Health Related Quality of Life among Medical Representatives

Objective: Medical Representatives’ work involves lot of stress and burnout as reported by many studies. Hence the study is one of the first attempt to identify the factors influencing health related quality of life among the surveyed population of medical representatives. Methods: In this study a structured questionnaire was used to collect the socio-demographic information from the Medical Representatives. EuroQol5 Dimension questionnaire was used to record the self-reported health related quality of life among the surveyed medical representatives. Kruskal-Wallis test was performed to compare the median VAS scores and BMI as well as other lifestyle related factors. Results: The mean age of the respondents was 27.55±4.79 years. More than half of the medical representatives use to travel more than 15Km daily and equal number were found not doing any physical activity other than job related work. 42 percent of the medical representatives were in the pre-obese category of BMI. Lack of involvement in physical activity other than routine work, and consumption of Junk/Fried food has a significant influence on HRQoL of respondents. Conclusion: Study found that lack of physical activity as a major factor which affected the health related quality of life among the medical representatives. When this is coupled with other lifestyle factors and occupation related stress it may lead to burnout, affecting the overall performance of the medical representatives. Key-words: Medical Representative, Occupational health, HRQoL, India. Correspondence : Pradeep M. Muragundi Assistant Professor, Senior Scale Dept. of Pharmacy Management MCOPS, Manipal University Manipal-576104, India. Telephone: +918202922482 ; Mobile: +919880377572 ; Fax: +91 8202571998 E-mail: [email protected]; [email protected] DOI: 10.5530/jyp.2016.1.5 PICTORIAL ABSTRACT KOTLO et al.: “HRQoL among Medical Representatives” Journal of Young Pharmacists, Vol 8, Issue 1, Jan-Mar 2016 19 period of 5 months, from November 2013 to March 2014. A questionnaire containing closed ended multiple choice questions and open ended questions were distributed to a total of 260 Medical Representatives (MRs) in these regions. The representatives, irrespective of their designation given by the company, but essentially performing the task of promoting a pharmaceutical company’s products to physicians in assigned territories, were eligible to participate. The face validity of the questionnaire was established and the questionnaire was pilot tested for its content among 15 medical representatives. Based on the feedback and suggestions from MRs, the questionnaire was modified. All the medical representatives were orally explained about the study and informed consent was obtained from all MRs who were willing to participate in the study. The questionnaire consisted of two sections. The first section captured demographic and socioeconomic characteristics such as age, gender, marital status, education, number of dependents and annual income. The questionnaire also consisted of questions to collect work related information such as distance of work place from home, average duration of work hours and number of outstation work days per month. Further the responses relating to lifestyle factors such as physical activity other than work, number of hours of sleep daily, consumption of tea/ coffee, consumption of alcohol, junk/fried food consumption and habit of cigarette smoking were also collected using the questionnaire. Questions pertaining to family history of lifestyle diseases, presence of lifestyle diseases among the working MRs, frequency of health check-up, and Body Mass Index (BMI) were included to collect relevant information to address study objectives. The second section of the questionnaire intends to measure Health Related Quality of Life (HRQoL) among MRs, for which EuroQolEQ-5D-5L questionnaire was used as it covers wide range of health conditions. It provides descriptive measure and single index measure of HRQoL and is used for both economic and clinical outcome measurements. The instrument is found to be a valid tool in assessing the HRQoL among Indians.7 EQ-5D is very easy to understand and quick to complete, hence makes it suitable for addressing objectives of survey and the study we intended to conduct.8,9 The EQ 5D-5L questionnaire contains descriptive measurements of five dimensions of health such as mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has five levels, no problems, slight problems, moderate problems, severe problems, and extreme problems. The participants were asked to complete self-rating visual analogue scale (VAS), in addition to the questionnaire. The participants were requested to complete three page EQ-5D-5Lquestionnaire. This self-rating leads to one digit number expressing the level indicating the respondents’ health. The five digit number obtained by combining all the digits of five dimensions indicates overall health of the respondent. The score of 11111 indicate no problems on all the dimensions whereas the score of 55555 indicates extreme problems. The third page of EQ-5D-5L questionnaire contains a 20 cm vertical visual analogue scale with bottom end mentioning “worst possible health” one can imagine and top end mentioning the“best possible health”. The VAS is split in to 100 equal units with number zero at the bottom and number one hundred at the top. The questionnaire asks the respondents to put X on the scale and also to indicate the number in the box provided, to indicate their level of health on that particular day. The five digit score indicating the descriptive score was converted to a score of 0 to 1 by EQ5D questionnaire health scoring system. The ethical approval for the conduct of the study was obtained from Manipal University ethics committee (UESC/12/2011). The participants were asked to sign informed consent before responding to the questionnaire, and the information provided was used only for research purpose. Table 1: Demographic and socio economic characteristics of Medical Representatives