The strengths of this study are the relative large patient series and the long follow-up period. The limitations are that only one instrument was used to measure the HRQOL and the background factors were ignored. Some degree of loss is inevitable in patient groups followed up for a long time, and this may affect the results, here specifically the results concerning HRQoL. This study did not analyze the effectiveness of the different interventions in the long run because the patients’ baseline characteristics in the three groups were different. No predictive statistical comparisons of HRQoL were made in the different treatment groups. No separate analysis of the different pharmacological treatment regimes was done. No power analysis was done.