Skip to main content
Erschienen in: Quality of Life Research 12/2020

18.07.2020

Patient-reported flare frequency is associated with diminished quality of life and family role functioning in systemic lupus erythematosus

verfasst von: Patricia Katz, George J. Wan, Paola Daly, Lauren Topf, Erin Connolly-Strong, Ryan Bostic, Michael L. Reed

Erschienen in: Quality of Life Research | Ausgabe 12/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To understand the influence of the systemic lupus erythematosus (SLE)-related flares on patient’s health-related quality of life (HRQoL).

Methods

An online survey included individuals with self-reported physician’s diagnosis of SLE or lupus nephritis (LN). Lupus impact tracker (LIT) assessed lupus symptoms and HRQoL, SLE-Family questionnaire measured family role functioning, and Healthy Days Core Module (HDCM) measured overall mental and physical health. Chi-square and analysis of variance evaluated differences by flare frequency. Multivariable linear regression and generalized linear models evaluated the independent relationships of flare frequency to HRQoL.

Results

1066 respondents with SLE or LN completed the survey. Mean (SD) duration of illness was 12.4 (10.1) years. 93.4% (n = 996) were women, 82.3% (n = 830) were White, and 49.7% (n = 530) were employed or students. More frequent flares were associated with significantly worse scores on all HRQoL measures: LIT (adjusted means: 0 flares, 31.8; 1–3 flares, 47.0; 4–6 flares, 56.1; ≥ 7 flares, 63.6; P < 0.001); SLE-Family (adjusted means: 0 flares, 3.1; 1–3 flares 3.8; 4–6 flares, 4.3; ≥ 7 flares, 4.6, P < 0.001); HDCM unhealthy days (0 flares, 8.7; 1–3 flares, 17.4; 4–6 flares, 21.5; ≥ 7 flares, 26.2 days, P < 0.001).

Conclusion

Lupus flares contributed to impaired functional and psychological well-being, family functioning, and number of monthly healthy days. Better understanding of the burden of flare activity from the patient’s perspective will support a holistic approach to lupus management.
Literatur
1.
Zurück zum Zitat Furst, D. E., Clarke, A. E., Fernandes, A. W., Bancroft, T., Greth, W., & Iorga, S. R. (2013). Incidence and prevalence of adult systemic lupus erythematosus in a large US managed-care population. Lupus, 22(1), 99–105.CrossRef Furst, D. E., Clarke, A. E., Fernandes, A. W., Bancroft, T., Greth, W., & Iorga, S. R. (2013). Incidence and prevalence of adult systemic lupus erythematosus in a large US managed-care population. Lupus, 22(1), 99–105.CrossRef
2.
Zurück zum Zitat Garris, C., Shah, M., & Farrelly, E. (2015). The prevalence and burden of systemic lupus erythematosus in a medicare population: Retrospective analysis of medicare claims. Cost Effectiveness and Resource Allocation, 13, 9.CrossRef Garris, C., Shah, M., & Farrelly, E. (2015). The prevalence and burden of systemic lupus erythematosus in a medicare population: Retrospective analysis of medicare claims. Cost Effectiveness and Resource Allocation, 13, 9.CrossRef
3.
Zurück zum Zitat Yazdany, J., & Yelin, E. (2010). Health-related quality of life and employment among persons with systemic lupus erythematosus. Rheumatic Disease Clinics of North America, 36(1), 15–32, vii. Yazdany, J., & Yelin, E. (2010). Health-related quality of life and employment among persons with systemic lupus erythematosus. Rheumatic Disease Clinics of North America, 36(1), 15–32, vii.
4.
Zurück zum Zitat Gordon, C., Isenberg, D., Lerstrom, K., Norton, Y., Nikai, E., Pushparajah, D. S., et al. (2013). The substantial burden of systemic lupus erythematosus on the productivity and careers of patients: A European patient-driven online survey. Rheumatology (Oxford), 52(12), 2292–2301.CrossRef Gordon, C., Isenberg, D., Lerstrom, K., Norton, Y., Nikai, E., Pushparajah, D. S., et al. (2013). The substantial burden of systemic lupus erythematosus on the productivity and careers of patients: A European patient-driven online survey. Rheumatology (Oxford), 52(12), 2292–2301.CrossRef
5.
Zurück zum Zitat Garris, C., Oglesby, A., Sulcs, E., & Lee, M. (2013). Impact of systemic lupus erythematosus on burden of illness and work productivity in the United States. Lupus, 22(10), 1077–1086.CrossRef Garris, C., Oglesby, A., Sulcs, E., & Lee, M. (2013). Impact of systemic lupus erythematosus on burden of illness and work productivity in the United States. Lupus, 22(10), 1077–1086.CrossRef
6.
Zurück zum Zitat Elera-Fitzcarrald, C., Fuentes, A., Gonzalez, L. A., Burgos, P. I., Alarcon, G. S., & Ugarte-Gil, M. F. (2018). Factors affecting quality of life in patients with systemic lupus erythematosus: Important considerations and potential interventions. Expert Review of Clinical Immunology, 14(11), 915–931.CrossRef Elera-Fitzcarrald, C., Fuentes, A., Gonzalez, L. A., Burgos, P. I., Alarcon, G. S., & Ugarte-Gil, M. F. (2018). Factors affecting quality of life in patients with systemic lupus erythematosus: Important considerations and potential interventions. Expert Review of Clinical Immunology, 14(11), 915–931.CrossRef
7.
Zurück zum Zitat Yelin, E., Trupin, L., & Yazdany, J. (2017). A prospective study of the impact of current poverty, history of poverty, and exiting poverty on accumulation of disease damage in systemic lupus erythematosus. Arthritis Rheumatol, 69(8), 1612–1622.CrossRef Yelin, E., Trupin, L., & Yazdany, J. (2017). A prospective study of the impact of current poverty, history of poverty, and exiting poverty on accumulation of disease damage in systemic lupus erythematosus. Arthritis Rheumatol, 69(8), 1612–1622.CrossRef
8.
Zurück zum Zitat Monahan, R. C., Beaart-van de Voorde, L. J. J., Steup-Beekman, G. M., Magro-Checa, C., Huizinga, T. W. J., Hoekman, J., et al. (2017). Neuropsychiatric symptoms in systemic lupus erythematosus: Impact on quality of life. Lupus, 26(12), 1252–1259.CrossRef Monahan, R. C., Beaart-van de Voorde, L. J. J., Steup-Beekman, G. M., Magro-Checa, C., Huizinga, T. W. J., Hoekman, J., et al. (2017). Neuropsychiatric symptoms in systemic lupus erythematosus: Impact on quality of life. Lupus, 26(12), 1252–1259.CrossRef
9.
Zurück zum Zitat Golder, V., Kandane-Rathnayake, R., Hoi, A. Y., Huq, M., Louthrenoo, W., An, Y., et al. (2017). Association of the lupus low disease activity state (LLDAS) with health-related quality of life in a multinational prospective study. Arthritis Research and Therapy, 19(1), 62.CrossRef Golder, V., Kandane-Rathnayake, R., Hoi, A. Y., Huq, M., Louthrenoo, W., An, Y., et al. (2017). Association of the lupus low disease activity state (LLDAS) with health-related quality of life in a multinational prospective study. Arthritis Research and Therapy, 19(1), 62.CrossRef
10.
Zurück zum Zitat Legge, A., Doucette, S., & Hanly, J. G. (2016). Predictors of organ damage progression and effect on health-related quality of life in systemic lupus erythematosus. Journal of Rheumatology, 43(6), 1050–1056.CrossRef Legge, A., Doucette, S., & Hanly, J. G. (2016). Predictors of organ damage progression and effect on health-related quality of life in systemic lupus erythematosus. Journal of Rheumatology, 43(6), 1050–1056.CrossRef
11.
Zurück zum Zitat Moldovan, I., Katsaros, E., Carr, F. N., Cooray, D., Torralba, K., Shinada, S., et al. (2011). The patient reported outcomes in lupus (PATROL) study: Role of depression in health-related quality of life in a Southern California lupus cohort. Lupus, 20(12), 1285–1292.CrossRef Moldovan, I., Katsaros, E., Carr, F. N., Cooray, D., Torralba, K., Shinada, S., et al. (2011). The patient reported outcomes in lupus (PATROL) study: Role of depression in health-related quality of life in a Southern California lupus cohort. Lupus, 20(12), 1285–1292.CrossRef
12.
Zurück zum Zitat Alarcon, G. S., McGwin, G., Jr., Uribe, A., Friedman, A. W., Roseman, J. M., Fessler, B. J., et al. (2004). Systemic lupus erythematosus in a multiethnic lupus cohort (LUMINA). XVII. Predictors of self-reported health-related quality of life early in the disease course. Arthritis and Rheumatism, 51(3), 465–474.CrossRef Alarcon, G. S., McGwin, G., Jr., Uribe, A., Friedman, A. W., Roseman, J. M., Fessler, B. J., et al. (2004). Systemic lupus erythematosus in a multiethnic lupus cohort (LUMINA). XVII. Predictors of self-reported health-related quality of life early in the disease course. Arthritis and Rheumatism, 51(3), 465–474.CrossRef
13.
Zurück zum Zitat Thumboo, J., Fong, K. Y., Chan, S. P., Leong, K. H., Feng, P. H., Thio, S. T., et al. (2000). A prospective study of factors affecting quality of life in systemic lupus erythematosus. Journal of Rheumatology, 27(6), 1414–1420.PubMed Thumboo, J., Fong, K. Y., Chan, S. P., Leong, K. H., Feng, P. H., Thio, S. T., et al. (2000). A prospective study of factors affecting quality of life in systemic lupus erythematosus. Journal of Rheumatology, 27(6), 1414–1420.PubMed
14.
Zurück zum Zitat Ruperto, N., Hanrahan, L. M., Alarcon, G. S., Belmont, H. M., Brey, R. L., Brunetta, P., et al. (2011). International consensus for a definition of disease flare in lupus. Lupus, 20(5), 453–462.CrossRef Ruperto, N., Hanrahan, L. M., Alarcon, G. S., Belmont, H. M., Brey, R. L., Brunetta, P., et al. (2011). International consensus for a definition of disease flare in lupus. Lupus, 20(5), 453–462.CrossRef
15.
Zurück zum Zitat Meacock, R., Dale, N., & Harrison, M. J. (2013). The humanistic and economic burden of systemic lupus erythematosus: A systematic review. Pharmacoeconomics, 31(1), 49–61.CrossRef Meacock, R., Dale, N., & Harrison, M. J. (2013). The humanistic and economic burden of systemic lupus erythematosus: A systematic review. Pharmacoeconomics, 31(1), 49–61.CrossRef
16.
Zurück zum Zitat Olesinska, M., & Saletra, A. (2018). Quality of life in systemic lupus erythematosus and its measurement. Reumatologia, 56(1), 45–54.CrossRef Olesinska, M., & Saletra, A. (2018). Quality of life in systemic lupus erythematosus and its measurement. Reumatologia, 56(1), 45–54.CrossRef
17.
Zurück zum Zitat Kulczycka, L., Sysa-Jedrzejowska, A., & Robak, E. (2010). Quality of life and satisfaction with life in SLE patients-the importance of clinical manifestations. Clinical Rheumatology, 29(9), 991–997.CrossRef Kulczycka, L., Sysa-Jedrzejowska, A., & Robak, E. (2010). Quality of life and satisfaction with life in SLE patients-the importance of clinical manifestations. Clinical Rheumatology, 29(9), 991–997.CrossRef
18.
Zurück zum Zitat Golder, V., Ooi, J. J. Y., Antony, A. S., Ko, T., Morton, S., Kandane-Rathnayake, R., et al. (2018). Discordance of patient and physician health status concerns in systemic lupus erythematosus. Lupus, 27(3), 501–506.CrossRef Golder, V., Ooi, J. J. Y., Antony, A. S., Ko, T., Morton, S., Kandane-Rathnayake, R., et al. (2018). Discordance of patient and physician health status concerns in systemic lupus erythematosus. Lupus, 27(3), 501–506.CrossRef
19.
Zurück zum Zitat Mok, C. C., Ho, L. Y., Cheung, M. Y., Yu, K. L., & To, C. H. (2009). Effect of disease activity and damage on quality of life in patients with systemic lupus erythematosus: A 2-year prospective study. Scandinavian Journal of Rheumatology, 38(2), 121–127.CrossRef Mok, C. C., Ho, L. Y., Cheung, M. Y., Yu, K. L., & To, C. H. (2009). Effect of disease activity and damage on quality of life in patients with systemic lupus erythematosus: A 2-year prospective study. Scandinavian Journal of Rheumatology, 38(2), 121–127.CrossRef
20.
Zurück zum Zitat Khanna, S., Pal, H., Pandey, R. M., & Handa, R. (2004). The relationship between disease activity and quality of life in systemic lupus erythematosus. Rheumatology (Oxford), 43(12), 1536–1540.CrossRef Khanna, S., Pal, H., Pandey, R. M., & Handa, R. (2004). The relationship between disease activity and quality of life in systemic lupus erythematosus. Rheumatology (Oxford), 43(12), 1536–1540.CrossRef
21.
Zurück zum Zitat Mozaffarian, N., Lobosco, S., Lu, P., Roughley, A., & Alperovich, G. (2016). Satisfaction with control of systemic lupus erythematosus and lupus nephritis: Physician and patient perspectives. Patient Prefer Adherence, 10, 2051–2061.CrossRef Mozaffarian, N., Lobosco, S., Lu, P., Roughley, A., & Alperovich, G. (2016). Satisfaction with control of systemic lupus erythematosus and lupus nephritis: Physician and patient perspectives. Patient Prefer Adherence, 10, 2051–2061.CrossRef
22.
Zurück zum Zitat Leong, K. P., Chong, E. Y., Kong, K. O., Chan, S. P., Thong, B. Y., Lian, T. Y., et al. (2010). Discordant assessment of lupus activity between patients and their physicians: The Singapore experience. Lupus, 19(1), 100–106.CrossRef Leong, K. P., Chong, E. Y., Kong, K. O., Chan, S. P., Thong, B. Y., Lian, T. Y., et al. (2010). Discordant assessment of lupus activity between patients and their physicians: The Singapore experience. Lupus, 19(1), 100–106.CrossRef
23.
Zurück zum Zitat Yen, J. C., Neville, C., & Fortin, P. R. (1999). Discordance between patients and their physicians in the assessment of lupus disease activity: Relevance for clinical trials. Lupus, 8(8), 660–670.CrossRef Yen, J. C., Neville, C., & Fortin, P. R. (1999). Discordance between patients and their physicians in the assessment of lupus disease activity: Relevance for clinical trials. Lupus, 8(8), 660–670.CrossRef
24.
Zurück zum Zitat Katz, P., Nelson, W. W., Daly, R. P., Topf, L., Connolly-Strong, E., & Reed, M. L. (2020). Patient-reported lupus flare symptoms are associated with worsened patient outcomes and increased economic burden. Journal of Managed Care & Specialty Pharmacy, 26(3), 275–283.CrossRef Katz, P., Nelson, W. W., Daly, R. P., Topf, L., Connolly-Strong, E., & Reed, M. L. (2020). Patient-reported lupus flare symptoms are associated with worsened patient outcomes and increased economic burden. Journal of Managed Care & Specialty Pharmacy, 26(3), 275–283.CrossRef
26.
Zurück zum Zitat Jolly, M., Garris, C. P., Mikolaitis, R. A., Jhingran, P. M., Dennis, G., Wallace, D. J., et al. (2014). Development and validation of the Lupus Impact Tracker: A patient-completed tool for clinical practice to assess and monitor the impact of systemic lupus erythematosus. Arthritis Care Research (Hoboken), 66(10), 1542–1550.CrossRef Jolly, M., Garris, C. P., Mikolaitis, R. A., Jhingran, P. M., Dennis, G., Wallace, D. J., et al. (2014). Development and validation of the Lupus Impact Tracker: A patient-completed tool for clinical practice to assess and monitor the impact of systemic lupus erythematosus. Arthritis Care Research (Hoboken), 66(10), 1542–1550.CrossRef
27.
Zurück zum Zitat Hassett, A. L., Li, T., Radvanski, D. C., Savage, S. V., Buyske, S., Schiff, S. A., et al. (2012). Assessment of health-related family role functioning in systemic lupus erythematosus: preliminary validation of a new measure. Arthritis Care Research (Hoboken), 64(9), 1341–1348.CrossRef Hassett, A. L., Li, T., Radvanski, D. C., Savage, S. V., Buyske, S., Schiff, S. A., et al. (2012). Assessment of health-related family role functioning in systemic lupus erythematosus: preliminary validation of a new measure. Arthritis Care Research (Hoboken), 64(9), 1341–1348.CrossRef
28.
Zurück zum Zitat Hennessy, C. H., Moriarty, D. G., Zack, M. M., Scherr, P. A., & Brackbill, R. (1994). Measuring health-related quality of life for public health surveillance. Public Health Reports, 109(5), 665–672.PubMedPubMedCentral Hennessy, C. H., Moriarty, D. G., Zack, M. M., Scherr, P. A., & Brackbill, R. (1994). Measuring health-related quality of life for public health surveillance. Public Health Reports, 109(5), 665–672.PubMedPubMedCentral
29.
Zurück zum Zitat Graham, J., & Hofer, S. (2000). Modeling longitudinal and multiple group data: Practical issues, applied approaches, and specific examples. Mahwah, NJ: Lawrence Erlbaum Associates. Graham, J., & Hofer, S. (2000). Modeling longitudinal and multiple group data: Practical issues, applied approaches, and specific examples. Mahwah, NJ: Lawrence Erlbaum Associates.
30.
Zurück zum Zitat Yacoub Wasef, S. Z. (2004). Gender differences in systemic lupus erythematosus. Gender Medicine, 1(1), 12–17.CrossRef Yacoub Wasef, S. Z. (2004). Gender differences in systemic lupus erythematosus. Gender Medicine, 1(1), 12–17.CrossRef
31.
Zurück zum Zitat Katz, P., Yazdany, J., Julian, L., Trupin, L., Margaretten, M., Yelin, E., et al. (2011). Impact of obesity on functioning among women with systemic lupus erythematosus. Arthritis Care Research (Hoboken), 63(10), 1357–1364.CrossRef Katz, P., Yazdany, J., Julian, L., Trupin, L., Margaretten, M., Yelin, E., et al. (2011). Impact of obesity on functioning among women with systemic lupus erythematosus. Arthritis Care Research (Hoboken), 63(10), 1357–1364.CrossRef
32.
Zurück zum Zitat Majka, D. S., & Holers, V. M. (2006). Cigarette smoking and the risk of systemic lupus erythematosus and rheumatoid arthritis. Annals of the Rheumatic Diseases, 65(5), 561–563.CrossRef Majka, D. S., & Holers, V. M. (2006). Cigarette smoking and the risk of systemic lupus erythematosus and rheumatoid arthritis. Annals of the Rheumatic Diseases, 65(5), 561–563.CrossRef
33.
Zurück zum Zitat Lateef, A., & Petri, M. (2012). Unmet medical needs in systemic lupus erythematosus. Arthritis Research and Therapy, 14(Suppl 4), S4.CrossRef Lateef, A., & Petri, M. (2012). Unmet medical needs in systemic lupus erythematosus. Arthritis Research and Therapy, 14(Suppl 4), S4.CrossRef
34.
Zurück zum Zitat Squance, M. L., Reeves, G. E., & Bridgman, H. (2014). The lived experience of lupus flares: Features, triggers, and management in an Australian Female Cohort. International Journal of Chronic Diseases, 2014, 816729.CrossRef Squance, M. L., Reeves, G. E., & Bridgman, H. (2014). The lived experience of lupus flares: Features, triggers, and management in an Australian Female Cohort. International Journal of Chronic Diseases, 2014, 816729.CrossRef
35.
Zurück zum Zitat Kan, H. J., Song, X., Johnson, B. H., Bechtel, B., O'Sullivan, D., & Molta, C. T. (2013). Healthcare utilization and costs of systemic lupus erythematosus in Medicaid. BioMed Research International, 2013, 808391.PubMed Kan, H. J., Song, X., Johnson, B. H., Bechtel, B., O'Sullivan, D., & Molta, C. T. (2013). Healthcare utilization and costs of systemic lupus erythematosus in Medicaid. BioMed Research International, 2013, 808391.PubMed
Metadaten
Titel
Patient-reported flare frequency is associated with diminished quality of life and family role functioning in systemic lupus erythematosus
verfasst von
Patricia Katz
George J. Wan
Paola Daly
Lauren Topf
Erin Connolly-Strong
Ryan Bostic
Michael L. Reed
Publikationsdatum
18.07.2020
Verlag
Springer International Publishing
Erschienen in
Quality of Life Research / Ausgabe 12/2020
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-020-02572-9

Weitere Artikel der Ausgabe 12/2020

Quality of Life Research 12/2020 Zur Ausgabe