Background/Purpose: In order to better discern medication efficacy for CLE, a better understanding of CLE’s impact on quality of life (QoL) in individuals with CLE is required. Further, the use of a theoretical framework allows for the development, validation, and eventual use of patient-reported outcome measures that identify empirical factors significantly impacting QoL of patients with CLE. Thus, the purpose of this study was to examine multiple factors associated with CLE that affect QoL, using the Revised Wilson and Cleary’s Model (WCM) for QoL. The WCM is a disease-based, physiological framework that links biological and physiological factors, symptoms status, functioning, general health perceptions, individual and environmental characteristics, and overall QoL.

Methods: A cross-sectional, correlational study was conducted in 101 CLE patients recruited from an outpatient university-based dermatology clinic in Dallas, Texas. Demographic, clinical characteristics, and QoL data were collected from patients. Descriptive statistics were calculated, and multiple regression was employed to determine significant (p<0.05) predictors of overall QoL. Data were analyzed using SPSS v24.

Results: The overall QoL – CLEQoL regression model was significantly different from zero, F=24.96; df.=14, 76; p=<0.001. Approximately 85 percent of the variation in overall QoL (R²=0.85) was accounted for by predictor variables within the WCM model, where the adjusted R² was 82 percent (R²=0.82). Disease activity (β=0.13, p=0.027), fatigue (β=0.24, p=0.002), and body image (β=0.62, p<0.001) were significant, positive predictors of overall QoL while controlling for other predictor variables (β=0.19, p=0.03). Pain (β=-0.23, p=0.019) and side-effects (β=-0.13, p=0.041) were negative predictors of overall QoL. Patients who experienced higher levels of disease activity, higher fatigue severity, and greater degree of body dissatisfaction had significantly poorer QoL. Lower pain intensity and fewer side effects experienced from CLE medications were significantly associated with higher QoL.

Conclusion: Hence, in addition to performing thorough skin exams, asking patients about symptoms, body perception, and medication toxicities can aid providers in better understanding CLE’s impact on patients’ QoL. Using a theoretical framework, patient-centered and clinical outcomes were integrated to facilitate a fuller understanding of the several factors impacting QoL in CLE patients. As such, future studies aimed at understanding QoL in CLE patients can consider using a theoretical framework as healthcare becomes more patient-centered.

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/assessing-a-conceptual-framework-of-quality-of-life-in-a-cutaneous-lupus-erythematosus-population/