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Health-related quality of life among spondyloarthritis and chronic low back pain patients: results from a nationwide population-based survey

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Abstract

Purpose

Both spondyloarthritis and chronic low back pain (CLBP) significantly impact health-related quality of life (HRQoL). It is important to clarify whether these disorders have different impacts on the several domains of HRQoL as different mechanisms may necessitate different treatment interventions. Moreover, the factors associated with HRQoL can inform more targeted group interventions to promote HRQoL.

Methods

We used data from EpiReumaPt, a population-based survey conducted from September 2011 to December 2013. HRQoL was assessed with EuroQoL-5-Dimensions (EQ-5D). Spondyloarthritis was diagnosed by expert opinion (rheumatologist) and predefined criteria. CLBP was diagnosed if low back pain was present on the day of the interview and persisted for > 90 days. Univariable and multivariable linear regression analyses compared HRQoL among subjects with spondyloarthritis, CLBP, and no rheumatic diseases. Multivariable linear regression analyses evaluated HRQoL factors in spondyloarthritis and CLBP subjects.

Results

We included 92 spondyloarthritis patients, 1376 CLBP patients, and 679 subjects without rheumatic diseases. HRQoL was similarly affected in spondyloarthritis and CLBP (ß =  − 0.03, 95% CI [− 0.08; 0.03]) in all EQ5D dimensions. A much lower HRQoL was found in spondyloarthritis and CLBP patients compared with subjects without rheumatic diseases (ß =  − 0.14, 95% CI [− 0.19; − 0.10]; ß =  − 0.12, 95% CI [− 0.14; − 0.09], respectively). In spondyloarthritis subjects, multimorbidity and active disease were associated with worse HRQoL (ß =  − 0.18; 95% CI [− 0.24; 0.03]; ß =  − 0.13; 95% CI [− 0.29; − 0.05], respectively), and regular physical exercise was associated with better HRQoL (ß = 0.18; 95% CI [0.10; 0.30]). In CLBP subjects, multimorbidity (β =  − 0.11; 95% CI [− 0.14; − 0.08]), obesity (β =  − 0.04; 95% CI [− 0.08; − 0.01]), and low back pain intensity (β =  − 0.02; 95% CI [− 0.03; − 0.02]) were associated with worse HRQoL, and regular physical exercise (β = 0.08; 95% CI [0.05; 0.11]) was significantly associated with better HRQoL.

Conclusion

Spondyloarthritis and CLBP subjects reported similar levels of impairment in the mental, physical, and social domains of HRQoL. Future health plans should address modifiable factors associated with HRQoL in these conditions to achieve better outcomes.

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Acknowledgements

We would like to acknowledge the contribution of all members of EpiReumaPt study group. Helena Santos further acknowledges the support from Sociedade Portuguesa de Reumatologia.

Funding

All authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Nova Medical School, EpiDoc Unit/Comprehensive Health Research Center, Instituto Português de Reumatologia, Rua da Beneficência, n 7, 1050-034, Lisbon, Portugal

    Helena Santos

  2. Nova Medical School, EpiDoc Unit/Comprehensive Health Research Center, Lisbon, Portugal

    Ana Rita Henriques, Jaime Branco, Helena Canhão & Ana Maria Rodrigues

  3. Centre for Rheumatology and Department of Neuromuscular Diseases, University College of London, London, UK

    Pedro M. Machado

  4. Nova Medical School, CEDOC—Rheumatic Diseases Lab, Lisbon, Portugal

    Fernando M. Pimentel-Santos

  5. Hospital Dos Lusíadas, Lisbon, Portugal

    Ana Maria Rodrigues

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  1. Helena Santos
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  4. Pedro M. Machado
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Contributions

All authors contributed to the study conception and design. Materials preparation, data collection, and analysis were performed by HS, ARH, and AMR. The first draft of the manuscript was written by HS, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Helena Santos.

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Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki, and approval was granted by the Ethics Committee of NOVA Medical School (nº123/2020/CEFCM).

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Informed consent was obtained from all individual participants included in the study.

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Santos, H., Henriques, A.R., Branco, J. et al. Health-related quality of life among spondyloarthritis and chronic low back pain patients: results from a nationwide population-based survey. Qual Life Res 32, 383–399 (2023). https://doi.org/10.1007/s11136-022-03274-0

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