Vol.:(0123456789) 1 3
Quality of Life Research (2019) 28:321–334
https://doi.org/10.1007/s11136-018-1986-1
REVIEW
Health-related quality of life (HRQoL) in beta-thalassemia major (β-
TM) patients assessed by 36-item short form health survey (SF-36):
a meta-analysis
Mahdieh Arian
1
· Majid Mirmohammadkhani
2
· Raheb Ghorbani
3
· Mohsen Soleimani
4
Accepted: 30 August 2018 / Published online: 7 September 2018
© Springer Nature Switzerland AG 2018
Abstract
Purpose The main purpose of this meta-analysis was to evaluate the impact of beta-thalassemia major (BTM) on the health-
related quality of life as assessed by the medical outcomes short-form-36 questionnaire (SF-36).
Methods A systematic literature search was performed on Cochrane library, Web of Science, Scopus, Science Direct,
ProQues, Medline/PubMed, Scholar Google until March 17, 2017 to obtain eligible studies. A fxed efect model was applied
to summarize the scores of each domain. The radar chart was used to compare the scores of BTM patients with other health
conditions. Spearman’s correlation analysis and meta-regression were used to explore the related factors.
Results 26 studies were included in this study, which were all reliable to summarize the scores of the SF36. Pooled mean
scores of the physical health domains ranged from 52.74 to 74.5, with the GH and PF domains being the lowest and the
highest, respectively. Further, the pooled mean scores of the mental health domains varied between 59.6 and 71.11, with
the (MH-VT) and SF domains being the maximum and the minimum, respectively. Patients with BTM had a substantially
compromised HRQoL in comparison with the general population.
Conclusion BTM could adversely afect the HRQoL of patients. Measuring HRQoL should be considered as an essential part
of the overall assessment of health status of BTM patients, which would provide valuable clues for improving the manage-
ment of disease and making decisions on the treatment.
Keywords Beta-thalassemia major · Health-related quality of life · Medical outcomes short-form-36 questionnaire · SF-36 ·
Meta-analysis
Introduction
Beta-thalassemia major (β-TM) is considered as an inher-
ited hemoglobinopathy which can be passed to a person
following mutations in the genes constructing the beta-
globin chain [1]. Given the fact that the thalassemia het-
erozygous form is resistant to malaria, the prevalence of
thalassemia minor in malaria-prone areas is reported to be
high and thus the thalassemia gene can be transmitted to
next generations [2, 3]. The thalassemia belt regions also
encompass the Mediterranean nations (Southern European
countries including Italy, Greece, and Cyprus), the Ara-
bian Peninsula, as well as parts of Africa, Turkey, Iran,
India, South-east Asia especially Thailand, Cambodia,
and Southern China. The prevalence rates of thalassemia-
related genetic disorders in these areas are estimated to
be 2.5–15%. In general, about 3% of the world’s popula-
tion is known to be carriers of beta-thalassemia gene [4].
* Mohsen Soleimani
soli257@yahoo.com
Mahdieh Arian
arianyem@gmail.com
Majid Mirmohammadkhani
majidmirmohammadkhani@yahoo.com
Raheb Ghorbani
ghorbani.raheb93@gmail.com
1
Student Research Committee, Faculty of Nursing
and Midwifery, Semnan University of Medical Sciences,
Semnan, Iran
2
Social Determinants of Health Research Center, Semnan
University of Medical Sciences, Semnan, Iran
3
Social Determinants of Health Research Center, Semnan
University of Medical Sciences, Semnan, Iran
4
Nursing Care Research Center, Nursing and Midwifery
Faculty, Semnan University of Medical Sciences, Semnan,
Iran