title: The systemic lupus erythematosus tri-nation study: longitudinal changes in physical and mental well-being.
abstract: OBJECTIVE
  We have shown that SLE patients in Canada and the UK incurred 20% and 13% lower health costs than those in the US, respectively, but did not experience worse outcomes as expressed by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. We now compare change in quality of life in these patients.
  
  
  METHODS
  Seven hundred and fifteen SLE patients (Canada 231, US 269, UK 215) completed the SF-36 annually over four years. The annual change in the SF-36 Physical and Mental Component Summary (PCS and MCS) scores over the course of the study were summarized by estimating a linear trend for each individual patient using hierarchical modelling. Cross-country comparison of the slopes in the PCS and MCS scores was then performed using simultaneous regressions.
  
  
  RESULTS
  The estimated mean annual changes (95% credible interval [CrI]) in the PCS scores in Canada, the US, and the UK were 0.18 (-0.07, 0.43), -0.05 (-0.27, 0.17), and 0.03 (-0.20, 0.27), respectively; the mean annual changes in the MCS scores were 0.15 (-0.04, 0.34), 0.23 (0.09, 0.37), and 0.08 (-0.10, 0.27), respectively. Regression results showed that the mean annual changes in PCS and MCS scores did not substantially differ across countries.
  
  
  CONCLUSIONS
  Quality of life remained stable across countries. Despite Canadian and British patients incurring lower health costs, on average, patients experienced similar changes in physical and mental well-being.
authors.affiliation: Division of Clinical Epidemiology, Room L10-413, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec, Canada H3G 1A4.
authors.forename: P
authors.initials: P
authors.lastname: Panopalis
authors.forename: M
authors.initials: M
authors.lastname: Petri
authors.forename: S
authors.initials: S
authors.lastname: Manzi
authors.forename: D A
authors.initials: DA
authors.lastname: Isenberg
authors.forename: C
authors.initials: C
authors.lastname: Gordon
authors.forename: J-L
authors.initials: JL
authors.lastname: Senecal
authors.forename: J R
authors.initials: JR
authors.lastname: Penrod
authors.forename: L
authors.initials: L
authors.lastname: Joseph
authors.forename: Y
authors.initials: Y
authors.lastname: St Pierre
authors.forename: C
authors.initials: C
authors.lastname: Pineau
authors.forename: P R
authors.initials: PR
authors.lastname: Fortin
authors.forename: N
authors.initials: N
authors.lastname: Sutcliffe
authors.forename: J-R
authors.initials: JR
authors.lastname: Goulet
authors.forename: D
authors.initials: D
authors.lastname: Choquette
authors.forename: T
authors.initials: T
authors.lastname: Grodzicky
authors.forename: J M
authors.initials: JM
authors.lastname: Esdaile
authors.forename: A E
authors.initials: AE
authors.lastname: Clarke
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology / Q000534:rehabilitation*; D008297:Male; D011788:Quality of Life; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology