1
|
Feng J, Yu L, Fang Y, Zhang X, Li S, Dou L. Correlation between disease activity and patient-reported health-related quality of life in rheumatoid arthritis: a cross-sectional study. BMJ Open 2024; 14:e082020. [PMID: 38697757 PMCID: PMC11086289 DOI: 10.1136/bmjopen-2023-082020] [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: 11/12/2023] [Accepted: 04/15/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE We aimed to provide a comprehensive assessment of health-related quality of life (HRQoL) in patients with rheumatoid arthritis (RA) of different activities and to evaluate the correlation between clinical activity measures and HRQoL instruments. This research also analysed the extent to which different aspects of HRQoL (physical, psychological and social) were affected. DESIGN Cross-sectional, observational, non-interventional study. SETTING The study was conducted at the Department of Rheumatology and Immunology, Qilu Hospital, Shandong University. METHODS From December 2019 to October 2020, a total of 340 RA patients participated in the survey using convenient sampling. Three generic instruments, EQ-5D-5L,SF-12 and the AQoL-4D, as well as an RA-specific instrument,the Stanford Health Assessment Questionnaire Disability Index (HAQ-DI), were administered to assess patients' HRQoL. The Disease Activity Score 28-Erythrocyte Sedimentation Rate (DAS28-ESR) was used by doctors to measure patients' clinical activity. Multivariable linear regression was used to compare patients' HRQoL across different levels of activity. Spearman's correlation was used to assess the correlation between doctor-reported clinical activity and HRQoL. RESULTS A total of 314 patients with RA participated in this study. The mean score of HAQ-DI was 0.87 (SD: 0.91). Using patients in the clinical remission group as a reference, patients in the moderate and high disease activity groups showed significantly reduced health state utility values and HRQoL scores (all p<0.05). On the contrary, there was an increase in HAQ-DI scores, indicating more impairment (p<0.05). All instruments included in the study tended to differentiate disease activity based on multiple criteria, with scores showing a moderate to strong correlation with RA activity (|rs|=0.50 to 0.65). Among them, the disease-specific instrument had the highest correlation. CONCLUSIONS RA can have considerable impairment on patients' HRQoL, both in terms of physical and psychosocial functioning. Given the strong correlation between clinical activity and HRQoL scores, and the fact that HRQoL can be an important clinical supplement. The EQ-5D-5L is probably the most appropriate generic measurement instrument for measuring HRQoL in RA patients.
Collapse
Affiliation(s)
- JunChao Feng
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
- Center for Health Preference Research, Shandong University, Jinan, China
| | - Lingjia Yu
- Nursing Department, Rheumatology Department, Qilu Hospital of Shandong University, Jinan, China
| | - Yingying Fang
- Nursing Department, Rheumatology Department, Qilu Hospital of Shandong University, Jinan, China
| | - Xianyu Zhang
- Nursing Department, Rheumatology Department, Qilu Hospital of Shandong University, Jinan, China
| | - Shunping Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
- Center for Health Preference Research, Shandong University, Jinan, China
| | - Lei Dou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
- Center for Health Preference Research, Shandong University, Jinan, China
| |
Collapse
|
2
|
Harrold LR, Zueger P, Nowell WB, Blachley T, Schrader A, Lakin PR, Curtis D, Stradford L, Venkatachalam S, Tundia N, Patel PA. A Real-World Effectiveness Study Using a Mobile Application to Evaluate Early Outcomes with Upadacitinib in Rheumatoid Arthritis. Rheumatol Ther 2023; 10:1519-1533. [PMID: 37728861 PMCID: PMC10654297 DOI: 10.1007/s40744-023-00594-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/18/2023] [Indexed: 09/21/2023] Open
Abstract
INTRODUCTION The impact of upadacitinib on rheumatoid arthritis (RA) symptoms was evaluated during the first 12 weeks of treatment via patient-reported outcomes (PROs) using a mobile health application (app). METHODS Participating rheumatologists from the CorEvitas RA Registry (prospective, observational cohort) recruited patients with RA initiating upadacitinib treatment. A modified version of the ArthritisPower® app was used to collect PROs, including the Routine Assessment of Patient Index Data 3 (RAPID3), duration of morning joint stiffness, and the Patient-Reported Outcomes Measurement Information System (PROMIS)-Fatigue 7a Short Form at baseline and weeks 1-4, 8, and 12. RAPID3 responses over time were assessed using Kaplan-Meier estimation to determine the proportion of patients achieving disease activity improvement and minimal clinically important difference (MCID). Results were analyzed for all patients initiating upadacitinib and a subsample of TNF inhibitor (TNFi)-experienced patients with moderate to severe disease at baseline. RESULTS A total of 103 patients with RA initiating upadacitinib (62.1% TNFi-experienced) were included. At week 12, 53 patients (51.4%) completed the study and provided PRO data via the app. Among all patients, improvements in RAPID3, pain, morning stiffness, and fatigue were observed at week 1 and were maintained or further improved through week 12. At week 12, 37.5% of patients achieved RAPID3 low disease activity. Starting at week 1, improvements in RAPID3 disease activity category (19.4% of patients) and achievement of MCID (16.3%) were reported, with nearly 50% of patients achieving these outcomes by week 4 (RAPID3 category: 48.8%; MCID: 49.2%) and 60% by week 12 (RAPID3 category: 59.6%; MCID: 59.8%). TNFi-experienced patients generally reported similar outcomes. Patient-reported medication convenience and compliance were generally high. CONCLUSIONS In this real-world cohort of patients with RA, treatment with upadacitinib was associated with early and significant improvement in RAPID3, pain, morning stiffness, and fatigue regardless of prior TNFi experience. Clinically meaningful improvement in RAPID3 patient-reported disease activity was observed as early as week 1, with continued improvement reported through week 12.
Collapse
Affiliation(s)
- Leslie R Harrold
- CorEvitas, LLC, 300 5th Avenue, Waltham, MA, 02451, USA.
- University of Massachusetts Medical School, Worcester, MA, USA.
| | | | | | | | - Amy Schrader
- CorEvitas, LLC, 300 5th Avenue, Waltham, MA, 02451, USA
| | - Paul R Lakin
- CorEvitas, LLC, 300 5th Avenue, Waltham, MA, 02451, USA
| | - David Curtis
- Global Healthy Living Foundation, Upper Nyack, NY, USA
| | | | | | | | | |
Collapse
|
3
|
Daifallah A, Salameh H, Suwan B, Rabayaa M, Khayyat Z, Hasoon M, Nazzal MA, Al-Jabi S, Zyoud SH. Cancer-related post-treatment pain and its impact on treatment satisfaction with medication in women with breast cancer: a cross-sectional study from Palestine. Support Care Cancer 2023; 31:509. [PMID: 37548711 DOI: 10.1007/s00520-023-07981-3] [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] [Received: 02/23/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Pain after therapy is an important clinical problem in patients with breast cancer. Unfortunately, cancer patients have a lower quality of life due to inadequate treatment of posttreatment pain; therefore, improving medication management plans and palliative care has become one of the most important targets of cancer therapy. Therefore, the current study aimed to examine the impact of posttreatment pain on medication satisfaction in patients with various stages of breast cancer in Palestine. METHODS A cross-sectional analytical study was conducted et al.-Watani Hospital and An-Najah National University Hospital in the Nablus area. Using the Brief Pain Inventory (BPI), the intensity and interference of pain were evaluated. In addition, patients' satisfaction with cancer management medications was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM). RESULTS Two hundred fifty-four patients were included in this study. All were women, with a mean ± SD age of 53.1 ± 10.7 years. The median score for pain severity was 7.0. Pain in the lower extremities was the most reported location. There was a negative association between the global satisfaction domain and the presence of posttreatment pain (p < 0.001). Furthermore, significant differences and negative correlations were found between global satisfaction and posttreatment pain on the day of the interview (p = 0.001), pain medication (p < 0.001), paracetamol use (p < 0.001), and the presence of side effects (p = 0.003). There were significant negative correlations (p < 0.05) between pain severity and interference with effectiveness (r = -0.258, -0.319, respectively), side effects (r = -0.414, -0.514, respectively), convenience (r = -0.274, -0.307, respectively), and global satisfaction domain scores (r = -0.293, -0.287, respectively). Exposure to chemotherapy was the only significant positive correlation with global satisfaction (p = 0.007). The regression analysis results indicated an independent association between chemotherapy use and a higher global satisfaction score (p = 0.011). CONCLUSIONS Patients with posttreatment pain, side effects, and greater interference of pain with their functioning had lower satisfaction scores. Therefore, better management of their treatment medications, side effects, and pain medications is recommended to enhance their satisfaction and quality of life. Several aspects of palliative care should be organized to improve the patient's satisfaction and quality of life in addition to conducting longitudinal studies to evaluate the pain and satisfaction of different types of cancers.
Collapse
Affiliation(s)
- Aiman Daifallah
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Husam Salameh
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine.
| | - Bushra Suwan
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Maha Rabayaa
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Zain Khayyat
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Mohammad Hasoon
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Maisa A Nazzal
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Samah Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine.
| |
Collapse
|
4
|
Koni AA, Suwan BA, Nazzal MA, Sleem A, Daifallah A, Allah MH, Odeh RY, Zyoud SH. Adherence to oral anticancer hormonal therapy in breast cancer patients and its relationship with treatment satisfaction: an important insight from a developing country. BMC Womens Health 2023; 23:114. [PMID: 36941628 PMCID: PMC10026465 DOI: 10.1186/s12905-023-02276-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 03/14/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Hormone-positive breast cancer is the most common type and represents a burden in all countries. Treatment satisfaction might be a predictor for adherence, as higher satisfaction with medication encourages patients to adhere appropriately to the medication and, consequently, successfully achieve the treatment goals. The present study evaluated the adherence of women with hormone-positive breast cancer to oral hormonal drugs and correlated it with treatment satisfaction and other sociodemographic and clinical factors. METHODS A cross-sectional design was applied. This study included two cancer centers. Data were collected from patients through face-to-face interviews and medical record reviews. The Medication Adherence Scale was adapted to assess medication adherence, and the Treatment Satisfaction Questionnaire for Medication (TSQM) version 1.4 was adopted to measure treatment satisfaction. RESULTS The final analysis included 106 patients, with a mean age ± SD of 51.9 ± 1.2. Approximately 35% were hospitalized in the past year. Current hormonal therapy among cancer patients included letrozole (38.7%), tamoxifen (31.1%), exemestane (17%), and anastrozole (13.2%). The median adherence score was 5.0 [4.8-6.0], and 62.3% adhered fully to their oral hormonal drugs in the past week. The median scores of effectiveness, side effects, convenience, and global satisfaction were 66.67 [61.11.0-72.22], 75.00 [48.44-100.00], 66.67 [66.67-72.22], and 71.43 [57.14-78.57], respectively. A significantly lower adherence score was identified in patients living in camps (p = 0.020). Patients with comorbidities and those who continued on the same hormonal therapy had higher adherence scores, although they were not statistically significant. Multiple linear regression analysis showed that two domains of treatment satisfaction, side effects (p = 0.013) and global satisfaction (p = 0.018), were predictors of adherence to oral hormonal drugs. CONCLUSIONS The current study revealed a significant association between treatment satisfaction and adherence to oral hormonal therapy. We recommend creating a specialized scale to measure adherence, considering the psychosocial factors that affect hormonal anticancer medication adherence.
Collapse
Affiliation(s)
- Amer A Koni
- Division of Clinical Pharmacy, Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine.
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
| | - Bushra A Suwan
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Maisa A Nazzal
- Division of Clinical Pharmacy, Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Alaa Sleem
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Aiman Daifallah
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Majd Hamed Allah
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Razan Y Odeh
- Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
- Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine
| |
Collapse
|