Torre-Alonso Juan Carlos, Queiro Rubén, Comellas Marta, Lizán Luís, Blanch Carles
Rheumatology Department, Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Monte Naranco, Oviedo, Spain.
Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain.
Patient Prefer Adherence. 2018 May 8;12:733-747. doi: 10.2147/PPA.S162420. eCollection 2018.
This review aims to summarize the current literature on patient-reported outcomes (PROs) in spondyloarthritis (SpA).
We performed a systematic literature review to identify studies (original articles and narrative and systematic reviews) regarding PROs (health-related quality of life [HRQoL], satisfaction, preferences, adherence/compliance, and persistence) in SpA patients published in the European Union through December 2016. International databases (Medline/PubMed, Cochrane Library, ISI Web of Knowledge, Scopus) were searched using keywords in English. The methodological quality of the studies was assessed using the Oxford Centre for Evidence-Based Medicine criteria.
A total of 26 publications met the inclusion criteria. Generally, studies indicated that SpA has a negative impact on patients' HRQoL. In patients with ankylosing spondylitis, physical domains were more affected than emotional ones, whereas for psoriatic arthritis, both physical and psychological factors were strongly affected by the disease. Data indicated that biological agents (BAs) greatly contributed to improvement in HRQoL in both ankylosing spondylitis and psoriatic arthritis patients. Findings on compliance with BAs were heterogeneous. However, persistence rates exceeded 50% irrespective of the BA administered. Results on preferences indicated that most SpA patients prefer being involved in decisions regarding their treatment and that besides efficacy and safety, frequency and route of administration may influence patients' preferences for BAs.
Implementing management programs for SpA patients focuses on the physical, emotional, and social consequences of the disease, in addition to assessing and including patient preferences in the treatment decision-making process, could be crucial to improve patients' HRQoL and ensure their satisfaction and compliance with treatment.
本综述旨在总结目前关于脊柱关节炎（SpA）患者报告结局（PROs）的文献。
我们进行了一项系统的文献综述，以识别2016年12月前在欧盟发表的有关SpA患者PROs（健康相关生活质量[HRQoL]、满意度、偏好、依从性/顺从性和持续性）的研究（原创文章、叙述性综述和系统综述）。使用英文关键词检索国际数据库（Medline/PubMed、Cochrane图书馆、ISI知识网络、Scopus）。采用牛津循证医学中心标准评估研究的方法学质量。
共有26篇出版物符合纳入标准。总体而言，研究表明SpA对患者的HRQoL有负面影响。在强直性脊柱炎患者中，身体领域比情感领域受影响更大，而对于银屑病关节炎，身体和心理因素均受到该疾病的强烈影响。数据表明，生物制剂（BAs）对强直性脊柱炎和银屑病关节炎患者HRQoL的改善有很大贡献。关于BAs依从性的研究结果存在异质性。然而，无论使用何种BAs，持续率均超过50%。偏好方面的结果表明，大多数SpA患者希望参与有关其治疗的决策，并且除疗效和安全性外，给药频率和途径可能会影响患者对BAs的偏好。
实施针对SpA患者的管理计划，除了在治疗决策过程中评估并纳入患者偏好外，还关注该疾病的身体、情感和社会后果，对于改善患者的HRQoL以及确保其对治疗的满意度和依从性可能至关重要。
