Health-Related Quality of Life in Korean Patients with Systemic Lupus Erythematosus

Sung, Yoon Kyoung; Oh, Kwang Taek; Kwak, Eun Joo; Lee, Hye Soon; Kim, Tae Hwan; Jun, Jae Bum; Jung, Sung Soo; Yoo, Dae Hyun; Bae, Sang Cheol

Abstract

OBJECTIVE
To assess the health-related quality of life (HRQOL) of systemic lupus erythematosus (SLE) patient, to compare the HRQOL of SLE patients with that of healthy controls, and to identify the predicting variables on physical and mental health in Korean patients with SLE.
METHODS
In this cross sectional study, the HRQOL and clinical and laboratory parameters were assessed by Short Form Health Survey-36 (SF-36), EuroQol5 Dimensions (EQ-5D), time trade off (TTO), standard gamble (SG), Centers for Epidemiologic StudiesDepression (CES-D), self-efficacy scale, social support, social network, SLE Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI), respectively, from 111 outpatients with SLE. And the data of the SF-36 and EQ-5D in SLE patients were compared with those in 228 healthy controls.
RESULTS
106 (95.5%) were women and 5 (4.5%) were men, with a mean (+/-SD) age of 33.2 years (+/-9.9) and mean disease duration of 7.19 years (+/-4.59). The mean scores of SF-36 global, mental component summary (MCS) and physical component summary (PCS) were 62.2 (+/-20.4), 67.5 (+/-24.6), and 65.7 (+/-24.8), respectively. The mean EQ-5D utility and visual analogue scale (VAS) score were 0.73 (+/-0.20) and 67.5 (+/-17.9). The mean scores of the TTO and SG were 0.60 (+/-0.55) and 0.59 (+/-0.45). The scores on the SF-36 global, EQ-5D utility and EQ-5D VAS in healthy controls were 77.5 (+/-13.1), 0.73 (+/-0.20) and 67.5 (+/-17.9), respectively. The mean scores of CES-D, self-efficacy scale, social support, and social network were 9.09 (+/-6.82), 66.5 (+/-17.4), 2.53 (+/-0.17) and 2.29 (+/-0.46), respectively. The mean SLEDAI and the mean SDI were 5.87 (+/-4.32) and 0.73 (+/-1.02). The SDI was negatively correlated with the scores of SF-36 global, PCS, and EQ-5D VAS (r=-0.30, p<0.001; r=-0.34, p<0.001; r=-0.28, p<0.003), and positively correlated with the CES-D (r=0.19, p<0.04). In multivariate models, the predicting variables on SF-36 global and 6 MCS was self-efficacy, and the predicting variables on SF-36 PCS were SLEDAI and self-efficacy.
CONCLUSION
In this study, we observed that HRQOL in Korean patients with SLE was lower than those in healthy control. The SF-36 and the EQ-5D were valid measurements to assess HRQOL in patients with SLE. In multivariate model, self-efficacy and SLEDAI were only meaningful variables correlated with HRQOL among variables. Therefore, to improve the HRQOL in Korean patients with SLE, we should focus on a program to improve self-efficacy.