scholarly journals FRI0321 UTILITY OF THE ASAS HEALTH INDEX QUESTIONNAIRE AS A TOOL FOR HEALTH ASSESSMENT IN PATIENTS WITH SPONDYLOARTHRITIS AND ITS ASSOCIATION WITH DISEASE ACTIVITY, FUNCTIONALITY, MOBILITY, AND STRUCTURAL DAMAGE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 752.1-752
Author(s):  
M. Á. Puche Larrubia ◽  
C. López-Medina ◽  
M. D. C. Castro Villegas ◽  
R. Ortega Castro ◽  
M. Ladehesa Pineda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Linear Regression ◽  
Disease Activity ◽  
Linear Correlation ◽  
Structural Damage ◽  
High Disease Activity ◽  
Continuous Variables ◽  
Health Index ◽  
The Impact

Background:The ASAS Health Index (ASAS-HI) questionnaire, a tool that measures the impact of the disease on the health in patients with Spondyloarthritis (SpA), has been recently validated. However, there are still no studies evaluating the utility of this questionnaire in daily clinical practice.Objectives:The objective of this study is to evaluate the association of ASAS-HI with disease activity, functionality, mobility, and structural damage in patients with SpA.Methods:This is an observational, cross-sectional and single-center study in which 126 consecutive patients with SpA were included. Sociodemographic data, scores related to disease activity (BASDAI and ASDAS), functionality (BASFI), structural damage (cervical, lumbar and total mSASSS), mobility (BASMI and UCOASMI), quality of life (ASAS-HI) and the presence of concomitant fibromyalgia (evaluated with the FIRST questionnaire) were obtained from all patients. The ASAS-HI questionnaire was considered as the main outcome (scale from 0 to 17). Pearson’s correlation coefficient was used to evaluate the association of the different continuous variables with each other. Student’s t-test was used to compare the ASAS-HI between different subgroups of patients (men vs. women, ASDAS>2,1 vs. ASDAS≤2,1 and fibromyalgia + vs. fibromyalgia-). Finally, a multivariate linear regression was performed to determine which factors explain the variability of ASAS-HI in these patientsResults:Among the 126 patients included, 83 (65.9%) were men, with a mean age of 45.1±12.3 years and a mean disease duration of 18.7±14.5 years. The mean ASAS-HI score in all patients was 4.7±4.0, showing a “strong” positive linear correlation (r>0.60) with BASDAI and BASFI, and “moderate” positive (r=0.40 to 0.60) with Global VAS and ASDAS (Figure 1). Patients with fibromyalgia showed a significantly higher ASAS-HI score compared with patients without fibromyalgia (9.5±3.2 vs 3.7±3.4, respectively). In addition, patients with high disease activity (ASDAS>2,1) showed a higher mean score in ASAS-HI compared with those with low activity (ASDAS≤2,1) (5.8 ± 3.8 vs 2.0 ± 2.4, p<0,001).Figure 1.Simple linear correlation (Pearson’s r) between the different variables studied.Finally, multiple linear regression showed that 57,4% (R2=0,574) of the ASAS-HI variability is explained by the presence of concomitant fibromyalgia (β = 2.23, 95%IC 0.73 to 3.80, p=0.004), BASDAI (β = 0.62, 95%IC 0.25 to 0.97, p=0.001) and BASFI (β = 0.57, 95%IC 0.26 to 0.88, p=0.001).Conclusion:In our study, the impairment of the quality of life in patients with SpA was mainly associated with a high disease activity (BASDAI), worsening functionality (BASFI) and with the presence of concomitant fibromyalgia. Neither mSASSS nor UCOASMI was associated with a change in ASAS-HI; thus, in our patients neither structural damage nor mobility seem to influence the quality of life. In a patient with a high ASAS-HI we must evaluate the presence of concomitant fibromyalgia.Acknowledgments:The authors wish to thank all patients who participated in the study.Disclosure of Interests:María Ángeles Puche Larrubia: None declared, Clementina López-Medina: None declared, María del Carmen Castro Villegas: None declared, Rafaela Ortega Castro: None declared, MLourdes Ladehesa Pineda: None declared, Pérez Sánchez Laura: None declared, Gómez García Ignacio: None declared, José Miguel Sequí-Sabater: None declared, Maria del Carmen Abalos-Aguilera: None declared, Inmaculada Concepcion Aranda-Valera: None declared, Garrido Castro Juan Luis: None declared, Alejandro Escudero Contreras Grant/research support from: ROCHE and Pfizer, Speakers bureau: ROCHE, Lilly, Bristol and Celgene., Eduardo Collantes-Estevez: None declared

scholarly journals ASAS Health Index as an Addition to Routine Clinical Practice

2021 ◽  
pp. jrheum.201440
Author(s):  
Rubén Queiro ◽  
Sara Alonso-Castro ◽  
Mercedes Alperi
Keyword(s):  
Quality Of Life ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Structural Damage ◽  
Activity Index ◽  
Functional Limitations ◽  
Disease Activity Index ◽  
Health Index ◽  
Quality Of Life Scale

We have read with great interest the recent editorial published in The Journal by Dr. Kiltz, et al, referring to the possibility of using the Spondyloarthritis international Society Health Index (ASAS HI) as an all-in-one in the assessment of axial spondyloarthritis (axSpA)1. AxSpA has been evaluated over the years with different tools that have tried to determine the degree of activity [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)/Ankylosing Spondylitis Disease Activity Score (ASDAS)], functional limitations (Bath Ankylosing Spondylitis Functional Index), mobility restrictions (Bath Ankylosing Spondylitis Metrology Index), structural damage accumulated over time (Bath Ankylosing Spondylitis Radiology Index/modified Stoke Ankylosing Spondylitis Spinal Score), or quality of life (Ankylosing Spondylitis Quality of Life scale) of these patients.

scholarly journals P181 Long-term improvement in axial spondyloarthritis clinical outcomes following 2-weeks of intensive education and rehabilitation: results from the Bath residential rehabilitation programme

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Rosie Barnett ◽  
Anita McGrogan ◽  
Matthew Young ◽  
Charlotte Cavill ◽  
Mandy Freeth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Rehabilitation Programme ◽  
Spinal Mobility ◽  
The Impact

Abstract Background/Aims  Axial spondyloarthritis (axSpA) is a chronic rheumatic condition, characterised by inflammatory back pain - often associated with impaired function and mobility, sleep disturbance, fatigue, and reduced quality of life. Despite the vast advances in pharmacological treatments for axSpA over the last few decades, physical activity and rehabilitation remain vital for effective disease management. At the Royal National Hospital for Rheumatic Diseases in Bath (RNHRD), the 2-week inpatient axSpA rehabilitation programme has been integral to axSpA care since the 1970’s. Prior research has demonstrated significant short-term improvements in spinal mobility (BASMI), function (BASFI) and disease activity (BASDAI) following course attendance. However, the long-term outcomes are yet to be evaluated in this unique cohort. Methods  Since the early 1990’s, clinical measures of spinal mobility, function and disease activity have been routinely collected at the RNHRD at all clinical appointments through administration of the BASMI, BASFI and BASDAI, respectively. Dates of attending the axSpA course and standard clinical and treatment follow-up data were also collected. Multiple linear regression models were used to investigate the impact of course attendance on final reported BASMI, BASDAI and BASFI scores (final score=most recent). Length of follow-up was defined as time between first and last recorded BASMI. Results  Of the 203 patients within the Bath SPARC200 cohort, 77.8% (158/203) had attended at least one rehabilitation course throughout follow-up. 70.0% (140/203) of patients were male. The mean duration of follow-up was 13.5 years (range 0-35 years); 28.1% (57/203) of individuals with 20+ years of follow-up. Course attendance (yes versus no) significantly reduced final BASMI score by 0.84 (p = 0.001, 95%CI -1.31 to -0.37) and final BASDAI score by 0.74 (p = 0.018, 95%CI -1.34 to -0.13). Although course attendance reduced final BASFI by 0.45 (95%CI -1.17 to 0.28), this relationship did not reach significance (p = 0.225). Whilst minimally clinically important difference (MCID) is, to our knowledge, yet to be defined for BASMI, MCIDs were achieved long-term for both BASDAI and BASFI - defined by van der Heijde and colleagues in 2016 as 0.7 and 0.4 for BASDAI and BASFI, respectively. Conclusion  These results provide novel evidence to support the integral role of education, physical activity and rehabilitation in the management of axSpA. Future work should investigate additional outcomes of critical importance to patients and clinicians, such as fatigue, quality of life and work productivity. Furthermore, a greater understanding of the factors that confound these outcomes may provide insights into those patients who may most benefit from attending a 2-week rehabilitation course. In addition to facilitating identification of those patients who may require additional clinical support. Disclosure  R. Barnett: None. A. McGrogan: None. M. Young: None. C. Cavill: None. M. Freeth: None. R. Sengupta: Honoraria; Biogen, Celgene, AbbVie, Novartis, MSD. Grants/research support; Novartis, UCB.

scholarly journals A139 IMPROVED QUALITY OF LIFE AFTER ENDOSCOPIC THERAPY FOR BARRETT’S ESOPHAGUS AND EARLY ESOPHAGEAL CANCER IN SOUTHERN ALBERTA

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 125-126
Author(s):  
T Jeyalingam ◽  
M Woo ◽  
S E Congly ◽  
J David ◽  
P J Belletrutti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Linear Regression ◽  
Multiple Linear Regression ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Endoscopic Therapy ◽  
Negative Impact ◽  
Older Age ◽  
The Impact

Abstract Background In patients with Barrett’s esophagus (BE), endoscopic therapy reduces the risk of progression to invasive esophageal adenocarcinoma (EAC). Data on the impact of endoscopic therapy on patient quality of life (QoL) is limited. Aims We aimed to assess: (1) change in QoL during the course of endoscopic therapy for BE, (2) factors which predict this change, (3) whether achieving complete remission of dysplasia (CRD) or intestinal metaplasia (CRIM) affect the degree of change. Methods We conducted a retrospective observational study using a prospectively maintained database of BE patients treated in Calgary, Alberta from 2013–2020 containing data on demographics, BE disease characteristics and therapeutics, QoL, and follow-up. QoL was determined prior to initiation of therapy and after each treatment session using a validated questionnaire. Descriptive statistics were calculated and change in QoL was compared using a Wilcoxon signed ranks test. Backwards multiple linear regression analysis was performed to determine predictors of change in QoL. Results Of 130 BE patients, 112 (86.1%) were male and 104 (80%) had dysplastic histology or intramucosal carcinoma on index endoscopy. Mean (SD) age was 65.6 (12.0) years. At time of analysis, 76 patients (58.5%) had completed endoscopic therapy, of whom 69 (90.8%) achieved CRIM; 54 patients (41.5%) were still undergoing treatment. There was significant improvement in all QoL measures during the treatment course except for “depression” (Table 1). Patients with CRIM or CRD had reductions in “sleep difficulty” and “negative impact on life” to a significantly greater degree vs patients not achieving CRIM (Δ sleep -0.45 vs 0.0, P=0.002; Δ negative impact -0.4 vs -0.05, P=0.014) or CRD (Δ sleep -0.40 vs +0.60, P=0.002; Δ negative impact -0.40 vs +0.20, P=0.04). Multiple linear regression revealed older age (B=-0.03, P=0.008) and fewer number of EMR sessions (B=0.254, P=0.008) were correlated with greater improvement in QoL. Conclusions Endoscopic therapy improves QoL in BE patients, especially in those achieving CRIM/CRD. Older age and fewer EMRs are correlated with greater improvement in QoL. These results further reinforce the role of endoscopic therapy as the first line treatment of BE and early EAC. Funding Agencies None

Outcomes

2013 ◽  
pp. 221-226
Author(s):  
David L. Scott
Keyword(s):  
Quality Of Life ◽  
Disease Activity ◽  
Short Form ◽  
Organ Damage ◽  
Confounding Factors ◽  
Short Term ◽  
Self Assessment ◽  
The Matrix ◽  
The Impact

Outcomes evaluate the impact of disease. In rheumatology they span measures of disease activity, end-organ damage, and quality of life. Some outcomes are categorical, such as the presence or absence of remission. Other outcomes involve extended numeric scales such as joint counts, radiographic scores, and quality of life measures. Outcomes can be measured in the short term—weeks and months—or over years and decades. Short-term outcomes, though readily related to treatment, may have less relevance for patients. Clinical trials focus on short-term outcomes whereas observational studies explore longer-term outcomes. The matrix of rheumatic disease outcomes is exemplified by rheumatoid arthritis. Its outcomes span disease activity assessments like joint counts, damage assessed by erosive scores, quality of life evaluated by disease-specific measures like the Health Assessment Questionnaire (HAQ) or generic measures like the Short Form 36 (SF-36), overall assessments like remission, and end result such as joint replacement or death. Outcome measures capture the impact of treating rheumatic diseases. They are influenced by disease severity and effective treatment. They also reflect many confounding factors. These include demographic factors like age, gender, and ethnicity and also deprivation, as poverty worsens outcomes. Comorbidities affect outcomes and patients with multiple comorbid conditions have worse quality of life with poorer outcomes. Patient self-assessment has grown in importance; it is simple and understandable. However, self-assessment can vary over time and does not always reflect assessors’ perspectives. Caution is needed comparing outcomes across units; the various confounding factors and measurement complexities make such comparative analyses challenging.

scholarly journals New European urticaria guideline. What’s new?

2018 ◽  
Vol 15 (4) ◽  
pp. 54-61
Author(s):  
I V Danilycheva
Keyword(s):  
Quality Of Life ◽  
Disease Activity ◽  
Negative Impact ◽  
Complete Control ◽  
2Nd Generation ◽  
Diagnostic Approaches ◽  
Fourth Step ◽  
The Impact ◽  
Dose Step

Urticaria is a disease which symptoms are caused by the activation and degranulation of the mast cells (MC). Urticaria and angioedema persisting for more than 6 weeks is concerning to be the chronic form of the disease (CU). Chronic spontaneous urticaria (CSU) is the most common subtype of CU and has a great negative impact on all aspects of the patient’s life, causing a decreasing a quality of life, as a burden for a health system and society as a whole. In the present version of the conciliatory document diagnostic approaches in CSU have three goals: to make a differential diagnosis; to evaluate an activity of the disease, its control and the impact on the patient’s life; to identify the triggers of exacerbation or, if possible, the causes of a disease. A basic assessment of disease activity (UAS, AAS), quality of life (CU-Q2oL, AE-QoL) and disease activity control (UCT) are necessary for decisionmaking in the treatment of patients with CSU, better understanding of the disease burden, and documentation improvement and standardization. The aim of a treatment of patients with CSU is the complete control of the symptoms. A therapy should be performed by steps. On the first step a 2nd generation of Hj-antihistamines in standard doses has to be applied. In case of unresponsiveness a dose step-up up to 4 times is recommended, at the third step omalizumab is advised, at the fourth step (inefficiency of omalizumab) - cyclosporine. At any step, it is possible to use a short term course of glucocorticosteroids to set back an exacerbation.

Outcomes

2016 ◽  
Author(s):  
David L. Scott
Keyword(s):  
Quality Of Life ◽  
Disease Activity ◽  
Short Form ◽  
Health Assessment ◽  
Organ Damage ◽  
Confounding Factors ◽  
Short Term ◽  
The Matrix ◽  
The Impact

Outcomes evaluate the impact of disease. In rheumatology they span measures of disease activity, end-organ damage, and quality of life. Some outcomes are categorical, such as the presence or absence of remission. Other outcomes involve extended numeric scales such as joint counts, radiographic scores, and quality of life measures. Outcomes can be measured in the short term—weeks and months—or over years and decades. Short-term outcomes, though readily related to treatment, may have less relevance for patients. Clinical trials focus on short-term outcomes whereas observational studies explore longer-term outcomes. The matrix of rheumatic disease outcomes is exemplified by rheumatoid arthritis. Its outcomes span disease activity assessments like joint counts, damage assessed by erosive scores, quality of life evaluated by disease-specific measures like the Health Assessment Questionnaire (HAQ) or generic measures like the Short Form 36 (SF-36), overall assessments like remission, and end result such as joint replacement or death. Outcome measures are used to capture the impact of treating rheumatic diseases, and are influenced by both disease severity and the effectiveness of treatment. However, they are also influenced by a range of confounding factors. Demographic factors like age, gender, and ethnicity can all have crucial impacts. Deprivation is important, as poverty invariably worsens outcomes. Finally, comorbidities affect outcomes and patients with multiple comorbid conditions usually have worse quality of life with poorer outcomes for all diseases. These multiple confounding factors mean comparing outcomes across units without adjustment will invariably show major differences.

Happiness, quality of life and their determinants among people with systemic sclerosis: a structural equation modeling approach

Rheumatology ◽  
2021 ◽  
Author(s):  
Tânia Louza Santiago ◽  
Eduardo Santos ◽  
Ana Catarina Duarte ◽  
Patrícia Martins ◽  
Marlene Sousa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Image ◽  
Systemic Sclerosis ◽  
Disease Activity ◽  
Personality Traits ◽  
Structural Equation ◽  
Equation Modeling ◽  
Disease Impact ◽  
The Impact

Abstract Background Patients’ objectives and experiences must be core to the study and management of chronic diseases, such as systemic sclerosis (SSc). Although patient-reported outcomes have attracted increasing attention, evaluation of the impact of disease on the overall subjective well-being, equivalent to ‘happiness’, is remarkably lacking. Objectives To examine the determinants of happiness and quality of life in patients with SSc, with emphasis on disease features and personality traits. Methods Observational, cross-sectional multicentre study, including 142 patients, with complete data regarding disease activity, disease impact, personality, health-related quality of life (HR-QoL) and happiness. Structural equation modelling was used to evaluate the association between the variables. Results The results indicated an acceptable fit of the model to the data. Perceived disease impact had a significant negative direct relation with HR-QoL (β=-0.79, p &lt; 0.001) and with happiness (β=-0.52, p &lt; 0.001). Positive personality traits had a positive relation with happiness (β = 0.36, p = 0.002) and an important indirect association upon QoL (β = 0.43) and happiness (β = 0.23). Perceived disease impact is influenced by body image, fatigue, and SSc-related disability to a higher degree (β =  0.6–0.7) than by disease activity (β = 0.28) or form (β = 0.17). Impact of disease had a much stronger relation with HR-QoL than with happiness. Conclusions The results suggest that treatment strategies targeting not only disease control but also the mitigation of relevant domains of disease impact (body image, fatigue, global disability) may be important to improve the patients’ experience of the disease. The reinforcement of resilience factors, such as positive psychological traits, may also play a contributory role towards better patient outcomes.

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