scholarly journals AB0102 EVALUATOR’S GLOBAL ASSESSMENT REFLECTS DISEASE ACTIVITY BUT NOT LINEARLY CORRELATES WITH DAILY ACTIVITY OR QUALITY OF LIFE COMPARED TO PATIENT’ GLOBAL ASSESSMENT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1079.2-1079
Author(s):  
I. Yoshii
Keyword(s):  
Quality Of Life ◽  
Disease Activity ◽  
Daily Activity ◽  
Global Assessment ◽  
Remission Rate ◽  
Objective Assessment ◽  
Mean Value ◽  
Mean Values ◽  
Significant Difference

Background:Evaluator’s global assessment (EGA) is the one component of indexed disease activity evaluation assessed by the rheumatologist for treatment of rheumatoid arthritis (RA). It does not included in the Boolean remission criteria nor 28-joints disease activity score (DAS28), however it is widely recognized among rheumatologist as an only comprehensive and objective assessment parameter.Objectives:The aim of this study is to evaluate how EGA correlates with other components and the influence of EGA on disease activity and daily activity, and quality of life.Methods:A total of 24,075 times of monitoring out of 683 RA patients who were followed up for more than three consecutive years was performed. Contents of monitoring included tenderness joint count (TJC), swollen joint count (SJC), patient’s global assessment (PGA), EGA, C-reactive protein (CRP), and calculated values of DAS28, SDAI, composite index of Boolean evaluation, pain score with visual analog scale (PS-VAS), Health Assessment Questionnaire Disability Index (HAQ-DI), and quality of life score (QOLS) calculated from Euro-QOL questionnaire with 5th dimensions. Each measurement was classified with the EGA score divided by one increment from zero to ten. Mean values of DAS28, CDAI, SDAI, remission rate of these indices and Boolean remission rate, and mean values of PS-VAS, HAQ-DI, and QOLS were statistically evaluated. Results were compared to the results that was analyzed in according to the PGA score substituted with the EGA score.Moreover, EGA at the time of Boolean remission of the patients who achieved Boolean remission at least once during treating were picked up. Patients were classified according to the EGA level with 0.5 increment from zero. Mean value of TJC, SJC, PGA, EGA, SDAI, Boolean remission rate, HAQ-DI, and PS-VAS after attaining Boolean remission were compared statistically.Results:Number of measures counted 15424, 2001, 3688, 1731, 664, 293, 144, 88, 29, 2, and 11 for each level of EGA. The EGA score tended to concentrate more in zero to two in comparing to the PGA score. Mean DAS28, CDAI, and SDAI demonstrated significant increase as the EGA level increased, and remission rate of the all indices including Boolean demonstrated significant decrease as the EGA level increases (p<0.01%). CDAI, SDAI, and Boolean remission rate demonstrated zero percent from two. Mean value of PS-VAS and HAQ-DI score demonstrated also significant decrease as the EGA level increases, and QOLS demonstrated significant decrease as the EGA level increases (p<0.01%). However, these tendency showed more irregular compared to that analyzed with the PGA score. Correlation coefficients with regarding to the EGA score was always less than that with regarding to the PGA score.In the patients who achieved Boolean remission, EGA levels were divided with 294 with zero (G-0) and 118 with 0.5 (G-.5), whereas 71 could not achieve Boolean remission. Average TJC (p<0.05), SJC (p<0.001), EGA (p<0.001), CRP (p<0.05), and SDAI (p<0.01) level in the G-0 group demonstrated significant less than in the G-.5 group, whereas PGA, Boolean remission rate, HAQ-DI, and PS-VAS demonstrated no significant difference in between the two groups.Conclusion:It is more reliable to estimate daily activity and quality of life from the PGA score than to estimate from the EGA score. EGA correlates with SJC and CRP more strongly than with TJC and CRP. EGA does not reflect HAQ-DI and PS-VAS.Disclosure of Interests:None declared

scholarly journals POS0439 THE INFLUENCE OF ESCALATED PGA SCORE ON DISEASE ACTIVITY, DAILY ACTIVITY, AND QUALITY OF LIFE, AND SOLUTION FOR OPTIMAL PGA LEVEL THAT DESERVES CLINICAL REMISSION IN PATIENT WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 448.2-448
Author(s):  
I. Yoshii
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Sensitivity And Specificity ◽  
Daily Activity ◽  
Remission Rate ◽  
Mean Value ◽  
Daily Activities ◽  
Mean Values

Background:Patient’s global assessment (PGA) is one most difficult component as a part of disease activity index for treatment of rheumatoid arthritis (RA), that often causes an obstacle to attaining clinical remission. Moreover, PGA level affects activities in daily living.Objectives:The influence of escalated PGA score on disease activity, daily activity, and quality of life for patient with RA was investigated., and the optimal PGA level for both disease activity and daily activities was investigated from real world data.Methods:A total of 24,075 times of monitoring for RA was performed in the institute. Monitored items included TJC, SJC, PGA, EGA, CRP, and calculated values of DAS28, CDAI, SDAI, composite index of Boolean evaluation (Boolean), pain score with visual analog scale (PS-VAS), Health Assessment Questionnaire Disability Index (HAQ-DI), and quality of life score (QOLS) calculated from Euro-QOL questionnaire with 5th dimensions. Each measured item was calculated as mean value according to the PGA score, which was measured at the same time. The PGA score was classified by one increment from zero to ten. The mean values of DAS28, CDAI, SDAI, remission rate of these indices and Boolean remission rate, and mean values of PS-VAS, HAQ-DI, and QOLS were statistically evaluated.HAQ-DI below 0.5 was determined as remission (HAQ remission). Sensitivity and specificity regarding attaining HAQ remission according to each level of PGA score were calculated, and cutoff index (COI) was determined with receiver operating characteristic (ROC) curve. For PS-VAS, sensitivity and specificity of Boolean remission regarding each level of PS-VAS after classification divided by one increment was calculated, and comparable level (PS-VAS remission) was determined with reference of the curve. ROC was performed according to PGA level, and COI was determined with a same manner.Results:Number of measures counted 10428, 3099, 3110, 2346, 998, 1773, 751, 703, 655, 139, and 73 for each PGA level. PGA level from 3 to 5, and 5 to 10 were put together for number adjusting.Mean DAS28, CDAI, and SDAI demonstrated significant increase as PGA level increased, and remission rate of the all indices including Boolean demonstrated significant decrease as PGA level increases (p<0.01%). Boolean remission rate demonstrated zero percent from two, and CDAI and SDAI remission rate demonstrated zero from five, whereas DAS remission rate showed gradual decrease then zero percent was not shown in any level. Mean value of PS-VAS and HAQ-DI score demonstrated also significant decrease as PGA level increases, and QOLS demonstrated significant decrease as PGA level increases (p<0.01%). Increase of HAQ-DI score and decline of QOLS demonstrated more steep from PGA level 3, whereas no significant difference demonstrated from zero to one.HAQ remission counted 15,703, whereas no HAQ remission counted 8,335. Using ROC, COI of the PGA level was 2.0, whereas sensitivity and specificity were 63.4% and 66.3%, respectively. The estimated PS-VAS remission level was 10mm. Optimal PGA level for PS-VAS remission was set as 1.0, and sensitivity and specificity regarding PS-VAS remission were 87.1% and 71.3%, respectively.Conclusion:Increase of PGA affects daily activities and quality of life. The evident level that increases deterioration risk significantly was supposed to be from 3. Optimal level of PGA score for attaining the PS-VAS remission was 1.0, whereas the optimal PGA level for HAQ-DI remission is 1.0, despite sensitivity and specificity for the HAQ remission were lower than these for the PS-VAS remission.Disclosure of Interests:None declared

scholarly journals AB0101 THE IMPACT OF TIME SPAN TO ACHIEVE BOOLEAN REMISSION FOR MAINTAINING DISEASE ACTIVITY AFTER ACQUISITION IN RHEUMATOID ARTHRITIS PATIENT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1079.1-1079
Author(s):  
I. Yoshii
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Duration ◽  
Remission Rate ◽  
Mean Value ◽  
Time Span ◽  
Mean Values ◽  
The Mean ◽  
The Relationship

Background:Boolean remission criteria is one most popular and stringent criteria in treating patient with rheumatoid arthritis (RA), because it may guarantees a stable clinical course after attaining remission.Objectives:Impact of time span from initiation to achieving Boolean remission on maintaining disease activity, daily activities, and quality of life after attaining Boolean remission was investigated from daily clinical practice data.Methods:685 patients with RA since August 2010 under the T2T strategy were treated. They were monitored for their TJC, SJC, PGA, EGA, CRP, and disease activity indices such as CDAI, SDAI, DAS28, and Boolean criteria at every visit. HAQ-DI score, pain score using visual analog scale (PS-VAS), and EQ-5D were also monitored, and the quality of life score (QOLS) calculated from EQ-5D was determined at every visit from the time of diagnosis (baseline).Of 685 patients, 465 patients had achieved Boolean remission >1 times, and were consecutively followed up for >3 years. These patients were enrolled in the study. Time span from the first visit to first Boolean remission was calculated. The relationship between the time span and each of background parameters, and the relationship between the time span and each of the mean values of the SDAI score, HAQ score, PS-VAS, SHS, and QOLS at the first Boolean remission and thereafter was evaluated statistically.Patients were subsequently divided into the G ≤ 6 and G > 6 groups based on the achievement of first Boolean remission within two groups: time span G ≤ 6 months and G > 6 months. The two groups were compared with regard to the SDAI score, HAQ score, PS-VAS, SHS, and QOLS at first visit and at the time of first Boolean remission, and the mean values of these parameters after remission were evaluated statistically. Moreover, changes of these parameters and the mean Boolean remission rate after the first remission, and SDAI remission rate at the first Boolean remission to thereafter were compared between the two groups statistically.Results:Out of 465 patients, females comprised 343 (73.7%), and the mean age was 67.8 years (range, from 21–95 years). The mean disease duration at first visit was 6.1 years (range, from 1 months–45 years). The mean follow up length was 88.1 months (range: 36–122 months; median: 85 months) and mean time span from the first visit to the first Boolean remission was 8.1 months. The mean SDAI score, HAQ score, PS-VAS, and the QOLS at first visit were 13.3, 0.467, 33.2, and 0.834, respectively. Among the study parameters, PS-VAS and QOLS were significantly correlated with the time span. For parameters at the first Boolean remission, HAQ-DI score, PS-VAS, and QOLS demonstrated significant correlation with the time span, whereas SDAI, HAQ-DI score, PS-VAS, SHS, and QOLS after the Boolean remission demonstrated significant correlation with the time span.The comparison between the G ≤ 6 and the G > 6 groups revealed that the disease duration, HAQ score, and PS-VAS at baseline in the G > 6 were significantly higher than that in the G ≤ 6 group, and QOLS in the G ≤ 6 group was significantly higher than that in the G > 6 group at baseline. Similarly, the HAQ score and PS-VAS at the first Boolean remission in the G > 6 group were significantly higher than that in the G ≤ 6 group, whereas QOLS in the G ≤ 6 group demonstrated no significant difference compared with that in the G > 6 group.The mean value of the SDAI score after the first Boolean remission in the G > 6 group was significantly higher than that in the G ≤ 6 group. Similarly, the SDAI score, HAQ score, and PS-VAS after the first Boolean remission in the G > 6 group were also significantly higher than those in the G ≤ 6 group, and the mean value of the QOLS in the G ≤ 6 group were significantly higher than that in the G > 6 group. The Boolean remission rate and SDAI remission rate after the first Boolean remission were significantly higher in the G ≤ 6 group than those in the G > 6 group.Conclusion:Attaining Boolean remission ≤ 6 months for RA has significant benefit for more stable disease control, that leads good maintenance of ADL.Disclosure of Interests:None declared

scholarly journals AB0217 IMPACT OF THE BODY-MASS-INDEX ON DISEASE ACTIVITY, FUNCTIONAL ABILITY AND QUALITY OF LIFE IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1409.2-1409
Author(s):  
L. Medjedovic ◽  
J. Mrdja ◽  
P. Ostojic
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Functional Ability ◽  
Mean Value ◽  
Normal Weight ◽  
Obese Patients ◽  
Mean Values ◽  
Index Measure

Objectives:This study aims to assess differences in disease activity, functional ability and quality of life among underweight, normal weight, overweigth and obese patients with rheumatoid arthritis (RA).Methods:715 patients with RA (609 women and 106 men) were included in this study. According to their Body-Mass-Index, all patients were divided into four subgroups: underweight (BMI <18,5), normal weight (BMI between 18,5 and 24,9), overweight (BMI between 25,0 and 29,9) and obesitas (BMI ≥ 30,0). Mean values of DAS28, CDAI and SDAI (measures of disease activity), HAQ-disability index (measure of functional ability) and RAQoL index (measure of qualitiy of life) were compared among four subgroups of patients.Results:28 (3,9%) RA patients were underweight, 310 (43,4%) had normal weight, 268 (37,5%) were overweight, whilst 109 (15,2%) patients were obese. Among these subgroups, no difference in mean age, disease duration, percentage of seropositive patients, and patients treated with glucocorticoids, csDMARDs or biologics, was noticed. There were no statistically significant differences in mean values of DAS28, CDAI und SDAI in four subgroups of patients. However, mean value of the HAQ disability index was significantly higher (p<0.05) in underweight (1.32) and obese patients (1.27), compared to normal (0.87) and overweigth patients (1.08). The mean value of the RAQoL-Index was also somewhat higher in underweight and obese patients (8.8 and 8.1, respectively) than patients who are overweight or have normal weigth (7.0 and 6.5, respectively), but the difference was not statistically significant.Conclusion:Underweight and obese RA patients have worse physical function than normal and overweight patients. However, worse disability can not be explained by higher disease activity.Disclosure of Interests:None declared

scholarly journals AB0100 EVALUATION OF PGA LEVEL FOR CLINICAL REMISSION WITH BOOLEAN CRITERIA, 10MM OR 20MM?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1078.1-1079
Author(s):  
I. Yoshii
Keyword(s):  
Disease Activity ◽  
Patient Group ◽  
Clinical Remission ◽  
Global Assessment ◽  
Activity Index ◽  
T Test ◽  
Mean Values ◽  
Significant Difference ◽  
Remission Criteria ◽  
The Mean

Background:Patient’s global assessment (PGA) is one important component of Boolean composite criteria for remission in treat with rheumatoid arthritis (RA). However, PGA no more than 10mm is sometimes obstacle to attain clinical remission. In recent few years, one opinion that PGA no more than 20mm may be comparable as no more than 10mm.Objectives:The aim of this study is to analyze how difference of these PGA level affect disease activity and daily activities in living, and evaluate which is optimal for the remission with Boolean remission criteria from real world setting.Methods:RA patients who were followed up for more than three years in the institute were picked up in the study. Each patient was monitored with tenderness joint count (TJC), swollen joint count (SJC), PGA, evaluator’s global assessment (EGA), serum C-reactive protein level (CRP), calculated disease activity score with simplified disease activity index(SDAI), Health Assessment Questionnaire Disability Index (HAQ-DI), and pain score using visual analog scale (PS-VAS) every consulted time from the first encounter (Baseline). Patients were classified according to achievement of Boolean remission criteria. Group 1: a patient group who attained Boolean remission wih TJC≦1, SJC≦1, CRP≦1mg/dl, and PGA≦1 (G-1), Group 2: a patient group who could not attained the Boolean remission used in the G-1 evaluation, but could attained another Boolean remission with TJC≦1, SJC≦1, CRP≦1mg/dl, and PGA≦2 (G-2), and Group 3: a patient group who could not attain Boolean remission for neither criterion.Mean values of measured parameters at Baseline and after the Baseline were compared statistically with Student T-test. Mean values of the same parameters in the G-1 and G-2 at the time of attain Boolean remission for each criteria, mean values of each of these parameters thereafter, and changes of these parameters were compared statistically with Student T-test.Results:A total of 438 patients 385 in the G-1 group, 16 in the G-2 group, and 37 in the G-3 group, were recruited. In parameters at Baseline, level of TJC, SJC, PGA, EGA, SDAI, and HAQ-DI in the G-1 was significantly lower than in the G-3, whereas no significant differences in any parameters demonstrated between in the G-2 and G-3. Level of HAQ-DI, and PS-VAS after Baseline in the G-1 was lower than in the G-3, whereas no significant difference of these parameters after Baseline demonstrated between in the G-2 and G-3. TJC, SJC, PGA, and EGA demonstrated significant less level in the G-1 than in the other two groups. The mean SDAI score at the time of first achievement of Boolean remission in the G-1 and G-2 were 1.08 and 2.57, respectively. The mean value of SDAI score after remission in the G-1 and G-2 were 3.35 and 6.44, respectively. These values and PS-VAS including change of the SDAI score demonstrated significant difference between the two groups (p<0.01), whereas HAQ-DI in the two groups demonstrated no significant difference.Conclusion:These results suggested that setting PGA as no more than 10mm should be reasonable for the evaluation of clinical remission with the Boolean criteria.Disclosure of Interests:None declared

scholarly journals Quality of life of obstetrics fistula patients before and after surgical repair in the Jimma University Medical Center, Southwest Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tilahun Fufa Debela ◽  
Zerihun Asefa Hordofa ◽  
Aster Berhe Aregawi ◽  
Demisew Amenu Sori
Keyword(s):  
Quality Of Life ◽  
Surgical Repair ◽  
Obstetric Fistula ◽  
Medical Center ◽  
Mean Value ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
Jimma University

Abstract Background The consequences of obstetric fistula on affected women are more than the medical condition. It has extensive physical, psychological, social, and economic consequences on them. Obstetric fistula affects the entire health and entire life of women. Women suffering from obstetric fistula are often abandoned by her partner, relatives, and the community. This study aimed to determine the quality of life of obstetrics fistula patients before and after surgical repair. Methods Institutional-based prospective, before and after study design was conducted in the Jimma University Medical Center from November 1, 2019–October 30, 2020. A face-to-face interview was conducted with fistula patients who visited Jimma University Medical center, fistula clinic during the study period. All fistula patients were included in the study. Accordingly, 78 women who underwent surgical repair were interviewed. The means and the standard deviation were computed using conventional statistics formulas. The unpaired t-test was used to compare two independent means, and one-way analysis of variance (ANOVA) was used to compare the quality of life before repair and after a successful repair. Linear regression analysis was done for identifying determinants of quality of life. A P value of 0.05 will be considered statistical significance. Result The overall quality of life of women was 58.17 ± 7.2 before the surgical repair and 71.20 ± 10.79 after surgical repair. The result indicates there is a significant difference in the mean value of pre and post-operative (P < 0.001). The overall satisfaction of women with their health status before the surgical repair was 22.5 ± 1.30and it has increased to 53.0 ± .90after surgical repair. The physical health dimension score was 16.51 ± 5.27 before the surgical repair while it has increased to 21.77 ± 5.38 after the surgical repair. The score of the social domain before the surgical repair was 5.19 ± 1.34 and it has increased to 7.13 ± 3.67 after the surgical repair. The score of the environmental health domain was 17.41 ± 2.89 before the surgery while it also increased to 21.65 ± 4.04 after the surgical repair. The results have shown there was a significant difference in the mean values of pre and post-operatives in both social and environmental scores (P < 0.001). The score of the psychological health domain before the surgery was 19.06 ± 1.46 and it was increased to 19.84 ± 3.21 after the surgical repair. The result showed there is a significant difference in mean value pre and post-operative (P = 0.048), though it is a slight improvement compared to other domains. Conclusion The overall quality of life of the patient with fistula was improved after successful surgical repair. Although all domains of quality of life had shown significant improvement after successful surgical repair, the psychological domain showed slight improvement.

scholarly journals Quality of life in a sample of Brazilian adults using the generic SF-12 questionnaire

2018 ◽  
Vol 64 (3) ◽  
pp. 234-242 ◽  
Author(s):  
Alessandro Gonçalves Campolina ◽  
Rossana Veronica Mendoza Lopez ◽  
Elene Paltrinieri Nardi ◽  
Marcos Bosi Ferraz
Keyword(s):  
Quality Of Life ◽  
Skin Color ◽  
Short Form ◽  
Mean Value ◽  
Life Assessment ◽  
Future Research ◽  
Mean Values ◽  
Socio Demographic Factors ◽  
Assess Quality

Summary Objective: This study describes the summary scores of the Short Form-12 (SF-12) questionnaire, according to socio-demographic factors obtained in a probabilistic and representative sample of the Brazilian urban population. Method: Five thousand (5,000) individuals, over the age of 15, were assessed in 16 capital cities, in the five regions of the country. The selection of households was random. Face-to-face approach was applied in the household interviews. The SF-12 questionnaire was used to assess quality of life. Demographic and socioeconomic characteristics were also evaluated: gender, age, marital status, skin color, region of the country and use of the public health service. Results: The mean value (SD) of the SF-12 for the entire population was 49.3 (8.7) for the physical component (PCS-12) and 52.7 (9.7) for the mental component (MCS-12). Statistical differences were found for gender (PCS-12 and MCS-12), age (PCS-12) and working status (PCS-12 and MCS-12). Women, elderly, widowed and unemployed individuals, those with lower income and with complaints in the last seven days showed lower mean values (PCS-12 and MCS-12). Conclusion: From this point forward, we can provide the basis for comparisons with future research that use the SF-12 for quality of life assessment in Brazil. The Brazilian population has a lower degree of quality of life related do the physical component, and the SF-12 is a useful and discriminative instrument for assessing quality of life in different socio-demographic groups.

scholarly journals Quality of life in patients with mental and behavioural disorders after application of group therapy

2020 ◽  
Vol 49 (2) ◽  
Author(s):  
Maja Brkić ◽  
Ranko Kovačević ◽  
Dženita Hrvić ◽  
Zihnet Selimbašić ◽  
Esmina Avdibegović
Keyword(s):  
Quality Of Life ◽  
Group Therapy ◽  
Interpersonal Relations ◽  
Total Sample ◽  
Physical And Mental Health ◽  
Behavioural Disorders ◽  
Mean Values ◽  
Significant Difference ◽  
Communications Skills

Background: People with mental and behavioural disorders have low satisfaction of quality of life, due to numerous symptoms, as well as poor interpersonal relations, communications skills, low tolerance on frustration.Aim: The aim of this paper was to evaluate whether there has been an improvement in satisfaction with the quality of life after the application of group therapyMethods: The study included 100 patients who attended group therapy, for a period of 6-12 weeks. The instruments used at the beginning and at the end of the treatment were Outcome Questionnaire-45 which measured symptoms distress, interpersonal relations, and social roles, and MANSA questionnaire that measured satisfaction with the quality of life. Results: In total sample (N = 100) there was approximately equal number of women and men (51% vs. 49%). The average age of the subjects was 48.11 ± 7.91. Majority of respondents had depressive disorder (45%). Measuring the mean values obtained on the OQ-45 questionnaire, it was found that after the application of group therapy a significant reduction of the level of dysfunction was achieved. A statistically significant difference was found in the areas of satisfaction with physical and mental health, and the overall score of the MANSA questionnaire.Conclusion: Results show that patients reported lower symptoms distress and higher satisfaction with quality of life after attending group therapy, better interpersonal relations, lower risk of suicidal behaviour and substance abuse. Group therapy is successful intervention which helps patients improve quality of life.

Prolonged clinical remission and low disease activity statuses are associated with better quality of life in systemic lupus erythematosus

Lupus ◽  
2019 ◽  
Vol 28 (10) ◽  
pp. 1189-1196 ◽  
Author(s):  
N Poomsalood ◽  
P Narongroeknawin ◽  
S Chaiamnuay ◽  
P Asavatanabodee ◽  
R Pakchotanon
Keyword(s):  
Quality Of Life ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Clinical Remission ◽  
Life Questionnaire ◽  
Systemic Lupus ◽  
Low Disease Activity ◽  
Significant Difference

Objective The objective of this study was to determine the association between disease activity status and health-related quality of life (HRQoL) in systemic lupus erythematosus (SLE) patients. Methods SLE patients in an out-patient clinic during the previous 12 months were included in the study. The Systemic Lupus Erythematosus-specific Quality-of-Life questionnaire (SLEQoL) was administered at the last visit. Disease activity status was determined retrospectively during the previous year. The categories of disease activity status were defined as: clinical remission (CR): clinical quiescent disease according to Systemic Lupus Erythematosus Disease Activity Index 2000, prednisolone ≤ 5 mg/day; low disease activity (LDA): SLEDAI-2K (without serological domain) ≤ 2, prednisolone ≤ 7.5 mg/day; and non-optimally controlled status: for those who were not in CR/LDA. Immunosuppressive drugs (maintenance dose) and antimalarials were allowed. Prolonged CR or LDA was defined as those with sustained CR or LDA for at least one year. The association between disease activity status and HRQoL was assessed by using regression analysis adjusting for other covariates. Results Of 237 SLE patients, 100 patients (42.2%) achieved prolonged CR, 46 patients (19.4%) achieved prolonged LDA and 91 patients (38.4%) were not in CR/LDA. Non-CR/LDA patients had significantly higher total SLEQoL score and in all domains compared to CR/LDA patients. No significant difference in SLEQoL domain scores was found between CR and LDA groups. Multivariable analysis revealed that non-CR/LDA was positively associated with SLEQoL score compared with CR/LDA (β 20.02, 95% confidence interval (CI) 6.81–33.23, p < 0.003). Moreover, non-CR/LDA was at a higher risk of impaired QoL (SLEQoL score > 80) compared with CR (hazard ratio 3.8; 95% CI 1.82–7.95; p < 0.001). However, there was no significant difference between CR and LDA in terms of SLEQoL score or impaired QoL. Other factors associated with higher SLEQoL score were damage index (β 9.51, 95% CI 3.52–15.49, p = 0.002) and anemia (β 24.99, 95% CI 5.71–44.27, p = 0.01). Conclusion Prolonged CR and LDA are associated with better HRQoL in SLE patients and have a comparable effect. Prolonged CR or optional LDA may be used as the treatment goal of a treat to target approach in SLE.

scholarly journals The Impact of Time Length to Boolean Remission for Tight Disease Activity Control After Acquisition in Rheumatoid Arthritis Patients

2021 ◽  
Author(s):  
Ichiro Yoshii ◽  
Tatsumi Chijiwa ◽  
Naoya Sawada
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Remission Rate ◽  
Health Assessment ◽  
Time Length ◽  
First Remission ◽  
The Impact ◽  
Questionnaire Disability

Abstract Importance of time length to achieving clinical remission on disease activity control, daily activities (ADL) and quality of life (QOL) maintenance after the remission was investigated for patients with rheumatoid arthritis (RA).In patients who achieved remission once or more, relationship between time length from initiation to achieve remission (TL) and patients’ background data at baseline, and relationship between TL and mean simplified disease activity score (SDAI), modified Health Assessment Questionnaire Disability Index (HAQ-DI) score, pain score with visual analog scale (PS-VAS), Sharp/van der Heijde Score (SHS) and quality of life score (QOLS) at the first remission and thereafter were evaluated statistically. Patients were divided into two groups whether TL was within 6 months or longer (G≤6 and G>6). Change of the parameters and Boolean remission rate (BRR) after the first remission between the two groups were compared statistically.In 465 patients, TL correlated significantly with the SDAI score, the HAQ score, PS-VAS, SHS, and the QOLS after the remission. The SDAI score and the BRR after the first remission were significantly better in the G≤6 than in the G>6.TL is an important key to guarantee good disease activity control, ADL and QOL.

scholarly journals Psychosocial profile of children with pediatric malignancy and their families

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
E A Zaky ◽  
D M A Elnasharty ◽  
R M Elhossiny
Keyword(s):  
Quality Of Life ◽  
Mean Value ◽  
Psychosocial Aspects ◽  
The Other ◽  
Newly Diagnosed ◽  
Children With Cancer ◽  
Mean Values ◽  
Other Hand ◽  
Anxiety Depression

Abstract Background The diagnosis and treatment of cancer are a stressful and threatening experience, which has tremendous impact on children and their families. As advances in cancer care have led to more treatment options and longer survival for cancer patients, a focus on quality of life for patients and their families has gained. Objectives The aim of this study was to evaluate the psychosocial aspects of children with different types of pediatric cancer (newly diagnosed as well as survivors), their parents, and sibs in comparison with those with normal children. Patients and Methods This study comprised 60 children, their sibs and caregivers. They were classified into three groups. Group I which comprised 20 newly diagnosed children with cancer, their caregivers and sibs, group II which comprised 20 cancer survivors children, their caregivers and sibs, group III which comprised 20 clinically healthy children, their caregivers and sibs. All children and their sibs in this study were subjected to full history taking, thorough clinical examination, assessment of socioeconomic standard, assessment of pediatric quality of life, a battery of psychometric tests included pediatric checklist, anxiety, depression, and self- esteem scores. All caregivers were subjected to record of demographic variable, assessment of socio-economic level, assessment of anxiety, depression, and isolation score, assessment of stress and burden related to the disease itself, if any, using standardized questionnaire and assessment of quality of life. Results Mean value of DS was significantly higher (P &lt; 0.05) in newly diagnosed cancer children and survivors compared to controls while AS and PCLS was only significantly higher (P &lt; 0.05) in newly diagnosed cancer children compared to controls. On the other hand, mean value of IQ of newly diagnosed cancer children and survivors was significantly than controls(P &lt; 0.05); Mean values of Child as well as the Parental Total HRQL were significantly lower in newly diagnosed and survivors compared to controls (P &lt; 0.05) with the former significantly lower than the later. In studied sib groups, AS was significantly higher in newly diagnosed compared to survivors and controls (P &lt; 0.05), while PCLS was only significantly higher when newly diagnosed compared to survivors. In studied parental groups, mean values of DS, AS, and SS were significantly higher(P,0.05) in newly diagnosed compared to survivors and controls. Meanwhile, IS was significantly higher in newly diagnosed compared to controls. Newly diagnosed children with cancer, their parents and sibs had significantly lower mean values of all Child HRQL subcategories. On the other hand, survivors showed only significantly lower physical and social subcategories compared to controls. In studied sib groups only sibs of newly diagnosed patients and those of survivors, had significantly lower mean value of social subcategory compared to controls. Conclusion The current study showed that newly diagnosed cancer children had severe impact on their psychosocial aspects as well as their HRQL compared to controls while survivors showed a much lesser effects. On the other hand, sibs were mainly affected socially while parents were extremely affected.

Sign in / Sign up

Export Citation Format

Share Document