General health questionnaire

Goldberg, D. (1978). Manual of the General Health Questionnaire. Windsor, UK NFER-Nelson. 

The study of HRQOL requires a multidimensional approach. Assessments must include components that evaluate, at a minimum, the health concepts of physical functioning, social and role functioning, mental health, and perception of general health. In addition, the full continuum of these concepts must be included, from the most limited to the healthiest. Approaches to capture HRQOL data include the self-administered questionnaire, personal interview, telephone interview, observation, and postal survey. The assessment instruments must possess acceptable reliability, validity, and sensitivity, and the investigators and the participants must accept them. Psychometrics... 

The SF36 (8) has eight component scores labeled physical function, physical role limitation, bodily pain, general health, vitality, social function, emotional role limitation, mental health, plus a single item on the reported health transition over the last year. Each dimension is scored separately and then transformed to a 0 to 100 scale, with lower scores indicating poorer health. The physical and mental component categories are collapsed to produce two summary scores, the physical component score (PCS) and the mental component score (MCS). The questionnaire takes 5 to 10 minutes to complete and is self-administered. 

As the evidence accumulates that ED is a marker for asymptomatic CAD its importance as a barometer of the vasculature generally is being appreciated. Vlachopoulos et al. studied 50 asymptomatic men for CAD with ED and performed angiography in 47 (28). Nine (19%) had angiographic silent CAD. In a health screening program in Vienna 2869 men aged 20 to 80 years completed the International Index to Erectile Function (IIEF) questionnaire (29). Men with moderate to severe ED but not mild ED had a 10-year relative risk increase... 

Other consequences of banning thioridazine have been reported in a rural general practice in Ireland, in which 29 of 40 GPs responded to a questionnaire and 17 reported management problems and adverse reactions (29). There was increased service demand, as 44% of the GPs described up to a 50% increase in referrals to the mental health service although most of the GPs (67%) reported satisfaction with alternative agents, 37% described adverse effects associated with the alternative agents. It seems reasonable that directives should incorporate the flexibility required to accommodate the needs of patients who are already successfully stabilized on these drugs. 

Prior to the intervention, the pharmacist would assess health outcome measures such as blood pressure, current medication adherence, and forms such as a general form (e.g., SF-36) and a disease-specific form (e.g., Hyperten-sion/Lipid Form 5.1) (Appendix 4). After the pharmacist intervention, a predetermined period of time must elapse before these questionnaires can be repeated (e.g., 6-12 mo). The questionnaires and blood pressure assessments are then repeated and it is determined whether the intervention had any effect on the patient outcome. 

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