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接受调节剂治疗的成年人的身体健康状况与护理负担:一项基于Well-ME调查中患者报告经历的混合方法研究。

Physical well-being and burden of care in adults on modulator therapy: A mixed methods study of patient-reported experiences from the Well-ME survey.

作者信息

Brown Cynthia D, Frederick Carla, Yu Elizabeth, Zagnit Emily, King Joel R, Van Citters Aricca D

机构信息

Indiana University School of Medicine, Division of Pulmonary, Critical Care, Occupational and Sleep Medicine, 1120 W. Michigan St, Indianapolis, IN, USA 46202.

Department of Medicine, Jacobs School of Medicine and Biomedical Sciences of the University of Buffalo, 1001 Main Street, Conventus Building, 4th floor, Buffalo, NY 14023, USA.

出版信息

J Cyst Fibros. 2025 Jul;24(4):652-659. doi: 10.1016/j.jcf.2025.04.010. Epub 2025 May 4.

Abstract

BACKGROUND

Despite widespread availability of modulator therapies and improved lung function in many people with cystic fibrosis (CF), physical symptoms may remain burdensome for some people with CF (PwCF). This study identifies the impact of ivacaftor (IVA) and elexacaftor/tezacaftor/ivacaftor (ETI) on self-reported physical well-being and burden of care among adults with CF.

METHODS

We conducted a secondary analysis of data from the Well-ME Survey. Participants included adults with CF (age≥18) who reported taking IVA or ETI. We used a mixed methods approach to identify self-reported health status, physical well-being, and experience of CF care while taking IVA or ETI.

RESULTS

Among 414 eligible respondents, overall health status was reported very good/excellent by 59 % (n = 243), good by 26 % (n = 114), and poor/fair by 14 % (n = 57). While the majority of respondents experienced improvements in respiratory symptoms, PwCF reporting poor/fair health were less likely to report improvement in overall physical health, fatigue, and ability to exercise compared to those with good or very good/excellent health and less likely to report improvement in pain, sinus issues, and cough than those with very good/excellent health. PwCF reporting poor/fair health or good health were less likely to report improvements in gastrointestinal issues or experience reductions in CF medications or treatments, compared to those reporting very good/excellent health.

CONCLUSIONS

Despite improvements in respiratory symptoms, some adults with CF taking IVA or ETI report their health is poor/fair. A better understanding of physical well-being and burden of care may help identify underrecognized comorbidities to improve care.

摘要

背景

尽管调节剂疗法已广泛应用,许多囊性纤维化(CF)患者的肺功能也有所改善,但一些CF患者(PwCF)的身体症状可能仍然很严重。本研究确定了依伐卡托(IVA)和依列卡托/替扎卡托/依伐卡托(ETI)对成年CF患者自我报告的身体健康状况和护理负担的影响。

方法

我们对来自Well-ME调查的数据进行了二次分析。参与者包括报告服用IVA或ETI的成年CF患者(年龄≥18岁)。我们采用混合方法来确定在服用IVA或ETI期间自我报告的健康状况、身体健康状况以及CF护理体验。

结果

在414名符合条件的受访者中,59%(n = 2�3)报告总体健康状况非常好/优秀,26%(n = 114)报告良好,14%(n = 57)报告较差/一般。虽然大多数受访者的呼吸道症状有所改善,但与健康状况良好或非常好/优秀的患者相比,报告健康状况较差/一般的PwCF在总体身体健康、疲劳和运动能力方面报告改善的可能性较小;与健康状况非常好/优秀的患者相比,他们在疼痛、鼻窦问题和咳嗽方面报告改善的可能性也较小。与报告健康状况非常好/优秀的患者相比,报告健康状况较差/一般或良好的PwCF在胃肠道问题方面报告改善的可能性较小,或在CF药物或治疗方面减少的可能性较小。

结论

尽管呼吸道症状有所改善,但一些服用IVA或ETI的成年CF患者报告其健康状况较差/一般。更好地了解身体健康状况和护理负担可能有助于识别未被充分认识的合并症,以改善护理。

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