Khanna D, Allanore Y, Denton CP, Matucci-Cerinic M, Pope J, Hinzmann B, Davies S, de Oliveira Pena J, Distler O. Patient perception of disease burden in diffuse cutaneous systemic sclerosis.
JOURNAL OF SCLERODERMA AND RELATED DISORDERS 2019;
5:66-76. [PMID:
35382406 PMCID:
PMC8922591 DOI:
10.1177/2397198319866615]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/06/2019] [Indexed: 12/19/2022]
Abstract
Purpose:
Systemic sclerosis is a rare multi-organ autoimmune rheumatic disease,
resulting in progressive fibrosis of the skin/internal organs. This study
aimed to understand the impact of diffuse cutaneous systemic sclerosis
symptoms and disease burden from the patient’s perspective.
Methods:
This was a mixed methodology, market research study involving ethnography,
structured interviews, video diaries, and patient tasks. Patients had been
diagnosed with diffuse cutaneous systemic sclerosis for ⩾ 6 months and were
recruited via healthcare professionals or patient associations (France,
Italy, the United Kingdom, and the United States). Patients filmed short
(~15 min) daily video diaries about their lives over 7 days and participated
in ethnographic sessions, patient tasks, and structured video interviews. In
Germany and Spain, patients participated in 60-min telephone interviews.
Results:
Twenty-three patients (mean age: 54 years; 83% women; minimum disease
duration: 6 months) participated in the study. Time to diagnosis was
prolonged, as patients overlooked their symptoms and some healthcare
professionals attributed symptoms to other causes. Patients rarely received
additional information or support services at diagnosis. Importantly,
although patients were aware of the seriousness of organ involvement, they
reported that skin changes, pain, and fatigue impaired their ability to
perform routine tasks. Patients had a high prescription treatment burden
(mean: 10 tablets/day; up to >25 tablets/day) with additional
non-prescription medication taken for other comorbidities. Treatment
discontinuation was common due to side effects. Patients experienced diffuse
cutaneous systemic sclerosis as a loss of independence and self-esteem.
Moreover, patients tended to have small support networks, and emotional
support services were not offered as standard care.
Conclusion:
Patients with diffuse cutaneous systemic sclerosis had high treatment and
disease burdens, with skin changes, pain, and fatigue profoundly affecting
their lives. There is an unmet need for patient information at the time of
diagnosis and emotional support services throughout the patient’s journey
with diffuse cutaneous systemic sclerosis. Based on the results of this
study, we provide recommendations for improving diffuse cutaneous systemic
sclerosis care.
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