6Fatigue, health-related quality of life and other patient-reported outcomes in systemic lupus erythematosus
Section snippets
Methodology
A search of all publications relating to the burden of SLE (January 2000 to March 2010) was performed using the Medline (PubMed) database. The following search terms were used to identify potentially relevant publications: SLE plus QoL, patient perspective, patient burden of illness/disease, family impact/burden, prognosis, self, employment/work impact, psychological impact, patient(s) and psychological impact/physical impact/daily living or functionality/fatigue/functioning and impact on
Assessment of HRQoL in patients with SLE
Twenty-four studies that evaluated HRQoL in patients with SLE used Short Form 36-Item Health Survey (SF-36) [2], [3], [4], [5], [6], [7], [8], [9], *[10], [11], [12], *[13], *[14], [15], [16], [17], [18], [19], [20], [21], *[22], [23], [24], *[25], [26], [27], [28], [29], *[30], [31]. Other generic instruments, such as the EuroQoL utility index (EuroQoL-5D), EuroQoL visual analogue scale (EuroQoL VAS) and shortened QoL instruments derived from SF-36 (SF-8, SF-6D and SF-12), were occasionally
Impact of SLE on working life
The grade of participation is finally the result that reflects best the influence of a disease on daily life and satisfaction. An essential part of participation is given by working life on which SLE can have a major impact.
Data from 12 studies revealed that employment rates in individuals with SLE (mean age at time of study: 38–50 years; mean age at diagnosis: 31–40 years) ranged from 26% to 54% [2], [5], [7], [9], [32], [40], [42], [46], [48], [49], [61], [62], [63] while the proportion of
Comparisons with other chronic conditions
Several studies have explored the burden of SLE in relation to that imposed by other chronic diseases.
The results of a large comparative study conducted in the USA showed that patients with SLE (n = 1316) generally had worse HRQoL than patients with RA (n = 13,722) or non-inflammatory rheumatic disease (n = 3623), but better HRQoL than patients with fibromyalgia (n = 2733) [24]. Although patients with SLE had mean SF-36 PCS (36.3, 36.7 and 36.4, respectively) and EuroQoL-5D (0.72, 0.73 and
Conclusions
The present literature analysis demonstrated that SLE has a considerable impact on the HRQoL of patients and their ability to carry out normal daily activities, resulting in a high prevalence of disability (25–57%). Multiple studies show that the HRQoL of patients with SLE is consistently lower than that of matched healthy control subjects or the population norm, with all aspects of HRQoL (including physical and mental health, vitality, pain and social and emotional functioning) affected by the
Acknowledgements
Dr. Heike Carnarius, Senior Medical Advisor at GSK, participated in the conception, analysis and interpretation of the literature search.
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