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Respir Med. 2017 Jun;127:1-6. doi: 10.1016/j.rmed.2017.04.002. Epub 2017 Apr 5.

Understanding the determinants of health-related quality of life in rheumatoid arthritis-associated interstitial lung disease.

Author information

1
Department of Medicine, University of California, San Francisco, USA.
2
Department of Medicine, National Jewish Health, Denver, CO, USA.
3
Department of Radiology, University of California, San Francisco, USA.
4
Department of Pathology, University of California, San Francisco, USA.
5
Department of Medicine, University of Colorado Denver, USA.
6
Department of Medicine, University of Colorado Denver, USA. Electronic address: joyce.lee@ucdenver.edu.

Abstract

RATIONALE:

Health-related quality of life (HRQL) is impaired among patients with interstitial lung disease (ILD). Little is understood about HRQL in specific subtypes of ILD.

OBJECTIVES:

The aim of this study was to characterize and identify clinical determinants of HRQL among patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) and compare them to patients with idiopathic pulmonary fibrosis (IPF).

METHODS:

We identified patients with a diagnosis of RA-ILD and IPF from an ongoing longitudinal cohort of ILD patients. HRQL was measured at their baseline visit using the Short Form Health Survey (SF-36), versions 1 and 2. Regression models were used to characterize and understand the relationship between selected baseline clinical covariates, the physical component score (PCS) and mental component score (MCS) of the SF-36.

MEASUREMENTS AND MAIN RESULTS:

RA-ILD patients (n = 50) were more likely to be younger and female compared to IPF patients (n = 50). After controlling for age and pulmonary function, RA-ILD patients had a lower HRQL compared to IPF patients, as measured by the PCS (P = 0.03), with significant differences in two of four PCS domains - bodily pain (P < 0.01) and general health (P = 0.01). Clinical covariates most strongly associated with a lower PCS in RA-ILD patients compared to IPF patients were the presence of joint pain or stiffness and dyspnea severity (P < 0.01). Mental and emotional health, as measured by the MCS, was similar between RA-ILD and IPF patients.

CONCLUSION:

The physical components of HRQL appear worse in RA-ILD patients compared to IPF patients as measured by the PCS of the SF-36. Differences in the PCS of the SF-36 can be explained in part by dyspnea severity and joint symptoms among patients with RA-ILD.

KEYWORDS:

Idiopathic pulmonary fibrosis; Interstitial lung disease; Pain; Quality of life; Rheumatoid arthritis

PMID:
28502413
PMCID:
PMC5486989
DOI:
10.1016/j.rmed.2017.04.002
[Indexed for MEDLINE]
Free PMC Article

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