Beyene Dessale Abate, Sisay Eskinder Ayalew, Fentie Atalay Mulu, Gebremedhin Amha
Tikur Anbessa Specialized Hospital, Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Tikur Anbessa Specialized Hospital, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Front Med (Lausanne). 2024 Nov 5;11:1423161. doi: 10.3389/fmed.2024.1423161. eCollection 2024.
The treatment of immune thrombocytopenia (ITP) is a major clinical challenge and has a significant impact on health-related quality of life (HRQoL), and prolonged use of corticosteroids may have a negative impact on HRQoL.
To evaluate the impact of ITP on HRQoL and complications of corticosteroid treatment in patients with ITP in two teaching hospitals in Ethiopia.
The institution-based cross-sectional study was conducted from November 15, 2022, to March 15, 2023, to recruit 214 study participants during the study period (4 months). The ITP Life Quality Index (ILQI) in the Amharic version was used to assess the impact of ITP. Linear regression analysis models were also used, and a -value of less than 0.05 was generally considered statistically significant.
Regarding treatment, the majority 172 (80.4%) of study participants were taking prednisolone only, and 143 (66.8%) of study participants had at least one side effect of corticosteroids during the entire treatment period. Predictive factors for a higher impact of ITP on HRQoL; all correlated variables explained 36.5% (adjusted R-squared = 0.365, < 0.0001) of the variance and had a moderate impact on HRQoL. Furthermore, predictive factors for an increasingly higher impact of ITP on HRQoL were the development of emotionally related corticosteroid side effects ( = 0.392, 95% CI: 5.160-9.961, < 0.001), the presence of fatigue during the assessment ( = 0.326, 95% CI: 4.394-9.475, < 0.001), patients not taking cotrimoxazole prophylaxis treatment ( = 0.236, 95% CI: 2.236-6.570, p < 0.001), living far from the hematology clinic (outside Addis Ababa) ( = 0166, 95% CI: 1.107-5.114 = 0.003), having epistaxis and/or wet purpura (mucosal bleeding) ( = 0.191, 95% CI: 0.091-4.259, = 0.001), and skin symptoms (petechiae and ecchymosis) ( = 0.041, 95% CI: 0.091-4.259 = 0.041) during diagnosis.
The impact of ITP on their energy levels and work life was high compared to the impact of ITP on daily life. The side effects of corticosteroids also affect the HRQoL of ITP patients.
免疫性血小板减少症（ITP）的治疗是一项重大临床挑战，对健康相关生活质量（HRQoL）有重大影响，长期使用皮质类固醇可能会对HRQoL产生负面影响。
评估ITP对埃塞俄比亚两家教学医院ITP患者HRQoL的影响以及皮质类固醇治疗的并发症。
基于机构的横断面研究于2022年11月15日至2023年3月15日进行，在研究期间（4个月）招募了214名研究参与者。使用阿姆哈拉语版本的ITP生活质量指数（ILQI）来评估ITP的影响。还使用了线性回归分析模型，P值小于0.05通常被认为具有统计学意义。
在治疗方面，大多数172名（8０.4%）研究参与者仅服用泼尼松龙，143名（66.8%）研究参与者在整个治疗期间至少出现一种皮质类固醇的副作用。ITP对HRQoL产生更高影响的预测因素；所有相关变量解释了36.5%（调整后的R平方=0.365，P<0.0001）的方差，并且对HRQoL有中等影响。此外，ITP对HRQoL产生越来越高影响的预测因素包括与情绪相关的皮质类固醇副作用的出现（β=0.392，95%置信区间：5.160-9.961，P<0.001）、评估期间存在疲劳（β=0.326，95%置信区间：4.394-9.475，P<0.001）、未接受复方新诺明预防性治疗的患者（β=0.236，95%置信区间：2.236-6.570，P<0.001）、居住在远离血液学诊所的地方（亚的斯亚贝巴以外）（β=0.166，95%置信区间：1.107-5.114，P=0.003）、有鼻出血和/或湿性紫癜（粘膜出血）（β=0.191，95%置信区间：0.091-4.259，P=0.001）以及诊断期间出现皮肤症状（瘀点和瘀斑）（β=0.041，95%置信区间：0.091-4.259，P=0.041）。
与ITP对日常生活的影响相比，ITP对患者能量水平和工作生活的影响更大。皮质类固醇的副作用也会影响ITP患者的HRQoL。
