AB1429 Sociodemographic and clinical factors associated with health-related quality of life in patients with inflammatory rheumatic diseases treated with glucocorticoids: A cross-sectional study

Lim, K. W.; Janagan, S.; Bhogal, R.; Bridgewater, S.; Silverthorne, C.; Richards, P.; Dawson, J.; Dures, E.; Hill, C.; Goodman, S.; Mackie, S.; Ndosi, M.; Robson, J. C.

Abstract

Background: Glucocorticoids (GCs) play a pivotal role in the management of inflammatory rheumatic conditions but they can adversely impact on patients in different ways. Conversely, there are certain patient characteristics that may be correlated with a poorer health-related quality of life (HRQoL). Objectives: The objective of this study was to identify socio-demographic and clinical factors associated with HRQoL in patients undertaking GCs for a rheumatic disease. Methods: This was a cross-sectional study using online survey methods. Participants taking GCs for a rheumatic disease from Australia/New Zealand (AU/NZ), United Kingdom (UK) and the United States of America (USA) were included. HRQoL was measured using the generic EuroQoL (EQ-5D-5L) converted into a linear EQ5D index value. Eight explanatory factors (age, sex, country, educational level, employment status, disease group, self-reported disease state, and dose of GCs) were tested for potential association with HRQoL using univariable and multivariable (hierarchical) analyses. Factors found to have a significant association with EQ5D index at a p<0.05 level in the multivariable model were considered independently associated with HRQoL. Results: A total of 945 patients completed the EQ-5D-5L with no missing values: UK n=742 (79%), USA n=139 (15%), AU/NZ n=64 (7%); mean age was 57.6 (SD=13.6); 833 (88%) were women. Participants with self-reported active disease were 726 (77%). Those with inflammatory arthritis were 197 (21%), connective tissue disease and/or vasculitis were 402 (43%), giant cell arteritis and/or polymyalgia rheumatica were 346 (36%). Mean (SD) EQ5D index was 0.64 (0.25); There were significant differences between groups in age (median split, t=-3.77, p<0.001); sex (t=3.40, p<0.01); educational level (F[3]=10.51, p<0.001); employment status (F[6]=37.67, p<0.001); disease group (T[2]=20.23, p<0.001); disease state (T=-8.46, p<0.001); and the dose of GCs (T=2.95, p<0.001). Worse HRQoL was associated with older age, being female, low educational attainment, being unemployed, having an inflammatory arthritis or a CTD, disease being active, and taking a higher dose of GCs. Five factors were identified as being independently associated with worse HRQoL: disease state (β=0.12, p<0.001), disease group (β=0.06, p<0.001), employment status (β =0.05, p<0.001), sex (β =0.05, p<0.001), and educational level (β =0.04, p<0.001). Conclusion: We identified 5 factors which were independently associated with worse HRQoL in patients being treated with GCs. Over 80% of the variance was not explained by our model likely due to use of a generic HRQoL measure (EQ-5D-5L) as outcome, and the small number of explanatory factors tested within this survey. Further research is required to identify potential targets to support interventions. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared. Figure 1 EQ-5D-5L proportions reported by dimensions dichotomised into no problem or any problems. Disease activity was patient‘s self-report of active or inactive disease. Table 1 EQ-5D-5L frequencies in the 3 disease categories, reported by dimensions dichotomised into no problem or any problems. IA (n=197) (%) CTD/vasculitis(n=402) (%) GCA/PMR(n=346) (%) Chi-Square (p-value) Mobility No problem 18 (9.2) 109 (27.1) 101 (29.2) 30.987 (<0.001) Any problems 179 (90.9) 293 (72.9) 245 (70.8) Self-care No problem 57 (28.9) 220 (54.7) 232 (67.1) 73.604 (<0.001) Any problems 140 (71.1) 182 (45.3) 114 (32.9) Activity No problem 17 (8.7) 59 (14.7) 65 (18.8) 10.234 (0.006) Any problems 180 (91.4) 343 (85.3) 281 (81.2) Pain/Discomfort No problem 6 (3.1) 48 (11.9) 27 (7.8) 13.833 (<0.001) Any problems 191 (97.0) 353 (87.8) 319 (92.2) Anxiety/Depression No problem 54 (27.4) 89 (22.1) 120 (34.7) 14.587 (<0.001) Any problems 143 (72.6) 313 (77.9) 226 (65.3)

• Presentation Conference Type: Conference Abstract
• Conference Name: EULAR 2024 European Congress of Rheumatology
• Start Date: Jun 12, 2024
• End Date: Jun 15, 2024
• Online Publication Date: Jun 10, 2024
• Publication Date: Jun 10, 2024
• Deposit Date: Jun 19, 2024
• Print ISSN: 0003-4967
• Electronic ISSN: 1468-2060
• Publisher: BMJ Publishing Group
• Volume: 83
• Issue: 1
• Article Number: 2070
• Book Title: Annals of the Rheumatic Diseases (ARD)
• DOI: https://doi.org/10.1136/annrheumdis-2024-eular.3928
• Public URL: https://uwe-repository.worktribe.com/output/12077218
• Publisher URL: https://ard.bmj.com/content/83/Suppl_1/2070.2