Skip to main content

Advertisement

SpringerLink
Log in

Health-related quality of life and utility: comparison of ankylosing spondylitis, rheumatoid arthritis, and systemic lupus erythematosus patients in Taiwan

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

The purpose of this study was to evaluate the health-related quality of life among patients with ankylosing spondylitis (AS), rheumatoid arthritis (RA), or systemic lupus erythematosus (SLE). This prospective, cross-sectional survey was conducted from September 1, 2008 to August 31, 2009. Patients answered questions with regard to demographics and disease characteristics and also completed generic (SF-36) and preference-based utility (SF-6D and EQ-5D) instruments. Multivariate analysis assessed the relationship of RA and SLE to AS with respect to the outcomes of the different health-related quality of life instruments. In general, baseline and disease characteristics differed across the three disease groups. Compared to SLE patients, RA patients scored worse on the higher-order summary scores of physical (PCS) and mental components (MCS) of SF-36 (P ≤ 0.002) and total SF-36 (P ≤ 0.005). RA also had worse PCS than AS (P ≤ 0.001). SLE patients scored higher on the utility score of SF-6D compared with RA patients and higher than both AS and RA patients for the utility score of EQ-5D. Multivariate analysis found that compared with AS patients, RA had significantly lower SF-36 total score and PCS, and SLE patients had greater PCS and a greater EQ-5D utility score. Multivariate analysis found no difference across the patient groups with respect to MCS or SF-6D utility score. These findings suggest that among the three rheumatic diseases studied, RA patients have the worse health-related quality of life, and AS patients have similar or poorer health-related quality of life as SLE patient.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Salaffi F, Carotti M, Gasparini S, Intorcia M, Grassi W (2009) The health-related quality of life in rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis: a comparison with a selected sample of healthy people. Health Qual Life Outcomes 7:25

    Article  PubMed  PubMed Central  Google Scholar 

  2. Salaffi F, De Angelis R, Grassi W, Prevalence MAP, study ING (2005) Prevalence of musculoskeletal conditions in an Italian population sample: results of a regional community-based study. I. The MAPPING study. Clin Exp Rheumatol 23(6):819–828

    CAS  PubMed  Google Scholar 

  3. Spondyloarthritis (Spondyloarthropathies) (2014) http://www.rchsd.org/documents/2014/02/spondyloarthritis.pdf. Accessed 20 Oct

  4. Rudwaleit M, van der Heijde D, Landewe R, Akkoc N, Brandt J, Chou CT, Dougados M, Huang F, Gu J, Kirazli Y, Van den Bosch F, Olivieri I, Roussou E, Scarpato S, Sørensen IJ, Valle-Oñate R, Weber U, Wei J, Sieper J (2011) The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis 70(1):25–31

    Article  CAS  PubMed  Google Scholar 

  5. Mok CC, Mak A, Chu WP, To CH, Wong SN (2005) Long-term survival of southern Chinese patients with systemic lupus erythematosus: a prospective study of all age-groups. Medicine (Baltimore) 84(4):218–224

    Article  Google Scholar 

  6. Alarcon GS, McGwin G Jr, Uribe A, Friedman AW, Roseman JM, Fessler BJ, Bastian HM, Baethge BA, Vilá LM, Reveille JD (2004) Systemic lupus erythematosus in a multiethnic lupus cohort (LUMINA). XVII. Predictors of self-reported health-related quality of life early in the disease course. Arthritis Rheum 51(3):465–474

    Article  PubMed  Google Scholar 

  7. Kvien TK (2004) Epidemiology and burden of illness of rheumatoid arthritis. PharmacoEconomics 22(2 Suppl 1):1–12

    PubMed  Google Scholar 

  8. Pincus T, Brooks RH, Callahan LF (1994) Prediction of long-term mortality in patients with rheumatoid arthritis according to simple questionnaire and joint count measures. Ann Intern Med 120(1):26–34

    Article  CAS  PubMed  Google Scholar 

  9. Isenberg D, Ramsey-Goldman R (1999) Assessing patients with lupus: towards a drug responder index. Rheumatology (Oxford) 38(11):1045–1049

    Article  CAS  Google Scholar 

  10. Ozgul A, Peker F, Taskaynatan MA, Tan AK, Dinçer K, Kalyon TA (2006) Effect of ankylosing spondylitis on health-related quality of life and different aspects of social life in young patients. Clin Rheumatol 25(2):168–174

    Article  PubMed  Google Scholar 

  11. Kobelt G, Andlin-Sobocki P, Maksymowych WP (2006) Costs and quality of life of patients with ankylosing spondylitis in Canada. J Rheumatol 33(2):289–295

    PubMed  Google Scholar 

  12. Zhu TY, Tam LS, Lee VW, Hwang WW, Li TK, Lee KK, Li EK (2008) Costs and quality of life of patients with ankylosing spondylitis in Hong Kong. Rheumatology (Oxford) 47(9):1422–1425

    Article  CAS  Google Scholar 

  13. Kobelt G, Sobocki P, Mulero J, Gratacos J, Pocovi A, Collantes-Estevez E (2008) The burden of ankylosing spondylitis in Spain. Value Health 11(3):408–415

    Article  PubMed  Google Scholar 

  14. Mok CC (2011) Epidemiology and survival of systemic lupus erythematosus in Hong Kong Chinese. Lupus 20(7):767–771

    Article  CAS  PubMed  Google Scholar 

  15. Chou CT, Pei L, Chang DM, Lee CF, Schumacher HR, Liang MH (1994) Prevalence of rheumatic diseases in Taiwan: a population study of urban, suburban, rural differences. J Rheumatol 21(2):302–306

    CAS  PubMed  Google Scholar 

  16. van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 27(4):361–368

    Article  PubMed  Google Scholar 

  17. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31(3):315–324

    Article  CAS  PubMed  Google Scholar 

  18. Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40(9):1725 No abstract available

    Article  CAS  PubMed  Google Scholar 

  19. Lu JF, Tseng HM, Tsai YJ (2003) Assessment of health-related quality of life in Taiwan (I): development and psychometric testing of SF-36 Taiwan version. Taiwan J Public Health 22:501–511

    Google Scholar 

  20. Brazier J, Roberts J, Deverill M (2002a) The estimation of a preference-based single index measure for health from the SF-36. J Health Econ 21:271–292

    Article  PubMed  Google Scholar 

  21. Drummond M, O’Brien B, Stoddard G, Torrance G (1997) Methods for the economic evaluation of healthcare programmes, 2 edn. Oxford University Press, Oxford

    Google Scholar 

  22. Group.EQ-5DUserGuide. Rotterdam, Netherlands: The EuroQol Group,1996

  23. Dolan P, Gudex C, Kind P, Williams A (1995) A social tariff for EuroQol: results from a UK general population study. Discussion Paper 138. Centre for Health Economics. The University of York

  24. Brazier J, Roberts J, Deverill M (2002b) The estimation of a preference-based measure of health from the SF-36. J Health Econ 21(2):271–292

    Article  PubMed  Google Scholar 

  25. Harrison MJ, Ahmad Y, Haque S, Dale N, Teh LS, Snowden N, Ho P, Gorodkin R, Bruce IN (2012) Construct and criterion validity of the short form-6D utility measure in patients with systemic lupus erythematosus. J Rheumatol 39(4):735–742

    Article  CAS  PubMed  Google Scholar 

  26. Wang SL, Wu B, Zhu LA, Leng L, Bucala R, Lu LJ (2014) Construct and criterion validity of the Euro Qol-5D in patients with systemic lupus erythematosus. PLoS One 9(6):e98883

    Article  PubMed  PubMed Central  Google Scholar 

  27. Aggarwal R, Wilke CT, Pickard AS, Vats V, Mikolaitis R, Fogg L, Block JA, Jolly M (2009) Psychometric properties of the EuroQol-5D and Short Form-6D in patients with systemic lupus erythematosus. J Rheumatol 36(6):1209–1216

    Article  PubMed  Google Scholar 

  28. Benitha R, Tikly M (2007) Functional disability and health-related quality of life in South Africans with rheumatoid arthritis and systemic lupus erythematosus. Clin Rheumatol 26(1):24–29

    Article  PubMed  Google Scholar 

  29. Tikly M, Zannettou N, Hopley M (2003) A longitudinal study of rheumatoid arthritis in South Africans. MedGenMed 5(1):2

    PubMed  Google Scholar 

  30. Ovayolu N, Ovayolu O, Karadag G (2011) Health-related quality of life in ankylosing spondylitis, fibromyalgia syndrome, and rheumatoid arthritis: a comparison with a selected sample of healthy individuals. Clin Rheumatol 30(5):655–664

    Article  PubMed  Google Scholar 

  31. Chorus AM, Miedema HS, Boonen A, Van Der Linden S (2003) Quality of life and work in patients with rheumatoid arthritis and ankylosing spondylitis of working age. Ann Rheum Dis 62(12):1178–1184

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Wolfe F, Michaud K, Li T, Katz RS (2010a) EQ-5D and SF-36 quality of life measures in systemic lupus erythematosus: comparisons with rheumatoid arthritis, noninflammatory rheumatic disorders, and fibromyalgia. J Rheumatol 37(2):296–304

    Article  PubMed  Google Scholar 

  33. Ward MM (1999) Health-related quality of life in ankylosing spondylitis: a survey of 175 patients. Arthritis Care Res 12(4):247–255

    Article  CAS  PubMed  Google Scholar 

  34. Pincus T (2007) Patient questionnaires and formal education as more significant prognostic markers than radiographs or laboratory tests for rheumatoid arthritis mortality—limitations of a biomedical model to predict long-term outcomes. Bull NYU Hosp Jt Dis 65(Suppl 1):S29–S36

    PubMed  Google Scholar 

  35. Wikstrom I, Book C, Jacobsson LT (2006) Difficulties in performing leisure activities among persons with newly diagnosed rheumatoid arthritis: a prospective, controlled study. Rheumatology (Oxford) 45(9):1162–1166

    Article  CAS  Google Scholar 

  36. Groessl EJ, Ganiats TG, Sarkin AJ (2006) Sociodemographic differences in quality of life in rheumatoid arthritis. PharmacoEconomics 24(2):109–121

    Article  PubMed  Google Scholar 

  37. Baczyk G (2005) The evaluation of the functioning and of the quality of life of patients with rheumatoid arthritis. Rocz Akad Med Bialymst 50(Suppl 1):170–173

    PubMed  Google Scholar 

  38. Wolfe F, Michaud K, Li T, Katz RS (2010b) Chronic conditions and health problems in rheumatic diseases: comparisons with rheumatoid arthritis, noninflammatory rheumatic disorders, systemic lupus erythematosus, and fibromyalgia. J Rheumatol 37(2):305–315

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study is based in part on data from the Taichung Veterans General Hospital Research Database and managed by the Clinical Informatics Research & Development Center of Taichung Veterans General Hospital (Registered number F16222). The interpretation and conclusions contained herein do not represent those of Taichung Veterans General Hospital.

Author information

Authors and Affiliations

  1. Department of Medical Research, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Boulevard, Taichung, 40705, Taiwan

    Hsin-Hua Chen, Der-Yuan Chen & Yi-Ming Chen

  2. Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, Taiwan

    Hsin-Hua Chen, Der-Yuan Chen & Yi-Ming Chen

  3. School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Hsin-Hua Chen, Der-Yuan Chen, Yi-Ming Chen & Kuo-Lung Lai

  4. Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan

    Hsin-Hua Chen, Der-Yuan Chen, Yi-Ming Chen & Kuo-Lung Lai

  5. School of Medicine, Chung-Shan Medical University, Taichung, Taiwan

    Hsin-Hua Chen & Der-Yuan Chen

  6. Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan

    Hsin-Hua Chen & Der-Yuan Chen

  7. Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan

    Hsin-Hua Chen

Authors
  1. Hsin-Hua Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Der-Yuan Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yi-Ming Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kuo-Lung Lai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hsin-Hua Chen.

Ethics declarations

The protocol was approved by the hospital’s institutional review board, and all patients gave their informed consent.

Disclosures

None.

Funding source

None.

Additional information

Key messages

• Overall, RA patients have lower health-related quality of life than AS and SLE patients.

• RA patients have worse physical function compared with AS and SLE patients.

• AS patients have similar or poorer health-related quality of life as SLE patient.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chen, HH., Chen, DY., Chen, YM. et al. Health-related quality of life and utility: comparison of ankylosing spondylitis, rheumatoid arthritis, and systemic lupus erythematosus patients in Taiwan. Clin Rheumatol 36, 133–142 (2017). https://doi.org/10.1007/s10067-016-3471-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-016-3471-y

Keywords

Search

Navigation