Impact of socioeconomic status, race, and ethnicity on quality of life in patients with cystic fibrosis in the United States.
BACKGROUND
Patient-reported outcomes are increasingly used in clinical trials to assess the natural history of chronic diseases and the efficacy of new treatments. Understanding the effects of socioeconomic and minority status on health-related quality of life (HRQOL) will facilitate interpretation of the results of clinical trials and suggest targets for interventions to improve patient care and outcomes. The objective of this study was to examine the effects of socioeconomic and minority status on HRQOL in patients with cystic fibrosis (CF) from childhood through adulthood in a large, comprehensive database containing medical and HRQOL data for patients with CF.


METHODS
A cross-sectional study was performed using data obtained from the Epidemiologic Study of Cystic Fibrosis on 4,751 patients and 1,826 parents who were non-Hispanic white, African-American, or Hispanic and who completed the Cystic Fibrosis Questionnaire-Revised (CFQ-R), a disease-specific HRQOL measure, during a stable clinic visit.


RESULTS
Multivariate models assessed the main effects of socioeconomic and minority status on clinical and HRQOL outcomes. Regression models that controlled for disease severity identified the contributions of these two variables to HRQOL. Low socioeconomic status was associated with significantly lower CFQ-R scores for children, parents, and adults on the majority of domains. After controlling for disease severity and socioeconomic status, African-American and Hispanic patients reported worse emotional and social functioning.


CONCLUSIONS
Low socioeconomic and minority status may affect important clinical and patient-reported outcomes for patients with CF across their life span.
Quittner
Alexandra L
AL
Department of Psychology and Pediatrics, University of Miami, Coral Gables, FL 33124-0751, USA. aquittner@miami.edu
Schechter
Michael S
MS
Rasouliyan
Lawrence
L
Haselkorn
Tmirah
T
Pasta
David J
DJ
Wagener
Jeffrey S
JS
D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000191:economics / Q000208:ethnology* / Q000523:psychology; D005006:Ethnicity; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D011788:Quality of Life; D012189:Retrospective Studies; D012923:Social Class; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult