background with no formal education (Odds ratio (OR) = 2.63, 95% CI 1.19-5.83), fairly poor/poor households (OR = 2.75, 95% CI 1.48-5.12), suffered Musculoskeletal diseases (OR = 1.61, 95% CI 1.02-2.56), unsatisfaction with health status (OR = 5.27, 95% CI 2.44-11.37), family conflicts (OR = 4.51, 95%CI 2.10-9.69), and low levels of social support (OR = 2.62; 95% CI 1.14-6.02). The analysis also revealed that workers (OR = 0.17, 95% CI 0.04-0.66) had a better QoL than farmer-fisherman. QoL in disadvantaged coastal communes was low, with the lowest scores in the physical health domain. Based on the socioeconomic factors associated with not good QoL identified here, it is recommended that local authorities take more appropriate and practical measures to increase support, including measures for all aspects of physical health, psychological health, social relations, and the living environment, especially for people affected by floods.

Is Social Support Associated with Colorectal Cancer Care Utilization? A Multilevel Mixed-Effects Model of a Cross-Sectional Cohort Study in Vietnam.

OBJECTIVE: To investigate the relationship between the social support (SS) and colorectal cancer (CRC) care utilization of patients in the central region of Vietnam. METHODS: This was a cross-sectional cohort study in which the cohort was defined as all residential patients diagnosed with CRC in a tertiary hospital, Hue Central Hospital (HCH), in central Vietnam from 2013 to 2019. Social support was considered the main independent variable and was evaluated using the Medical Outcomes Study Social Support Survey (MOS-SSS), a self-administered 19-item SS survey. MOS-SSS is a widely used scale for assessing social support in CRC patients because it is brief, easy to use, reliable, and valid. In this study, we considered a data framework with a multilevel structure that included the patient level and duration of diagnosis as the second level. We estimated the magnitude of SS and CRC-specific treatment modalities using multilevel mixed-effects (MM) models under a hierarchical approach. RESULTS: The findings indicated that CRC care utilization rates were 89.9%, 48.5%, and 30.6% for surgical resection, chemotherapy, and radiation therapy, respectively. The overall trend of SS decreased significantly and affected the CRC care utilization. We found a positive effects of overall SS, as well as emotional and tangible support, on the number of hospitalization admissions and chemotherapy utilization. CONCLUSION: This study suggests that the use of the MOS-SSS should be continued in the long term for CRC patients to enhance medical accessibility and care utilization.