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Predictors of health-related quality of life and fatigue in systemic sclerosis: evaluation of the EuroQol-5D and FACIT-F assessment tools

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Abstract

This study evaluates predictors of health-related quality of life (HRQoL) and fatigue in systemic sclerosis (SSc) using two novel self-report indices. A cross-sectional study of patients with SSc was undertaken using a postal questionnaire including the EuroQol-5Domain health questionnaire (EQ-5D™), Functional Assessment of Chronic Illness Therapy—Fatigue scale (FACIT-F) and the Scleroderma Health Assessment Questionnaire (SHAQ). The EQ-5D assesses five domains of health quality and is quantified as a time trade-off (TTO) value and patient global assessment (0–100 visual analogue scale [VAS]). The FACIT-F is a 13-item questionnaire (0–52 scale). Higher scores for both the EQ-5D and FACIT-F indicate better health. Case notes were scrutinised for patient demographics, disease duration, serology and clinical phenotype. Sixty-eight patients (60 females, mean age 62.6 years) completed the questionnaires. Fatigue correlated closely with HRQoL (r s = 0.78 and 0.77 for FACIT-F vs. EQ-5D VAS and TTO respectively, p < 0.01) and disability (r s = −0.74 for FACIT-F vs. HAQ-DI, p < 0.01). Pain was the most frequently reported health problem (80 %) in the EQ-5D. HRQoL also correlated closely with disability (r s = 0.83 for EQ-5D vs. HAQ-DI, p < 0.01). SHAQ-VAS scores correlated well with the FACIT-F, EQ-5D and HAQ-DI scores (p < 0.05 for all comparisons). Of the patient demographics and clinical disease associations, only the absence of upper gastrointestinal complications was associated with better levels of fatigue, HRQoL and function. There is a strong correlation between disability, fatigue and HRQoL measured using self-reports, possibly reflecting similarly perceived health beliefs amongst patients across outcomes. There was little association between self-report indices and patient demographics and/or clinical phenotype.

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Acknowledgments

Dr Gemma Strickland is funded through the Ken Muirden Fellowship. Dr John Pauling is funded through the Dando fellowship and is grateful for the ongoing support of the Raynaud’s and Scleroderma Association.

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Authors and Affiliations

  1. Rheumatology Department, Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath, BA1 1RL, UK

    Gemma Strickland, John Pauling & Neil McHugh

  2. Bath Institute for Rheumatic Diseases, Bath, UK

    Charlotte Cavill & Neil McHugh

  3. Department of Pharmacy and Pharmacology, University of Bath, Bath, UK

    Neil McHugh

Authors
  1. Gemma Strickland
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  2. John Pauling
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  3. Charlotte Cavill
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  4. Neil McHugh
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Correspondence to Gemma Strickland.

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Strickland, G., Pauling, J., Cavill, C. et al. Predictors of health-related quality of life and fatigue in systemic sclerosis: evaluation of the EuroQol-5D and FACIT-F assessment tools. Clin Rheumatol 31, 1215–1222 (2012). https://doi.org/10.1007/s10067-012-1997-1

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  • DOI: https://doi.org/10.1007/s10067-012-1997-1

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