The effect of medication-related support on the quality of life of patients with vasculitis in relapse and remission

Abstract

Objective: Few studies have investigated whether the utility of social support for patients with a relapsing, remitting illness varies by activity level of the disease. Our goal was to determine whether disease status (relapse vs remission) moderates the effect of medication-related support from physicians and partners on the health-related quality of life (HRQOL) of patients with vasculitis.

Methods: Patients with vasculitis (n = 228) completed baseline measures of disease status and medication-related support and a 3-month followup measure of HRQOL (RAND 36-item health survey 1.0). We calculated 8 HRQOL dimensions: physical functioning, physical role limitations, bodily pain, general health, vitality, social functioning, emotional role limitations, and mental health. Bonferroni-corrected t tests compared the HRQOL of patients in relapse to patients in remission, and multivariate analysis of covariance determined whether disease status moderated the effect of medication-related support from physicians and partners on patient HRQOL. Wilks' lambda assessed whether the support-by-disease status interaction terms were significant.

Results: Relapsing patients reported significantly worse quality of life compared with nonrelapsing patients for every HRQOL dimension except physical role limitations. Disease status did not moderate the effect of physician (lambda = 0.48; p = 0.86) or partner (lambda = 1.51; p = 0.16) medication-related support on HRQOL, although greater physician and partner support predicted better HRQOL for all dimensions except bodily pain and vitality.

Conclusion: Vasculitis patients experience compromised HRQOL but the magnitude of the compromise is greater for patients experiencing a relapse. Medication-related support from physicians and partners is beneficial for patients' HRQOL regardless of disease status.

Figure 1

Norm-based health related quality of life scores for patients with vasculitis in relapse (n = 64) and in remission (n = 164) and a 1998 general US population, ages 55–64 years. PF: physical functioning, RP: physical role limitations, BP: bodily pain, GH: general health, VT: vitality, SF: social functioning, RE: emotional role limitations, MH: mental health. *Significant Bonferroni-corrected t test comparing patients in relapse to patients in remission (p < 0.00625).