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Melikova NA, Filatova EG, Filatova ES. [Features of fibromyalgia in patients with rheumatoid arthritis]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:28-36. [PMID: 38465808 DOI: 10.17116/jnevro202412402128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To determine the features of fibromyalgia (FM) in patients with rheumatoid arthritis (RA). MATERIAL AND METHODS Seventy-six patients participated in the study. The patients were divided into 2 groups: RA+FM (n=55), FM (n=21). Anamnesis of life and disease was carefully collected in all patients. The intensity (according to VAS) and phenotype (Pain DETECT, DN4) of pain syndrome (PS), the presence of symptoms of central sensitization (CSI), fatigue (FSS), signs of anxiety and depression (HADS), sleep quality (PSQI), cognitive functions (DSST) and quality of life (QoL) (EQ-5D, FIQR) were also evaluated. RESULTS The average age of patients in the FM group was significantly lower (42 [35; 53] vs. 50 [42.5; 59], p=0.042). Patients with «pure» FM without RA were more often divorced and had no children (p=0.045 and p=0.02, respectively). The duration of PS in the groups did not differ (11 [7; 17] vs. 8 [5; 13] years, p=0.429), however, patients with «pure» FM waited longer for diagnosis (115 [40; 198] vs. 20 [5.5; 59] months, p<0.001), and they also were less likely to be recognized as disabled (p=0.003). Patients of both groups had equally severe fatigue, anxiety, depression, sleep disorders and cognitive functions compared to the norms. Patients of the FM group noted a lower QoL (according to EQ-5D, p=0.041) then in RA+FM group, despite the comparable severity of FM and the intensity of the PS in both groups. CONCLUSION FM in patients with RA develops at a later age compared to «pure» FM. The clinical picture of FM with and without RA does not differ in the main manifestations, however, the QoL of patients with «pure» FM is lower. Accounting for fibromyalgia in the treatment of rheumatoid diseases can significantly improve the QoL of patients.
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Affiliation(s)
- N A Melikova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Nasonova Research Institute of Rheumatology, Moscow, Russia
| | - E G Filatova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - E S Filatova
- Nasonova Research Institute of Rheumatology, Moscow, Russia
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Ristic B, Carletto A, Fracassi E, Pacenza G, Zanetti G, Pistillo F, Cristofalo D, Bixio R, Bonetto C, Tosato S. Comparison and potential determinants of health-related quality of life among rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis: A cross-sectional study. J Psychosom Res 2023; 175:111512. [PMID: 37844390 DOI: 10.1016/j.jpsychores.2023.111512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES This study aimed to compare the health-related quality of life scores among rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis and to evaluate socio-demographic and clinical determinantes of quality of life across diseases. METHODS The sample comprised 490 patients with rheumatoid arthritis, 198 with psoriatic arthritis, and 119 with spondyloarthritis who completed a series of health examinations and self-reported questionnaires. Quality of life was evaluated using the Short-Form 36 Health Survey, disease activity by DAS28-CRP, DAPSA, and ASDAS-CRP (for rheumatoid arthritis, psoriatic arthritis, and spondyloarthritis, respectively), depression and anxiety using the Hospital Anxiety and Depression Scale. ANOVA was used to compare the quality of life dimensions and their physical and mental summary measures among rheumatic diseases, and multivariate analysis was used to explore their potential determinants. RESULTS Rheumatoid arthritis had significantly worse scores than spondyloarthritis in the following dimensions: physical functioning, role limitation due to physical health, physical component score, and mental health. Psoriatic arthritis was not significantly different from the other two diseases. Multivariate analysis revealed that physical quality of life was mainly associated with disease activity across rheumatic diseases, rheumatological treatment and depression in rheumatoid arthritis and psoriatic arthritis. Mental quality of life is primarily associated with depression and anxiety across rheumatic diseases. CONCLUSION There were differences in quality of life among patients with inflammatory rheumatic diseases, but overall, approximately uniform factors explained the variance in quality of life across diseases. Clinicians should develop general approaches and strategies for inflammatory rheumatic diseases to improve patients' quality of life.
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Affiliation(s)
- Branko Ristic
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona; Verona, Italy
| | - Antonio Carletto
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Elena Fracassi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Giulio Pacenza
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona; Verona, Italy
| | - Giulia Zanetti
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Francesca Pistillo
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Doriana Cristofalo
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona; Verona, Italy
| | - Riccardo Bixio
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona; Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona; Verona, Italy.
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Landgren AJ, Klingberg E, Jacobsson L, Bergsten U, Dehlin M. Health-related quality of life in gout, psoriatic arthritis, rheumatoid arthritis and ankylosing spondylitis, results from a cross-sectional survey in Western Sweden. Scand J Rheumatol 2023; 52:506-518. [PMID: 36745082 DOI: 10.1080/03009742.2022.2157962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 12/09/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Inflammatory joint diseases (IJDs) substantially affect health-related quality of life (HRQoL). We aimed to compare HRQoL between patients with gout, psoriatic arthritis (PsA), rheumatoid arthritis (RA), and ankylosing spondylitis (AS): (i) overall; (ii) stratified by sex; and (iii) between women and men with the same IJD diagnosis. METHOD A survey including the RAND36-Item Health Survey for assessing HRQoL was sent to patients with a diagnosis of gout, PsA, RA, or AS, registered at a rheumatology clinic or primary care centre during 2015-2017. HRQoL was compared across IJDs. Because of age differences between diagnoses, age-matched analyses were performed. RESULTS In total, 2896/5130 (56.5%) individuals responded to the questionnaire. Of these, 868 had gout, 699 PsA, 742 RA, and 587 AS. Physical component summary (PCS) scores were more affected than mental component summary (MCS) scores for all diagnoses (PCS range: 39.7-41.2; MCS range: 43.7-48.9). Patients with gout reported better PCS scores than patients with PsA, RA, and AS, who reported similar scores in age-matched analysis. MCS scores were close to normative values for the general population and similar across IJDs. When comparing women and men with respective IJDs, women reported worse PCS (range, all IJDs: 34.5-37.4 vs 37.5-42.5) and MCS (PsA: 44.0 vs 46.8; RA: 46.1 vs 48.7) scores. CONCLUSION We found that patients with gout reported better PCS scores than patients with other IJDs, for whom the results were similar. Women reported overall worse PCS and MCS scores than men.
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Affiliation(s)
- A J Landgren
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research and Development Primary Health Care, Gothenburg, Södra Bohuslän, Sweden
| | - E Klingberg
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lth Jacobsson
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - U Bergsten
- R&D Department, Region Halland, Halmstad, Sweden
| | - M Dehlin
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Liao C, Tao S, Xiong Y, Dai J, Bai Y, Wang X, Li Y, Wu P. The Effects and Potential Mechanisms of Moxibustion for Rheumatoid Arthritis-Related Pain: A Randomized, Controlled Trial. J Pain Res 2023; 16:1739-1749. [PMID: 37261035 PMCID: PMC10228586 DOI: 10.2147/jpr.s408814] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/09/2023] [Indexed: 06/02/2023] Open
Abstract
Purpose To investigate the effects of moxibustion in relieving pain, and other clinical symptoms for patients with rheumatoid arthritis (RA), and explore the potential mechanism of moxibustion treatment for RA. Patients and Methods Seventy qualified RA patients were randomly assigned in a 1:1 ratio to the moxibustion group or the routine group. The routine group only took oral methotrexate tablets and folic acid tablets. The moxibustion group was treated with moxibustion based on oral pharmaceutical. Moxibustion was performed two times weekly for 8 weeks, a total of 16 sessions. Patients scored their pain on a visual analog scale (VAS). The American College of Rheumatology improvement criteria of 20%, 50% and 70% (ACR20, ACR50 and ACR70) after treatment were investigated. Clinical symptoms, a disease activity score using 28 joint counts (DAS28), simplified disease activity index (SDAI), clinical disease activity index (CDAI), health assessment questionnaire (HAQ), interleukin 1β (IL-1β), tumor necrosis factor-alpha (TNF-α), and vascular endothelial growth factor (VEGF) of RA patients were analyzed before and after treatment. Results After treatment, the VAS scores, tender and swollen joint counts, morning stiffness scores, disease activity scores (DAS28, SDAI, CDAI), HAQ scores in the two groups were both improved, and the effects of moxibustion group were more obvious (P < 0.05). The ACR20 and ACR50 of the moxibustion group were greater than that of the routine group (P < 0.05), no significant difference of the ACR70 existed between the two groups (P > 0.05). In addition, the decreases of IL-1β, TNF-α, VEGF of the moxibustion group were better than that of the routine group (P < 0.05). Conclusion Moxibustion could effectively relieve pain, ameliorate the clinical symptoms, and decrease the disease activity of RA. The potential mechanism may be the decrease in the level of serum inflammatory factors.
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Affiliation(s)
- Chenxi Liao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Siyu Tao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Yan Xiong
- Department of Osteoporosis, Huaxi Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Jingyang Dai
- Department of Traditional Chinese Medicine, Chengdu Fifth People’s Hospital, Chengdu, People’s Republic of China
| | - Yu Bai
- Department of Traditional Chinese Medicine, Chengdu Second People’s Hospital, Chengdu, People’s Republic of China
| | - Xue Wang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Yuan Li
- Department of Rheumatology, The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
| | - Ping Wu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China
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Santos H, Henriques AR, Branco J, Machado PM, Canhão H, Pimentel-Santos FM, Rodrigues AM. Health-related quality of life among spondyloarthritis and chronic low back pain patients: results from a nationwide population-based survey. Qual Life Res 2023; 32:383-399. [PMID: 36308590 DOI: 10.1007/s11136-022-03274-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Both spondyloarthritis and chronic low back pain (CLBP) significantly impact health-related quality of life (HRQoL). It is important to clarify whether these disorders have different impacts on the several domains of HRQoL as different mechanisms may necessitate different treatment interventions. Moreover, the factors associated with HRQoL can inform more targeted group interventions to promote HRQoL. METHODS We used data from EpiReumaPt, a population-based survey conducted from September 2011 to December 2013. HRQoL was assessed with EuroQoL-5-Dimensions (EQ-5D). Spondyloarthritis was diagnosed by expert opinion (rheumatologist) and predefined criteria. CLBP was diagnosed if low back pain was present on the day of the interview and persisted for > 90 days. Univariable and multivariable linear regression analyses compared HRQoL among subjects with spondyloarthritis, CLBP, and no rheumatic diseases. Multivariable linear regression analyses evaluated HRQoL factors in spondyloarthritis and CLBP subjects. RESULTS We included 92 spondyloarthritis patients, 1376 CLBP patients, and 679 subjects without rheumatic diseases. HRQoL was similarly affected in spondyloarthritis and CLBP (ß = - 0.03, 95% CI [- 0.08; 0.03]) in all EQ5D dimensions. A much lower HRQoL was found in spondyloarthritis and CLBP patients compared with subjects without rheumatic diseases (ß = - 0.14, 95% CI [- 0.19; - 0.10]; ß = - 0.12, 95% CI [- 0.14; - 0.09], respectively). In spondyloarthritis subjects, multimorbidity and active disease were associated with worse HRQoL (ß = - 0.18; 95% CI [- 0.24; 0.03]; ß = - 0.13; 95% CI [- 0.29; - 0.05], respectively), and regular physical exercise was associated with better HRQoL (ß = 0.18; 95% CI [0.10; 0.30]). In CLBP subjects, multimorbidity (β = - 0.11; 95% CI [- 0.14; - 0.08]), obesity (β = - 0.04; 95% CI [- 0.08; - 0.01]), and low back pain intensity (β = - 0.02; 95% CI [- 0.03; - 0.02]) were associated with worse HRQoL, and regular physical exercise (β = 0.08; 95% CI [0.05; 0.11]) was significantly associated with better HRQoL. CONCLUSION Spondyloarthritis and CLBP subjects reported similar levels of impairment in the mental, physical, and social domains of HRQoL. Future health plans should address modifiable factors associated with HRQoL in these conditions to achieve better outcomes.
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Affiliation(s)
- Helena Santos
- Nova Medical School, EpiDoc Unit/Comprehensive Health Research Center, Instituto Português de Reumatologia, Rua da Beneficência, n 7, 1050-034, Lisbon, Portugal.
| | - Ana Rita Henriques
- Nova Medical School, EpiDoc Unit/Comprehensive Health Research Center, Lisbon, Portugal
| | - Jaime Branco
- Nova Medical School, EpiDoc Unit/Comprehensive Health Research Center, Lisbon, Portugal
| | - Pedro M Machado
- Centre for Rheumatology and Department of Neuromuscular Diseases, University College of London, London, UK
| | - Helena Canhão
- Nova Medical School, EpiDoc Unit/Comprehensive Health Research Center, Lisbon, Portugal
| | | | - Ana Maria Rodrigues
- Nova Medical School, EpiDoc Unit/Comprehensive Health Research Center, Lisbon, Portugal
- Hospital Dos Lusíadas, Lisbon, Portugal
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Cengiz F, Günaydin N. How Do Cognition and Emotion Regulation Strategies and Intolerance of Uncertainty Predict the Severity of Fatigue and Daily Life Activities of Rheumatoid Arthritis Patients? JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2022. [DOI: 10.1007/s10942-022-00480-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Life among Chinese fibromyalgia patients: a cross-sectional study. Clin Rheumatol 2022; 41:3479-3485. [PMID: 35831690 DOI: 10.1007/s10067-022-06290-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/20/2022] [Accepted: 07/07/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study is to examine the impact of age on the clinical characteristics, fibromyalgia-related symptom severity and quality of life (QOL) among Chinese fibromyalgia patients. METHODS A packet of questionnaires on demographics, medical history, and severity of six major symptoms of fibromyalgia (i.e., pain, fatigue, sleep quality, depression, stress, and QOL) was completed by 124 Chinese patients. The patients were stratified into three groups by age (32 (25.8%) "young" patients, ≤ 39 years; 73 (58.9%) "middle-age" patients, 40-59 years; and 19 (15.3%) "older" patients, ≥ 60 years). Analysis of covariance was conducted and adjusted for body mass index and symptom fibromyalgia duration. RESULTS The majority of patients in this study were women (107, 86.3%), and the mean age was 49.4 years (SD 10.8 years). Pairwise comparisons among the three age groups found that the young and middle-aged patients were significantly more troubled than the older patients by their symptoms in several categories: morning tiredness (P ≤ 0.012), depression (P ≤ 0.002), anxiety (P ≤ 0.004), mental health index (P ≤ 0.002), and mental component summary score (P ≤ 0.017). The middle-aged patients reported more trouble than the older patients with regard to social functioning (P = 0.008), emotional roles (P = 0.012), depression (P = 0.012), and sleep quality (P = 0.017). The young patients exhibited the highest levels of current experienced stress (young vs. old, P = 0.013). CONCLUSION This study has identified that middle-aged Chinese fibromyalgia patients exhibited less compromise of their QOL than did their older peers. This discrepancy begs a logical explanation and deserves further study. Key Points • This is the first clinical study to show the potential effect of age on fibromyalgia patients in China. • Characteristics, symptom severity, and QOL differ in different age groups. • The younger patients are, the worse their quality of life.
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Galvez-Sánchez CM, Duschek S, Del Paso GAR. Is reduced health-related quality of life a primary manifestation of fibromyalgia? A comparative study with Rheumatoid arthritis. Psychol Health 2022:1-19. [PMID: 35694814 DOI: 10.1080/08870446.2022.2085705] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 12/26/2021] [Accepted: 05/27/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Fibromyalgia syndrome (FMS) is a chronic pain condition associated with a significant reduction in health-related quality of life (HRQoL). This study compared the different components of HRQoL between FMS and rheumatoid arthritis (RA) patients, and evaluated the relationships between HRQoL and clinical and emotional factors in FMS and RA patients. METHOD Women with FMS (n = 80), RA (n = 43) and healthy women (n = 67) participated in the study. HRQoL was assessed by the SF-36 survey. Associations between HRQoL and symptom severity were assessed by correlation and multiple linear regression analyses. RESULTS FMS patients displayed lower values for all SF-36 variables than RA patients and healthy participants, while RA patients showed lower values for all SF-36 variables than healthy participants. These group differences persisted after statistically controlling for demographic, clinical and emotional variables. Clinical and emotional factors were inversely associated with SF-36 scores in the overall FMS + RA sample. Depression and fatigue were the strongest negative predictors. However, after the statistical control of the effect of diagnosis (FMS vs. RA) in the regression analysis, most of the associations disappear. CONCLUSIONS The fact that group differences in HRQoL remained highly significant after statistically controlling of group differences in clinical symptom severity, and that associations between clinical symptoms and HRQoL disappear when the type of diagnosis was considered in the regression analysis, suggest that impairment of HRQoL could be considered a primary feature of FMS.
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Affiliation(s)
| | - Stefan Duschek
- Department of Psychology, UMIT TIROL-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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S B, Naidu G, Sharma A, Minz RW, Gupta A, Baishya J. Peripheral nervous system involvement in Sjogren's syndrome and its impact on quality of life. Clin Exp Med 2022; 23:539-545. [PMID: 35666344 DOI: 10.1007/s10238-022-00837-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/26/2022] [Indexed: 11/29/2022]
Abstract
Sjogren's syndrome (SS) is a multisystem disorder of autoimmune etiology, which can be primary or secondary. Quality of life in SS depends on severity of involvement of different systems. The aims of this study are to analyze peripheral nervous system involvement in primary and secondary SS and its impact on quality of life (QOL). In this cross-sectional observational study conducted between January 2020 and June 2021, 67 patients of SS attending to this tertiary care center were included. Nerve conduction study and sympathetic skin response test were done in all cases. QOL was assessed with SF-36 questionnaire. Out of 67 cases, 50 had primary and 17 had secondary SS. 50.7% of cases had peripheral neuropathy. In primary SS, prevalence of peripheral neuropathy was 56% as against 35.3% in secondary. 50% of peripheral neuropathy were asymptomatic and were diagnosed after electrodiagnostic tests. Polyneuropathy was the most common pattern. There was no difference of other system involvement or immunological markers among those with and without peripheral neuropathy in either primary or secondary SS. Cases with peripheral neuropathy in the primary Sjogren's group and in the cohort as a whole scored significantly lower in 7 domains of SF-36. Peripheral nervous system involvement is common in Sjogren's syndrome, and most of them are asymptomatic. Peripheral neuropathy has significant impact on QOL in people with SS. Early detection and halting the progression of asymptomatic cases can be helpful in improving QOL.
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Affiliation(s)
- Balaraja S
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Gsrsnk Naidu
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aman Sharma
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ranjana W Minz
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amit Gupta
- Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jitupam Baishya
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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Ability to Participate in Social Activities of Rheumatoid Arthritis Patients Compared with Other Rheumatic Diseases: A Cross-Sectional Observational Study. Diagnostics (Basel) 2021; 11:diagnostics11122258. [PMID: 34943495 PMCID: PMC8700244 DOI: 10.3390/diagnostics11122258] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To compare the ability to participate in social activities among rheumatoid arthritis patients with other rheumatic disease patients and identify potentially implicated factors. PATIENTS AND METHODS Between June and November 2019, we consecutively selected patients aged ≥18 years with RA (defined according to ACR/EULAR 2010), SpA (ASAS/EULAR 2010), and SLE (ACR 1997). MAIN OUTCOME MEASURES Ability to participate in social roles and activities evaluated using the PROMIS score v2.0 short-form 8a (PROMIS-APS). SECONDARY OUTCOMES Participation in social activities according to a series of variables (mobility, depression, satisfaction with social relationships, social isolation, company, emotional support, instrumental support, and support via information). We evaluated the association between the ability to participate in social activities and associated variables using multivariable linear regression analysis. RESULTS The study population comprised 50 patients with RA (33.1%), 51 patients (33.8%) with SpA, and 50 patients (33.1%) with SLE. The mean PROMIS-APS scores were similar in the three groups. The multivariable analysis for the whole sample showed that the ability to participate in social activities was inversely associated with depression and directly with social satisfaction, mobility, company, and age. The stratified analysis revealed an inverse association between inflammatory activity and ability to participate in social activities in patients with RA and SpA, but not in those with SLE. CONCLUSION All patients with RA, SpA, and SLE had a similar ability to participate in social activities. This was associated with other psychosocial factors (social satisfaction, mobility, company, depression) and clinical factors (age and inflammatory activity).
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Kiltz U, Wei JCC, van der Heijde D, van den Bosch F, Walsh JA, Boonen A, Gensler LS, Hunter T, Carlier H, Dong Y, Li X, Bolce R, Strand V, Braun J. Ixekizumab Improves Functioning and Health in the Treatment of Radiographic Axial Spondyloarthritis: Week 52 Results from 2 Pivotal Studies. J Rheumatol 2020; 48:188-197. [DOI: 10.3899/jrheum.200093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2020] [Indexed: 12/20/2022]
Abstract
Objective.This study evaluated the effect of ixekizumab (IXE) on self-reported functioning and health in patients with radiographic axial spondyloarthritis (r-axSpA) who were either biological disease-modifying antirheumatic drug (bDMARD)–naïve or failed at least 1 tumor necrosis factor inhibitor (TNFi).Methods.In 2 multicenter, randomized, double-blind, placebo-controlled, and active-controlled (bDMARD-naïve only) trials, patients with r-axSpA were randomly assigned to receive 80 mg of IXE [every 2 weeks (Q2W) or every 4 weeks (Q4W)], placebo (PBO), or adalimumab (ADA; bDMARD-naïve only). After 16 weeks, patients who received PBO or ADA were rerandomized to receive IXE (Q2W or Q4W) up to Week 52. Functioning and health were measured by the generic 36-item Short Form Health Survey (SF-36) and the disease-specific Assessment of Spondyloarthritis international Society Health Index (ASAS HI). Societal health utility was assessed by the 5-level EuroQol-5 Dimension (EQ-5D-5L).Results.At Week 16, both doses of IXE in bDMARD-naïve and TNFi-experienced patients resulted in larger improvement in SF-36, ASAS HI, and EQ-5D-5L versus placebo. For SF-36, the largest improvements were seen for the domains of bodily pain, physical function, and role physical. A larger proportion of patients reaching improvement in ASAS HI ≥ 3 as well as an achievement of ASAS HI good health status was reported in patients treated with IXE. Improvements were maintained through Week 52.Conclusion.IXE significantly improved functioning and health as assessed by both generic and disease-specific measures, as well as societal health utility values in patients with r-axSpA, as measured by SF-36, ASAS HI, and EQ-5D-5L at Week 16, and improvements were sustained through 52 weeks.
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Jaskólska M, Chylińska M, Masiak A, Nowicka-Sauer K, Siemiński M, Ziętkiewicz M, Czuszyńska Z, Zdrojewski Z. Peripheral neuropathy and health-related quality of life in patients with primary Sjögren's syndrome: a preliminary report. Rheumatol Int 2020; 40:1267-1274. [PMID: 32172462 PMCID: PMC7316843 DOI: 10.1007/s00296-020-04543-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 02/27/2020] [Indexed: 12/20/2022]
Abstract
Sjögren's syndrome (SS) is a chronic autoimmune disease with a wide spectrum of possible organ involvement. Peripheral (PNS) and central nervous system (CNS)-related symptoms may occur in the course of the disease. The aim of this study was to compare the health-related quality of life (HR-QOL) in SS patients with and without peripheral neuropathy. The study involved 50 patients with primary Sjögren's syndrome (pSS). All patients underwent neurological clinical examination followed by nerve conduction studies (NCS) and rheumatological examination. Thirty-six-item Short Form Health Survey (SF-36) was used for evaluating HR-QOL. To assess pSS activity, the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) and EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) were used. For the assessment of clinical disability due to peripheral neuropathy, the Overall Disability Sum Score scale (ODSS) was used. Additional evaluation of pain was performed with the use of the Visual Analogue Scale (VAS) and a semistructured interview. Twenty-three (46%) patients were diagnosed with peripheral neuropathy. The most common PNS manifestation was sensorimotor neuropathy (47%). Neurological symptoms preceded the diagnosis of pSS in eight patients. The following domains of the SF-36 form were significantly lower scored by patients with peripheral nervous system involvement: role-physical [0 (0-100) vs. 75 (0-100)], role-emotional [67 (0-100) vs. 100 (0-100)], vitality [40 (10-70) vs. 50 (20-75)], bodily pain [45 (10-75) vs. 55 (0-100)], and general health [20 (5-50) vs. 30 (0-50)] (p ≤ 0.05). Our study showed that peripheral neuropathy was a common organ-specific complication in SS patients. In pSS patients, coexisting neurological involvement with symptoms such as pain and physical disability may be responsible for diminished HR-QOL.
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Affiliation(s)
- Marta Jaskólska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdańsk, Poland.
| | | | - Anna Masiak
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdańsk, Poland
| | | | - Mariusz Siemiński
- Department of Adult Neurology, Medical University of Gdansk, Gdańsk, Poland
| | - Marcin Ziętkiewicz
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdańsk, Poland
| | - Zenobia Czuszyńska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdańsk, Poland
| | - Zbigniew Zdrojewski
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdańsk, Poland
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Pain catastrophizing mediates the negative influence of pain and trait-anxiety on health-related quality of life in fibromyalgia. Qual Life Res 2020; 29:1871-1881. [PMID: 32112278 DOI: 10.1007/s11136-020-02457-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Patients with fibromyalgia syndrome (FMS) usually display a decrease in health-related quality of life (HRQoL). This decrease in HRQoL is related to clinical pain, anxiety, and depression. This cross-sectional study analyzes the mediating role of pain-coping strategies (especially catastrophizing) in the negative relationships of pain, anxiety, depression, and HRQoL in FMS. METHODS One hundred and thirteen women with FMS and 63 healthy women were assessed using the Short-Form Health Survey (SF-36). Participants completed self-report questionnaires to evaluate clinical pain, anxiety, depression, and pain-coping strategies. RESULTS Pain catastrophizing was inversely associated with the physical function, general health perception, vitality, emotional role, mental health, the physical and mental general components, and the global index of HRQoL, with percentages of variance explained ranging between 9 and 18%. Cognitive distraction showed a positive association with the physical function, general health perception, vitality, emotional role, mental health, physical component, and global index of HRQoL, with percentages of variance explained ranging between 4 and 7%. Mediation analysis showed that catastrophizing mediates the negative influence of clinical pain and trait-anxiety on the physical function, general health perception, vitality, mental health, and global index of HRQoL. No mediating effect of pain catastrophizing on the relation between depression and HRQoL was observed. CONCLUSIONS Patients with FMS exhibited markedly lower HRQoL than healthy individuals. While pain catastrophizing was inversely related to several domains of HRQL, associations were positive for cognitive distraction. Catastrophizing mediates the negative influence of clinical pain and trait-anxiety on HRQoL. Therefore, cognitive behavioral treatments focused on adaptive management and control of catastrophizing and negative emotional states may be helpful.
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Bucourt E, Martaillé V, Goupille P, Joncker-Vannier I, Huttenberger B, Réveillère C, Mulleman D, Courtois AR. A Comparative Study of Fibromyalgia, Rheumatoid Arthritis, Spondyloarthritis, and Sjögren’s Syndrome; Impact of the Disease on Quality of Life, Psychological Adjustment, and Use of Coping Strategies. PAIN MEDICINE 2019; 22:372-381. [DOI: 10.1093/pm/pnz255] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Fibromyalgia, rheumatoid arthritis, spondyloarthritis, and Sjögren’s syndrome are chronic rheumatic diseases with very different clinical characteristics, but which share symptoms such as pain and fatigue. The aim of the study was to examine the impact of the disease on psychological adaptation in fibromyalgia compared with other rheumatic diseases (rheumatoid arthritis, spondyloarthritis, and Sjögren’s syndrome).
Methods
In a multicenter study, 165 women with rheumatic diseases (48 with fibromyalgia, 47 with rheumatoid arthritis, 47 with spondyloarthritis, 23 with Sjögren’s syndrome) completed the General Health Questionnaire–28 (emotional distress), Fatigue Severity Scale (fatigue), Fibromyalgia Impact Questionnaire (impact of the disease), Coping Strategies Questionnaire (coping), and Mini International Neuropsychiatric Interview (comorbidity with DSM IV axis-I disorders). We used the Kruskal-Wallis test, Mann-Whitney U test, and chi2 test to compare comorbid anxiety and depressive disorders and to compare the impact of the disease on patients’ mental well-being and daily life and adjustment (coping strategies).
Results
Anxiety and depressive disorders were more common in fibromyalgia patients; they had higher scores on impact of the disease, physical symptoms, pain, and fatigue than rheumatoid arthritis patients and reported more fatigue than patients with spondyloarthritis. Overall, they used more maladaptive coping strategies (less use of distancing from pain than patients with rheumatoid arthritis and spondyloarthritis, less use of ignoring pain sensations, and more use of catastrophizing than those with rheumatoid arthritis). No differences were found between fibromyalgia and Sjögren’s syndrome on impact and adjustment.
Conclusions
Compared with other rheumatic diseases, fibromyalgia has a greater impact on daily life; patients have more difficulty adjusting to the disease and generally use poorer strategies to cope with pain.
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Affiliation(s)
- Emilie Bucourt
- Département de Psychologie, Université de Tours, EE 1901 Qualipsy ‘Qualité de Vie et Santé Psychologique,’ Tours Cedex, France
| | - Virginie Martaillé
- Service de Rhumatologie, CHRU de Tours, Université de Tours, Tours, France
| | - Philippe Goupille
- Service de Rhumatologie, CHRU de Tours, Université de Tours, Tours, France
| | | | - Brigitte Huttenberger
- Plastique de la Face et Stomatologie, Service de Chirurgie Maxillo-Faciale, CHRU de Tours, Université de Tours, Tours, France
| | - Christian Réveillère
- Département de Psychologie, Université de Tours, EE 1901 Qualipsy ‘Qualité de Vie et Santé Psychologique,’ Tours Cedex, France
| | - Denis Mulleman
- Service de Rhumatologie, CHRU de Tours, Université de Tours, Tours, France
| | - and Robert Courtois
- Département de Psychologie, Université de Tours, EE 1901 Qualipsy ‘Qualité de Vie et Santé Psychologique,’ Tours Cedex, France
- CHRU de Tours, Clinique Psychiatrique Universitaire, Tours Cedex, France
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Nørgaard K, Kielgast U. Quality of Life is Markedly Impaired by Rheumatological and Skin Manifestations in Patients with Type 1 Diabetes: A Questionnaire Survey. Diabetes Ther 2019; 10:635-647. [PMID: 30778903 PMCID: PMC6437232 DOI: 10.1007/s13300-019-0587-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION To estimate lifetime prevalence of diabetes-related upper limb and non-acquired skin manifestations in a representative type 1 diabetes (T1D) population and to identify associations between these conditions and quality of life. METHODS A questionnaire on these complications and measures of quality of life (World Health Organization-Five Well-Being Index [WHO-5]), depression, and diabetes-specific burden (Problem Areas in Diabetes [PAID] scale) was sent to all T1D patients in a Danish clinic (N = 583). RESULTS The response rate was 68.6%. Lifetime prevalence of any upper limb soft tissue lesion was 72%; prevalence of any skin lesion was 10.5%. Frozen shoulder and vitiligo were most common upper limb and skin manifestation, at a prevalence of 53 and 9.1%, respectively. Compared to patients with no skin lesion, those with at least one skin lesion had more depression (19 vs. 33%; P < 0.01) and lower WHO-5 scores. Frozen shoulder was associated with lower WHO-5 scores (P < 0.001), more depression (29 vs. 14%; P < 0.001), and a higher PAID score (P < 0.01). A diagnosis of carpal tunnel syndrome was associated with lower WHO-5 scores (P < 0.001), a higher risk of depression (29 vs. 16%; P < 0.01), and a higher PAID score (P < 0.001). CONCLUSION Upper limb soft tissue lesions and diabetes-specific non-acquired skin lesions are very common in patients with T1D and strongly associated with impaired life quality and increased risk of depression.
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Affiliation(s)
- Kirsten Nørgaard
- Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.
| | - Urd Kielgast
- Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Zealand University Hospital, Køge, Denmark
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16
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Resistance Training Improves Quality of Life and Associated Factors in Patients With Fibromyalgia Syndrome. PM R 2019; 11:703-709. [DOI: 10.1016/j.pmrj.2018.09.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 02/05/2023]
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17
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Derraik JGB, Albert BB, de Bock M, Butler ÉM, Hofman PL, Cutfield WS. Socioeconomic status is not associated with health-related quality of life in a group of overweight middle-aged men. PeerJ 2018; 6:e5193. [PMID: 30013848 PMCID: PMC6047501 DOI: 10.7717/peerj.5193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 06/18/2018] [Indexed: 01/22/2023] Open
Abstract
Socioeconomic status is a known determinant of health. In secondary data analyses, we assessed whether socioeconomic status affected health-related quality of life in a group of overweight (body mass index 25–30 kg/m2) middle-aged (45.9 ± 5.4 years) men, recruited in Auckland (New Zealand). Health-related quality of life was assessed with SF-36v2 three times: at baseline, and 12 and 30 weeks later. Socioeconomic status was determined by geo-coded deprivation scores derived from current address using the New Zealand Index of Deprivation 2006 (NZDep2006), as well as capital value of residence. Univariable and multivariable analyses showed no associations between measures of socioeconomic status and any mental or physical health domains. Our findings may reflect the fact that these men are not currently experiencing comorbidities associated with overweight.
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Affiliation(s)
- José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start-National Science Challenge, Auckland, New Zealand.,Department of Women's and Children's Health, Uppsala Universitet, Uppsala, Sweden
| | | | - Martin de Bock
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Éadaoin M Butler
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start-National Science Challenge, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start-National Science Challenge, Auckland, New Zealand
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18
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Affiliation(s)
- Tania Gudu
- Research Center of Rheumatic Diseases, Sf Maria Hospital, University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Laure Gossec
- Department of Rheumatology, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique; AP-HP, Pitié Salpêtrière Hospital, Paris, France
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Sanabria Mazo JP, Gers M. IMPLICACIONES DEL DOLOR CRÓNICO EN LA CALIDAD DE VIDA DE MUJERES CON FIBROMIALGIA. PSICOLOGIA EM ESTUDO 2018. [DOI: 10.4025/psicolestud.v23i0.38447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
El objetivo de esta investigación fue comprender las implicaciones del dolor crónico en la calidad de vida de un grupo de mujeres diagnosticadas con fibromialgia. Para ello, se realizó un estudio cualitativo de diseño fenomenológico interpretativo en el que participaron 15 mujeres, con edades comprendidas entre los 23 y los 60 años. El análisis de los datos se realizó con el apoyo del programa Atlas.Ti. Los resultados indican que la intensidad de los síntomas, la interferencia del dolor crónico en actividades cotidianas, las alteraciones emocionales y las cogniciones negativas influyeron en su vida personal, familiar, social y laboral. Las estrategias de afrontamiento que asumieron las participantes facilitaron u obstaculizaron la aceptación de la enfermedad. Se concluye que el impacto de la fibromialgia en la calidad de vida depende más de las estrategias de afrontamiento que de los síntomas de la enfermedad. Las redes de apoyo facilitan el desarrollo de estrategias activas para afrontar la enfermedad.
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20
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Fitzcharles MA, Brachaniec M, Cooper L, Dubin R, Flynn T, Gerhold K, Häuser W, Cowan K, Laupacis A, Marleau R, Milot M, Szajcz-Keller N, Sumpton J, Walsh Z, El-Gabalawy H. A paradigm change to inform fibromyalgia research priorities by engaging patients and health care professionals. CANADIAN JOURNAL OF PAIN-REVUE CANADIENNE DE LA DOULEUR 2017; 1:137-147. [PMID: 35005349 PMCID: PMC8730558 DOI: 10.1080/24740527.2017.1374820] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: Research objectives should be focused toward advancing knowledge that has meaningful impact on health. However, research agendas are mostly driven by the health care community, with limited input from patients. Aims: In this study, prioirities of uncertainties for the management of fibromyalgia (FM) that could propel future research were identified by a defined process using the James Lind Alliance Priority Setting Partnership (JLA-PSP) methodology. Methods: As a first step, a survey was distributed across Canada that engaged patients, caregivers, and health care professionals to provide narrative input to eight open-ended questions regarding FM care. Responses were thematically condensed and synthesized into an initial list of 43 uncertainties used to guide a comprehensive literature search. Questions already effectively addressed in the literature were excluded, leaving 25 uncertainties that were ranked during a one-day consensus workshop. Results: Three broad themes emerged: the value of personalized targeted treatment and subgrouping of patients; the efficacy of various self-management strategies and educational initiatives; and identification of the ideal health care setting to provide FM care. Opioids and cannabinoids were the only specific pharmacologic interventions ranked as needing further research. Conclusions: The prioritized questions highlight the importance of recognizing the heterogeneity of FM symptoms, the need for a personalized treatment approach, and a better understanding of the value of self-management strategies. This is the first study that uses an established and transparent methodology to engage all FM stakeholders to help inform researchers and funding bodies of clinically relevant research priorities.
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Affiliation(s)
- Mary-Ann Fitzcharles
- Division of Rheumatology and Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal, QC, Canada
| | | | | | - Ruth Dubin
- Department of Family Medicine, Queen’s University, Kingston, Canada
| | | | - Kerstin Gerhold
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada
| | - Winfried Häuser
- Department of Internal Medicine 1, Klinikum Saarbrücken, Saarbrücken, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Technische Universität München, Munich, Germany
| | | | - Andreas Laupacis
- Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto and Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | | | - Nicole Szajcz-Keller
- Canadian Institutes for Health Research, Institute of Musculoskeletal Health and Arthritis, Winnipeg, MB, Canada
| | - Janice Sumpton
- Department of Pharmacy, London Health Sciences Centre, London, ON, Canada
| | - Zach Walsh
- Department of Psychology, University of British Columbia, Kelowna, BC, Canada
| | - Hani El-Gabalawy
- Canadian Institutes for Health Research, Institute of Musculoskeletal Health and Arthritis, Winnipeg, MB, Canada
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21
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Liu L, Xu X, Xu N, Wang L. Disease activity, resilience and health-related quality of life in Chinese patients with rheumatoid arthritis: a multi-center, cross-sectional study. Health Qual Life Outcomes 2017; 15:149. [PMID: 28738816 PMCID: PMC5525274 DOI: 10.1186/s12955-017-0725-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 07/19/2017] [Indexed: 02/05/2023] Open
Abstract
Background Positive psychological constructs that can moderate or mediate the negative impact of disease activity on health-related quality of life (HRQOL) in patients with rheumatoid arthritis (RA) have not been explored widely. This study aimed to assess the associations of disease activity, resilience with HRQOL and the moderating and mediating roles of resilience among Chinese RA patients. Methods A multi-center, cross-sectional study was conducted in RA inpatients in northeast of China. A total 298 subjects completed the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and Ego-Resiliency Scale (ERS) to measure HRQOL and resilience. For the SF-36, physical function, physical role limitation, bodily pain and general health perception are gathered into physical component summary (PCS), while vitality, social functioning, emotional role limitation and mental health are gathered into mental component summary (MCS). Disease activity was evaluated by the Disease Activity Score 28-C-reactive protein (DAS28-CRP). Hierarchical regression analysis was applied to examine the associations of disease activity, resilience and the disease activity*resilience interaction with PCS and MCS, respectively. Asymptotic and resampling strategies were utilized to examine the mediating role of resilience. Results The mean scores of PCS and MCS were 40.67 and 59.14, respectively. Disease activity was negatively associated with both PCS and MCS, and resilience was only positively associated with MCS. The disease activity*resilience interaction term were significantly associated with MCS (β = 0.144, P = 0.003). The associations between disease activity and MCS were gradually reduced in low (1 SD below the mean, β = −0.369, P < 0.001), mean (β = −0.218, P < 0.001) and high (1 SD above the mean, β = −0.068, P = 0.369) groups of resilience. Resilience acted as a partial mediator in the disease activity-MCS association (effect size was −0.085, BCa 95% CI: −0.159, −0.028). Conclusions Disease activity was negatively associated with both physical and mental HRQOL, and resilience was only positively associated with mental HRQOL. Resilience could attenuate and mediate the association between disease activity and mental HRQOL. In addition to controlling disease activity, targeted intervention strategies designed for resilience should be strengthened to improve the HRQOL of this population.
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Affiliation(s)
- Li Liu
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, People's Republic of China
| | - Xin Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, People's Republic of China
| | - Neili Xu
- Department of Rheumatology, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, Liaoning, 110004, People's Republic of China
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, 110122, People's Republic of China.
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Georgopoulou S, Efraimidou S, MacLennan SJ, Ibrahim F, Cox T. The relationship between social support and health-related quality of life in patients with antiphospholipid (hughes) syndrome. Mod Rheumatol 2017; 28:147-155. [DOI: 10.1080/14397595.2017.1317319] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sofia Georgopoulou
- Academic Department of Rheumatology, King’s College London, School of Medicine, London, United Kingdom
| | - Sofia Efraimidou
- Centre for Sustainable Working Life, Birkbeck University of London, United Kingdom
| | | | - Fowzia Ibrahim
- Academic Department of Rheumatology, King’s College London, School of Medicine, London, United Kingdom
| | - Thomas Cox
- Centre for Sustainable Working Life, Birkbeck University of London, United Kingdom
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Chen HH, Chen DY, Chen YM, Lai KL. Health-related quality of life and utility: comparison of ankylosing spondylitis, rheumatoid arthritis, and systemic lupus erythematosus patients in Taiwan. Clin Rheumatol 2016; 36:133-142. [PMID: 27837342 DOI: 10.1007/s10067-016-3471-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 09/28/2016] [Accepted: 10/27/2016] [Indexed: 01/14/2023]
Abstract
The purpose of this study was to evaluate the health-related quality of life among patients with ankylosing spondylitis (AS), rheumatoid arthritis (RA), or systemic lupus erythematosus (SLE). This prospective, cross-sectional survey was conducted from September 1, 2008 to August 31, 2009. Patients answered questions with regard to demographics and disease characteristics and also completed generic (SF-36) and preference-based utility (SF-6D and EQ-5D) instruments. Multivariate analysis assessed the relationship of RA and SLE to AS with respect to the outcomes of the different health-related quality of life instruments. In general, baseline and disease characteristics differed across the three disease groups. Compared to SLE patients, RA patients scored worse on the higher-order summary scores of physical (PCS) and mental components (MCS) of SF-36 (P ≤ 0.002) and total SF-36 (P ≤ 0.005). RA also had worse PCS than AS (P ≤ 0.001). SLE patients scored higher on the utility score of SF-6D compared with RA patients and higher than both AS and RA patients for the utility score of EQ-5D. Multivariate analysis found that compared with AS patients, RA had significantly lower SF-36 total score and PCS, and SLE patients had greater PCS and a greater EQ-5D utility score. Multivariate analysis found no difference across the patient groups with respect to MCS or SF-6D utility score. These findings suggest that among the three rheumatic diseases studied, RA patients have the worse health-related quality of life, and AS patients have similar or poorer health-related quality of life as SLE patient.
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Affiliation(s)
- Hsin-Hua Chen
- Department of Medical Research, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Boulevard, Taichung, 40705, Taiwan.
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, Taiwan.
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
- School of Medicine, Chung-Shan Medical University, Taichung, Taiwan.
- Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan.
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.
| | - Der-Yuan Chen
- Department of Medical Research, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Boulevard, Taichung, 40705, Taiwan
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, Chung-Shan Medical University, Taichung, Taiwan
- Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yi-Ming Chen
- Department of Medical Research, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Boulevard, Taichung, 40705, Taiwan
- Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Kuo-Lung Lai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
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The health-related quality of life of ankylosing spondylitis patients assessed by SF-36: a systematic review and meta-analysis. Qual Life Res 2016; 25:2711-2723. [PMID: 27324038 DOI: 10.1007/s11136-016-1345-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2016] [Indexed: 12/26/2022]
Abstract
PURPOSE The main purpose of this meta-analysis was to evaluate the impact of ankylosing spondylitis on the health-related quality of life assessed by the Medical Outcomes Short-Form-36 questionnaire (SF-36). METHODS A systematic literature search was performed on PubMed and Web of Science until January 22, 2016 to obtain eligible studies. Random effect model was performed to summarize the scores of each domain. The radar chart was used to compare the scores of AS patients with other health conditions. Spearman's correlation analysis and meta-regression were used to explore the related factors. STATA (version 11.0) and SPSS (version 13.0) were adopted in this meta-analysis. RESULTS Thirty-eight studies were included in this study, which were all reliable to summarize the scores of the SF-36. Pooled mean scores of the physical health domains ranged from 45.93 to 58.17, with the RP and PF domains being the lowest and the highest, respectively. Pooled mean scores of the mental health domains ranged from 47.49 to 62.52, with the VT and SF domains being the lowest and the highest, respectively. Besides, the physical component summary was lower than the mental component summary. BASDAI and BASFI were negatively associated with some domains of the SF-36 significantly. Patients with AS had a substantial impaired HRQoL in comparison with the general population. CONCLUSIONS AS could adversely affect the HRQoL of patients. Measuring HRQoL should be considered as an essential part of the overall assessment of health status of AS patients, which would provide valuable clues for improving the management of disease and making decisions regarding treatment.
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Caglayan M, Gunes M, Bozkurt M, Nas K. Assessment of Quality of Life, Psychological and Functional Status and Disease Activity in Patients with Ankylosing Spondylitis and Fibromyalgia. JOURNAL OF CLINICAL AND EXPERIMENTAL INVESTIGATIONS 2016. [DOI: 10.5799/jcei.328679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Hoeksema L, Los LI. Vision-Related Quality of Life in Patients with Inactive HLA-B27-Associated-Spectrum Anterior Uveitis. PLoS One 2016; 11:e0146956. [PMID: 26808922 PMCID: PMC4725670 DOI: 10.1371/journal.pone.0146956] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 12/22/2015] [Indexed: 11/18/2022] Open
Abstract
We investigated the vision-related quality of life (VR-QOL) in patients with HLA-B27 associated anterior uveitis (AU). The study was conducted in 2012 at the ophthalmology department of the University Medical Center of Groningen. We included AU patients who were HLA-B27 positive and/or were diagnosed by a rheumatologist with an HLA-B27 associated systemic disease. Sixty-one of 123 (50%) adult patients participated. All patients filled-out the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25), Beck Depression Inventory (BDI-II), social support lists and an additional questionnaire for gathering general information. Medical records were reviewed for clinical characteristics. Analyses were conducted on various patient and ocular characteristics. We compared our NEI VFQ-25 scores with those previously found in the literature. Our main outcome measures were VR-QOL scores and their associations with various general patient and ocular characteristics. We found that the NEI VFQ-25 mean overall composite score was 88.9±8.8, which is relatively high, but lower than that found in a normal working population. The mean general health score was 47.4±20.8, which is lower than in patients with other ocular diseases. Patients with a systemic disease scored significantly lower on general health and VR-QOL, compared to patients without a systemic disease. Patients with a depression (6/59 (10%)) frequently had ankylosing spondylitis (5/6 patients) and they scored significantly worse on VR-QOL. We concluded that patients with HLA-B27 associated AU have a relatively high VR-QOL. However, the presence of a systemic disease is associated with lower VR-QOL and general health scores. In addition, depression is associated with a lower VR-QOL.
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Affiliation(s)
- Lisette Hoeksema
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- W.J. Kolff Institute, Graduate School of Medical Sciences, University of Groningen, Groningen, the Netherlands
- * E-mail:
| | - Leonoor I. Los
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- W.J. Kolff Institute, Graduate School of Medical Sciences, University of Groningen, Groningen, the Netherlands
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Uguz F, Kucuk A, Cicek E, Kayhan F, Salli A, Guncu H, Çilli AS. Quality of life in rheumatological patients: The impact of personality disorders. Int J Psychiatry Med 2015; 49:199-207. [PMID: 25930734 DOI: 10.1177/0091217415582183] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Rheumatological diseases are associated with lower quality of life (QoL) levels. Psychiatric disturbances are frequently observed in these patients. This study examined the impact of personality disorders on the QoL of patients with rheumatological diseases. METHOD The study sample consisted of 142 participants including patients suffering from rheumatological disease with a personality disorder (n = 30), without any personality disorder (n = 112), and healthy control participants without physical or psychiatric disorders (n = 60). The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I) and the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders (SCID-II) were used to determine Axis I and Axis II psychiatric disorders, respectively. QoL levels were assessed by means of the World Health Organization QoL Assessment-Brief. RESULTS The subscale scores of physical health, psychological health, and social relationships were significantly lower in patients with rheumatological disease regardless of the existence of personality disorder compared with the control participants. Rheumatological patients with a personality disorder had significantly lower subscale scores of psychological health (p = 0.003) and social relationships (p < 0.003) compared with patients without any personality disorder. CONCLUSIONS Personality disorders seem to be a relevant factor that maybe associated with QoL in patients suffering from rheumatological disease.
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Affiliation(s)
- Faruk Uguz
- Department of Psychiatry, Meram Faculty of Medicine, University of Necmettin Erbakan, Konya, Turkey
| | - Adem Kucuk
- Department of Rheumatology, Meram Faculty of Medicine, University of Necmettin Erbakan, Konya, Turkey
| | - Erdinc Cicek
- Department of Psychiatry, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Fatih Kayhan
- Department of Psychiatry, Faculty of Medicine, Mevlana University, Konya, Turkey
| | - Ali Salli
- Department of Psychiatry, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Hatice Guncu
- Department of Psychiatry, Meram Faculty of Medicine, University of Necmettin Erbakan, Konya, Turkey
| | - Ali Savas Çilli
- Department of Psychiatry, Meram Faculty of Medicine, University of Necmettin Erbakan, Konya, Turkey
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Jiao J, Davis III JM, Cha SS, Luedtke CA, Vincent A, Oh TH. Association of rheumatic diseases with symptom severity, quality of life, and treatment outcome in patients with fibromyalgia. Scand J Rheumatol 2015; 45:49-56. [DOI: 10.3109/03009742.2015.1052553] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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del Pozo-Cruz J, Alfonso-Rosa RM, Castillo-Cuerva A, Sañudo B, Nolan P, del Pozo-Cruz B. Depression symptoms are associated with key health outcomes in women with fibromyalgia: a cross-sectional study. Int J Rheum Dis 2015; 20:798-808. [DOI: 10.1111/1756-185x.12564] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jesús del Pozo-Cruz
- Department of Physical Education and Sports; University of Seville; Seville Spain
| | - Rosa M. Alfonso-Rosa
- Department of Physical Education and Sports; University of Seville; Seville Spain
| | | | - Borja Sañudo
- Department of Physical Education and Sports; University of Seville; Seville Spain
| | - Paul Nolan
- Department of Sport and Exercise Science; University of Auckland; Auckland New Zealand
| | - Borja del Pozo-Cruz
- Department of Sport and Exercise Science; University of Auckland; Auckland New Zealand
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Rohekar S, Chan J, Tse SM, Haroon N, Chandran V, Bessette L, Mosher D, Flanagan C, Keen KJ, Adams K, Mallinson M, Thorne C, Rahman P, Gladman DD, Inman RD. 2014 Update of the Canadian Rheumatology Association/Spondyloarthritis Research Consortium of Canada Treatment Recommendations for the Management of Spondyloarthritis. Part I: Principles of the Management of Spondyloarthritis in Canada. J Rheumatol 2015; 42:654-64. [DOI: 10.3899/jrheum.141000] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2014] [Indexed: 01/04/2023]
Abstract
Objective.The Canadian Rheumatology Association (CRA) and the Spondyloarthritis Research Consortium of Canada (SPARCC) have collaborated to update the recommendations for the management of spondyloarthritis (SpA).Methods.A working group was assembled and consisted of the SPARCC executive committee, rheumatologist leaders from SPARCC collaborating sites, Canadian rheumatologists from across the country with an interest in SpA (both academic and community), a rheumatology trainee with an interest in SpA, an epidemiologist/health services researcher, a member of the CRA executive, a member of the CRA therapeutics committee, and a patient representative from the Canadian Spondylitis Association. An extensive review was conducted of literature published from 2007 to 2014 involving the management of SpA. The working group created draft recommendations using multiple rounds of Web-based surveys and an in-person conference. A survey was sent to the membership of the CRA to obtain an extended review that was used to finalize the recommendations.Results.Guidelines for the management of SpA were created. Part I focuses on the principles of management of SpA in Canada and includes 6 general management principles, 5 ethical considerations, target groups for treatment recommendations, 2 wait time recommendations, and recommendations for disease monitoring. Also included are 6 modifications for application to juvenile SpA.Conclusion.These recommendations were developed based on current literature and applied to a Canadian healthcare context. It is hoped that the implementation of these recommendations will promote best practices in the treatment of SpA.
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Llewellyn AM, Skevington SM. Using guided individualised feedback to review self-reported quality of life in health and its importance. Psychol Health 2014; 30:301-17. [PMID: 25280244 DOI: 10.1080/08870446.2014.972396] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This pilot study investigated the effects of providing guided, individualised feedback on subjective quality of life (QoL), using results from the multidimensional WHOQOL-BREF profile. Participants (n = 129; 85 chronically ill) were recruited in the community, and primary care. They were randomised to receive written or verbal guidance on interpreting a new graphical summary profile, which simultaneously presented (a) their individual self-ratings of QoL and (b) the importance attributed to each QoL dimension. Before and after feedback, participants completed health status, subjective QoL, QoL Importance, goal-oriented QoL and mood measures. Receiving individualised feedback was associated with increased psychological QoL, with modest effect size. No effects were found for physical, social or environmental QoL or QoL importance, health status, mood or goal-oriented QoL. There were no differences between modes of delivering guidance, indicating equal effectiveness. Chronic illness participants reported poorer QoL, moved more slowly towards their QoL goals, and had larger differences between core QoL and QoL Importance than healthy participants. Guided individualised empirical feedback about QoL judgements could be used to promote psychological well-being. Although professional interpretation of feedback is unnecessary, if shared, patients' profiled WHOQOL information could support self-monitoring, self-management and clinical decision-making.
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Affiliation(s)
- Alison M Llewellyn
- a Department of Psychology , WHO Centre for the Study of Quality of Life, University of Bath , Bath , UK
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Kotsis K, Voulgari PV, Drosos AA, Carvalho AF, Hyphantis T. Health-related quality of life in patients with ankylosing spondylitis: a comprehensive review. Expert Rev Pharmacoecon Outcomes Res 2014; 14:857-72. [PMID: 25193010 DOI: 10.1586/14737167.2014.957679] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Ankylosing spondylitis (AS) is a complex systemic rheumatological disease which often causes severe disability and impaired quality of life (QoL). We searched the PubMed/MEDLINE electronic database for available literature on QoL and its predictors in patients with AS. Recent evidence indicates that AS patients have poorer QoL compared to the general population, but similar to that of patients with other rheumatological disorders. Disease activity is one of the most powerful predictors of QoL, however latest advances in pharmacological treatment (namely, anti-TNF-α) along with physical exercise can minimize the effects of AS on QoL. Psychological distress symptoms contribute to impaired QoL both directly and indirectly by influencing disease activity. The impact of other psychosocial variables, however, is less studied and more prospective investigations are necessary, which could eventually lead to the development of psychosocial interventions that are personalized to this patient population.
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Affiliation(s)
- Konstantinos Kotsis
- Department of Psychiatry, Division of Medicine, School of Health Sciences, University of Ioannina, Ioannina 45110, Greece
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Jiao J, Vincent A, Cha SS, Luedtke CA, Oh TH. Relation of age with symptom severity and quality of life in patients with fibromyalgia. Mayo Clin Proc 2014; 89:199-206. [PMID: 24485133 DOI: 10.1016/j.mayocp.2013.09.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 09/24/2013] [Accepted: 09/30/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the relation of age with symptom severity and quality of life (QOL) in patients with fibromyalgia, and to compare physical and mental health of our female patients with those of the US female general population. PATIENTS AND METHODS We studied 978 patients with fibromyalgia from May 1, 2001 through April 30, 2004, and divided them into age groups of young (≤39 years), middle-aged (40-59 years), and older (≥60 years). They completed the Fibromyalgia Impact Questionnaire and the Short Form-36 Health Status Questionnaire (SF-36). Standardized SF-36 physical and mental health summary scores were compared with those of the US female general population of similar age. One-way analysis of variance and post hoc paired t test analyses were performed to detect differences across age groups. RESULTS Pairwise comparison found young and middle-aged patients having worse fibromyalgia symptoms in all subscales except the anxiety subscale compared with older patients (P≤.01). Similarly, these young and middle-aged patients had worse QOL in the SF-36 mental component summary, as well as SF-36 general health perceptions, vitality, social functioning, and mental health index, compared with older patients (all P<.001). When the QOL of our female patients was compared with that of the US female general population of similar age with standardized SF-36 scores, all age groups had lower QOL in physical, as well as mental, health, with more reduction in physical health, particularly in young patients. CONCLUSION Our study shows that symptom severity and QOL differ across age groups in patients with fibromyalgia, with young and middle-aged patients having poorer QOL and worse fibromyalgia symptoms than do older patients. QOL in physical health was reduced more than in mental health, particularly in young patients, compared with the general population.
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Affiliation(s)
- Juan Jiao
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - Ann Vincent
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN; Fibromyalgia and Chronic Fatigue Clinic, Mayo Clinic, Rochester, MN
| | - Stephen S Cha
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN
| | - Connie A Luedtke
- Fibromyalgia and Chronic Fatigue Clinic, Mayo Clinic, Rochester, MN
| | - Terry H Oh
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN; Fibromyalgia and Chronic Fatigue Clinic, Mayo Clinic, Rochester, MN.
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Campos APR, Silva CM, Castro SSD, Graminha CV. Depressão e qualidade de vida em indivíduos com artrite reumatoide e indivíduos com saúde estável: um estudo comparativo. FISIOTERAPIA E PESQUISA 2013. [DOI: 10.1590/s1809-29502013000400016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi verificar a ocorrência de depressão e alterações da qualidade de vida (QV) em indivíduos com artrite reumatoide (AR).Participaram da pesquisa 60 indivíduos, divididos em 2 grupos com 30 cada, sendo o Grupo Teste composto por indivíduos com AR e o Grupo Controle composto por indivíduos com saúde estável. A QV foi avaliada pelo Medical Outcomes Study 36-Item Short-Form Healthy Survey (SF-36) e a depressão, pela Escala de Depressão de Beck (BDS). Para estabelecer comparações entre os grupos quanto aos escores de cada domínio do SF-36, utilizamos o teste de Mann-Whitney e, para os dados do "estado de saúde em geral" do SF-36, o teste do χ². Para comparar os grupos quanto ao escore total de depressão e quanto aos escores de cada categoria de depressão, empregamos respectivamente os testes Wilcoxon-Mann-Whitney (WMW) e χ². Para as variáveis "estado de saúde" em geral do SF-36 e classificação da depressão, calculou-se a Odds Ratio bruta e ajustada por meio de modelagem de regressão logística. O nível de significância foi estabelecido em 5%. Os resultados mostraram que houve diferenças entre os grupos nos oito domínios do SF-36, indicando queindivíduos com AR apresentam menores índices de QV e autoavaliação em saúde (ORajustada=14,38) e que 63,33% dos participantes com AR apresentam algum grau de depressão. Concluímos que a AR causa um impacto negativo na QV e que a depressão poder ser considerada um sintoma associado à diminuição da capacidade funcional decorrente da doença.
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Functional outcomes in patients with Borrelia burgdorferi reinfection. Ticks Tick Borne Dis 2013; 5:58-62. [PMID: 24215678 DOI: 10.1016/j.ttbdis.2013.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 09/12/2013] [Accepted: 09/16/2013] [Indexed: 11/24/2022]
Abstract
When Lyme disease is treated with appropriate antibiotic therapy in the early stages, long-term outcomes are good. However, a few patients have persistent symptoms despite appropriate therapy. Whether these patients' symptoms are any different from those of patients with reinfection is unclear. Our objective was to compare long-term symptoms and functional outcomes of patients with Borrelia burgdorferi reinfection with those of patients with only 1 episode of infection and with no history of infection. We compared outcomes of Lyme reinfection patients, characterized by recurrent erythema migrans (EM) lesions, with those of patients with 1 episode of Lyme disease (Lyme control) and with no history of Lyme disease (non-Lyme control) by retrospective medical record review and a survey consisting of a 36-item Short-Form Health Survey (SF-36) and a 10-item symptom questionnaire. Analysis of variance (ANOVA) for continuous variables and χ(2) analysis for categorical variables were used. In cases of low cell counts, Fisher's exact tests were used. Bonferroni correction was used for multiple comparisons when ANOVA was significant. Reinfection was identified in 23/673 (3.4%) patients who had a diagnosis of Lyme disease in our health system during 2000-2004. Of the 23, 15 had long-term follow-up data and were age- and sex-matched to 45 Lyme control and 60 non-Lyme control group patients. Clinical characteristics were similar in the reinfection and Lyme control groups. SF-36 results were similar between groups for all domains except energy/vitality (VT). The SF-36 domain of VT was significantly different between groups: 63.0 vs. 54.5 vs. 64.5 in the reinfection, Lyme control, and non-Lyme control groups, respectively (p=0.047). Clinical features and long-term outcomes of patients with recurrent EM lesions were similar to those of the control groups and consistent with B. burgdorferi reinfection, not persistent infection. Patients with Lyme reinfection should be treated with antibiotic regimens similar to those used for patients with an initial episode of Lyme disease.
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Bateman L, Palmer RH, Trugman JM, Lin Y. Results of switching to milnacipran in fibromyalgia patients with an inadequate response to duloxetine: a phase IV pilot study. J Pain Res 2013; 6:311-8. [PMID: 23658494 PMCID: PMC3643187 DOI: 10.2147/jpr.s43395] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the safety, tolerability, and efficacy of milnacipran following a direct switch from duloxetine in fibromyalgia patients experiencing inadequate clinical response to duloxetine after receiving treatment for 6 weeks or longer. METHODS This exploratory study included 107 patients with fibromyalgia who had been treated with duloxetine 60 mg/day for at least 4 weeks prior to enrollment. Following a 2-week open-label period on duloxetine, patients who had visual analog scale pain scores ≥ 40 and were dissatisfied with current treatment were randomized 4:1 to milnacipran 100 mg/day (n = 86) or placebo (n = 21) for 10 weeks of double-blind treatment. The small placebo group was included solely to blind the study and minimize expectation bias among patients and investigators, and there was no preplanned statistical comparison between treatment groups. The primary efficacy parameter was the percentage of patients rating themselves as "much improved" or "very much improved" on the Patient Global Impression of Change (PGIC) at the final visit. Other efficacy parameters included changes in one-week recall visual analog scale pain, Fibromyalgia Impact Questionnaire Revised (FIQR), and Multiple Ability Self-Report Questionnaire (MASQ). RESULTS Of patients switched to milnacipran, 32.9% were classified as PGIC responders, and they also demonstrated improvement in visual analog scale pain, FIQR total, and MASQ total scores (mean changes from baseline were -12.3, -7.77, and -2.39, respectively). Nausea and dizziness were the most common treatment-emergent adverse events in patients switched to milnacipran, reported in 21% and 15%, respectively, of patients in this group. CONCLUSION Results from this exploratory study suggest that switching from duloxetine to milnacipran may be beneficial in some patients with fibromyalgia who have an inadequate response to duloxetine. Further research investigating the efficacy and safety of switching fibromyalgia therapies is warranted.
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Abstract
BACKGROUND Fibromyalgia is a disease process without an obvious etiology. While some evidence suggests that adverse experiences in childhood contribute to its development, specific evidence has been equivocal. METHODS A total of 36 patients with fibromyalgia from the greater New York area were recruited and surveyed using the Centers for Disease Control's Behavioral Risk Factor Surveillance System survey, and questions from the section on adverse childhood experiences were administered. The results were compared to those obtained from over 400,000 people surveyed by the Centers for Disease control each year, and were monitored for statistically significant differences. RESULTS A statistically significant difference was noted among the control group, suggesting that individuals reported growing up with someone who was depressed when the respondents were between the ages of 0 and 18 years old. Moreover, respondents reported that they were hit by their parents in some way, were insulted or cursed at by their parents, and had been forced to have sex with someone at least 5 years older than them or with an adult. No correlation was found with the following variables and the development of fibromyalgia: growing up with divorced or separated parents; growing up with someone sentenced to serve time in jail; or having parents that abused each other. Additionally, statistically significant differences were found for the following categories: lack of emotional support; life dissatisfaction; fair or poor health; physical, mental or emotional disability; and being divorced or not married. DISCUSSION Using this well-validated survey, it became clear that at least six specific adverse childhood experiences were correlated with the development of fibromyalgia. Data pertaining to disability, quality of life, life satisfaction, number of days of depression, emotional support, and marriage status illustrated the extent of subjective disability that these patients feel every day.
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Affiliation(s)
| | | | - Michel Dubois
- Department of Pain Management, New York University Langone Medical Center, New York, NY, USA
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Campos RP, Vázquez MI. The impact of Fibromyalgia on health-related quality of life in patients according to age. Rheumatol Int 2012; 33:1419-24. [DOI: 10.1007/s00296-012-2568-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 10/21/2012] [Indexed: 10/27/2022]
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Pakpour AH, Zeidi IM, Hashemi F, Saffari M, Burri A. Health-related quality of life in young adult patients with rheumatoid arthritis in Iran: reliability and validity of the Persian translation of the PedsQL™ 4.0 Generic Core Scales Young Adult Version. Clin Rheumatol 2012; 32:15-22. [PMID: 22965776 DOI: 10.1007/s10067-012-2084-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 08/20/2012] [Accepted: 08/31/2012] [Indexed: 11/25/2022]
Abstract
The objective of the present study was to determine the reliability and validity of the Persian translation of the Pediatric Quality of Life Inventory (PedsQL™) 4.0 Generic Core Scales Young Adult Version in an Iranian sample of young adult patients with rheumatoid arthritis (RA). One hundred ninety-seven young adult patients with RA completed the 23-item PedsQL™ and the 36-item Short-Form Health Survey (SF-36). Disease activity based on Disease Activity Score 28 was also measured. Internal consistency and test-retest reliability, as well as construct, discriminant, and convergent validity, were tested. Confirmatory factor analysis (CFA) was used to verify the original factor structure of the PedsQL™. Also, responsiveness to change in PedsQL™ scores over time was assessed. Cronbach's alpha coefficients ranged from α = 0.82 to α = 0.91. Test-retest reproducibility was satisfactory for all scales and the total scale score. The PedsQL proved good convergent validity with the SF-36. The PedsQL distinguished well between young adult patients and healthy young adults and also RA groups with different comorbidities. The CFA did not confirm the original four-factor model, instead, analyses revealed a best-fitting five-factor model for the PedsQL™ Young Adult Version. Repeated measures analysis of variance indicated that the PedsQL scale scores for young adults increased significantly over time. The Persian translation of the PedsQL™ 4.0 Generic Core Scales Young Adult Version demonstrated good psychometric properties in young adult patients with RA and can be recommended for the use in RA research in Iran.
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Affiliation(s)
- Amir H Pakpour
- Qazvin Research Center for Social Determinants of Health, Qazvin University of Medical Sciences, Qazvin, Iran.
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Pizutti LT, Taborda JG, Tourinho TF. Evaluation of Religious Spiritual Coping in Patients with Fibromyalgia Syndrome: A Case–Controlled Study. ACTA ACUST UNITED AC 2012. [DOI: 10.3109/10582452.2012.704139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Edwards CJ, Campbell J, van Staa T, Arden NK. Regional and temporal variation in the treatment of rheumatoid arthritis across the UK: a descriptive register-based cohort study. BMJ Open 2012; 2:bmjopen-2012-001603. [PMID: 23144258 PMCID: PMC3533005 DOI: 10.1136/bmjopen-2012-001603] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES To describe current disease-modifying antirheumatic drugs (DMARDs) prescription in rheumatoid arthritis (RA) with reference to best practice and to identify temporal and regional trends in the UK. DESIGN Descriptive, register-based cohort study. PARTICIPANTS Permanently registered patients aged ≥18 years with a recorded diagnosis of RA between 1 January 1995 and 31 March 2010 and matched controls. Participants with RA were identified through screening of all patients in the General Practice Research Database (GPRD) with a clinical or referral record for RA and at least 1 day of follow-up. SETTING 639 general practices in the UK supplying data to the GPRD. MAIN OUTCOME MEASURES Medication prescribing between 3 and 12 months of RA diagnosis by region and time period (1995-1999, 2000-2005 and 2006-April 2010). RESULTS Of the 35 911 patients in the full RA cohort, 15 259 patients (42%) had incident RA. Analysis of prescribing in incident RA patients demonstrated that between 1995 (baseline) and 2010 there was a substantial increase in DMARD, and specifically methotrexate, prescribing across all regions with a less marked increase in combination DMARD prescribing. Taking 12-month prescribing as a snapshot: DMARD prescribing was 19-49% at baseline increasing to 45-74% by 2006-April 2010; methotrexate prescribing was 4-16% at baseline increasing to 32-60%; combination DMARD prescribing was 0-8% at baseline increasing to 3-17%. However, there was marked regional variation in the proportion of RA patients receiving DMARD regardless of time period. CONCLUSIONS There has been a substantial increase in prescribing of DMARDs for RA since 1995; however, regional variation persists across the UK with relative undertreatment, according to established best practice. Improved implementation of evidence-based best clinical practice to facilitate removal of treatment variation is warranted. This may occur as a result of the implementation of published national guidance.
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Affiliation(s)
- Christopher John Edwards
- Department of Rheumatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- University of Southampton, Southampton, UK
| | - Jennifer Campbell
- General Practice Research Database, Medicines and Healthcare Products Regulatory Agency, London, UK
| | - Tjeerd van Staa
- General Practice Research Database, Medicines and Healthcare Products Regulatory Agency, London, UK
- Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Nigel K Arden
- University of Southampton, Southampton, UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
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Home-based exercise therapy in patients with ankylosing spondylitis: effects on pain, mobility, disease activity, quality of life, and respiratory functions. Clin Rheumatol 2011; 31:91-7. [DOI: 10.1007/s10067-011-1791-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 04/15/2011] [Accepted: 05/31/2011] [Indexed: 10/18/2022]
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