Predictors of Impaired Quality of Life and Work Disability in Patients with Systemic Diseases

Abstract

Background: Systemic diseases are heterogeneous diseases that represent one of the leading causes of disability with high rates of premature mortality and significant social costs. Methods: We conducted a cross-sectional study at an Internal Medicine Department between July 2017 and September 2017. We investigated patients with systemic rheumatic diseases and we evaluated the Quality of Life (QoL). The outcomes were baseline Short Form Health Survey Physical (PCS) and Mental (MCS) Component Scores. Work disability was evaluated by the Work Productivity Assessment Impairment (WPAI) questionnaire. Correlations were calculated by the test t student or ANOVA factor test and comparison with Chi2 test and multivariate regressions were then performed. Results: Two hundred thirty five patients were included, 183 females and 52 males. The average age was 48.3 years. 47% of the population had work during the study. The most frequent diseases were: Systemic lupus erythematosus in 66 patients, Behcet syndrome in 33 patients and Sjogren primary syndrome in 27 patients. Mean PCS were 52.55 ± 17.3 and MCS scores were 47.74 ± 14.8. For the predictors related to patients: the age ((PCS:r=-0.250,p=0.000), (MCS:r=-0.160,p=0.014)), the presence of comorbidities (PCS p=0.003) and the low level of education (p=0.001) were significantly correlated with impaired QoL, the presence of profession was not significantly correlated with QoL. For the predictors related to the disease; inflammatory myositis influences most the QoL. Pulmonary manifestations (PCS:p=0.021,MCS: p=0.006) were the most correlated with impaired QoL. Multivariate analysis showed effect of age, corticosteroids therapy and work disability on MCS and the effect of age and gender on PCS. Work disability was evaluated in working patients: absenteeism was at 31.16 ± 24, productivity impairment at 48.77and systemic sclerosis was the most disease predictive of absenteeism and work disability (p=0.011). Conclusion: QoL may be severely impaired in patients suffering from systemic diseases. We studied for the first time, in Tunisia, the predictors of impaired QoL for all patients followed in our department. This measure aims to further humanize medical practice, to maintain the quality of life of patients and to take into account the individuality of each patient.