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患有关节炎和/或纤维肌痛的成年人的健康相关生活质量概况:一项横断面研究。

Health-related quality of life profiles of adults with arthritis and/or fibromyalgia: a cross-sectional study.

作者信息

Knight Erin M, Carluzzo Kathleen L, Reeve Bryce B, Mueller Kristen L, Singh Jasvinder A, Lin Li, Schifferdecker Karen E

机构信息

Center for Program Design and Evaluation, Geisel School of Medicine, Dartmouth College, WTRB Level 5, 1 Medical Center Drive, Lebanon, NH, 03756, USA.

The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, 03756, USA.

出版信息

Qual Life Res. 2025 Feb;34(2):523-534. doi: 10.1007/s11136-024-03831-9. Epub 2024 Nov 20.

Abstract

PURPOSE

Adults with arthritis experience poor health-related quality of life (HRQOL), though research often focuses on single HRQOL outcomes or summary scores. We aimed to identify HRQOL profiles in adults with different arthritis types and determine risk and protective factors.

METHODS

Data including PROMIS-29 Profile v2.1 and PROMIS Short Form v2.0 - Emotional Support 4a were collected through a national foundation's online survey of adults with arthritis in the U.S. We used latent profile analysis (LPA) to characterize the heterogeneity in arthritis patients by clustering them into HRQOL profiles, based on statistical model fit and clinical interpretability. We fit a multinomial logistic regression model with HRQOL profile assignment as the outcome to determine associations with protective and risk factors.

RESULTS

We included 25,305 adults with arthritis. The LPA results favored a five-HRQOL profile solution (entropy = 0.83). While some profiles displayed better HRQOL in some domains, 93% of the sample displayed impacted pain and physical functioning. One profile (20%) displayed mean T-scores nearly 2 standard deviations below the population mean. Despite poor physical HRQOL outcomes, one profile (10%) displayed average mental health. All demographic and clinical factors contributed significantly to the model, including risk factors (arthritis types, work status) and protective factors (more emotional support, starting exercise).

CONCLUSION

We identified profiles with consistently impacted HRQOL in arthritis, though one displayed average mental health functioning despite poor physical functioning. These results highlight the value of considering the patient's HRQOL experience alongside treatment options, and the potentially positive impact of non-pharmacological interventions.

摘要

目的

患有关节炎的成年人健康相关生活质量(HRQOL)较差,尽管研究通常侧重于单一的HRQOL结果或综合评分。我们旨在确定不同关节炎类型成年人的HRQOL概况,并确定风险和保护因素。

方法

通过一个全国性基金会对美国患有关节炎的成年人进行的在线调查,收集了包括PROMIS-29概况v2.1和PROMIS简表v2.0 - 情感支持4a的数据。我们使用潜在概况分析(LPA),根据统计模型拟合度和临床可解释性,将关节炎患者聚类为HRQOL概况,以表征其异质性。我们拟合了一个多项逻辑回归模型,将HRQOL概况分配作为结果,以确定与保护因素和风险因素的关联。

结果

我们纳入了25305名患有关节炎的成年人。LPA结果支持五HRQOL概况解决方案(熵 = 0.83)。虽然某些概况在某些领域显示出较好的HRQOL,但93%的样本显示出疼痛和身体功能受到影响。一个概况(20%)显示平均T分数比总体平均值低近2个标准差。尽管身体HRQOL结果不佳,但一个概况(10%)显示心理健康状况平均。所有人口统计学和临床因素对模型均有显著贡献,包括风险因素(关节炎类型、工作状态)和保护因素(更多情感支持、开始锻炼)。

结论

我们确定了关节炎患者中HRQOL持续受到影响的概况,尽管其中一个概况在身体功能不佳的情况下仍显示出平均心理健康功能。这些结果凸显了在考虑治疗方案时兼顾患者HRQOL体验的价值以及非药物干预的潜在积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6085/11865125/84bb1ab3cf04/11136_2024_3831_Fig1_HTML.jpg

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