Saketkoo Lesley Ann, Russell Anne-Marie, Jensen Kelly, Mandizha Jessica, Tavee Jinny, Newton Jacqui, Rivera Frank, Howie Mike, Reese Rodney, Goodman Melanie, Hart Patricia, Strookappe Bert, De Vries Jolanda, Rosenbach Misha, Scholand Mary Beth, Lammi Mathew R, Elfferich Marjon, Lower Elyse, Baughman Robert P, Sweiss Nadera, Judson Marc A, Drent Marjolein
New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, LA 70112, USA.
Comprehensive Pulmonary Hypertension Center and Interstitial Lung Disease Clinic Programs, University Medical Center, New Orleans, LA 70112, USA.
Diagnostics (Basel). 2021 Jun 15;11(6):1089. doi: 10.3390/diagnostics11061089.
Health-related quality of life (HRQoL), though rarely considered as a primary endpoint in clinical trials, may be the single outcome reflective of patient priorities when living with a health condition. HRQoL is a multi-dimensional concept that reflects the degree to which a health condition interferes with participation in and fulfillment of important life areas. HRQoL is intended to capture the composite degree of physical, physiologic, psychological, and social impairment resulting from symptom burden, patient-perceived disease severity, and treatment side effects. Diminished HRQoL expectedly correlates to worsening disability and death; but interventions addressing HRQoL are linked to . Sarcoidosis, being a multi-organ system disease, is associated with a diffuse array of manifestations resulting in multiple symptoms, complications, and medication-related side effects that are linked to reduced HRQoL. Diminished HRQoL in sarcoidosis is related to decreased physical function, pain, significant loss of income, absence from work, and strain on personal relationships. Symptom distress can result clearly from a sarcoidosis manifestation (e.g., ocular pain, breathlessness, cough) but may also be non-specific, such as pain or fatigue. More complex, a single non-specific symptom, e.g., fatigue may be directly sarcoidosis-derived (e.g., inflammatory state, neurologic, hormonal, cardiopulmonary), medication-related (e.g., anemia, sleeplessness, weight gain, sub-clinical infection), or an indirect complication (e.g., sleep apnea, physical deconditioning, depression). Identifying and distinguishing underlying causes of impaired HRQoL provides opportunity for treatment strategies that can greatly impact a patient's function, well-being, and disease outcomes. Herein, we present a reference manual that describes the current state of knowledge in sarcoidosis-related HRQoL and distinguish between diverse causes of symptom distress and other influences on sarcoidosis-related HRQoL. We provide tools to assess, investigate, and diagnose compromised HRQoL and its influencers. Strategies to address modifiable HRQoL factors through palliation of symptoms and methods to improve the sarcoidosis health profile are outlined; as well as a proposed research agenda in sarcoidosis-related HRQoL.
健康相关生活质量(HRQoL),尽管在临床试验中很少被视为主要终点,但可能是反映患者在患有健康状况时优先事项的唯一结果。HRQoL是一个多维概念,反映了健康状况干扰参与和实现重要生活领域的程度。HRQoL旨在捕捉由症状负担、患者感知的疾病严重程度和治疗副作用导致的身体、生理、心理和社会损害的综合程度。HRQoL下降预计与残疾恶化和死亡相关;但针对HRQoL的干预措施与……相关。结节病作为一种多器官系统疾病,与一系列广泛的表现相关,导致多种症状、并发症以及与药物相关的副作用,这些都与HRQoL降低有关。结节病患者HRQoL下降与身体功能下降、疼痛、收入大幅损失、旷工以及人际关系紧张有关。症状困扰可能明显由结节病表现引起(如眼痛、呼吸困难、咳嗽),但也可能是非特异性的,如疼痛或疲劳。更复杂的是,单一的非特异性症状,如疲劳,可能直接源于结节病(如炎症状态、神经、激素、心肺方面)、与药物相关(如贫血、失眠、体重增加、亚临床感染)或间接并发症(如睡眠呼吸暂停、身体机能下降、抑郁)。识别和区分HRQoL受损的潜在原因,为能够极大影响患者功能、幸福感和疾病结局的治疗策略提供了机会。在此,我们呈现一本参考手册,描述结节病相关HRQoL的当前知识状态,并区分症状困扰的不同原因以及对结节病相关HRQoL的其他影响因素。我们提供评估、调查和诊断受损HRQoL及其影响因素的工具。概述了通过缓解症状来解决可改变的HRQoL因素的策略以及改善结节病健康状况的方法;还提出了结节病相关HRQoL的研究议程。