Health-related quality of life in adults with sickle cell disease (SCD): a report from the comprehensive sickle cell centers clinical trial consortium.
Adults with Sickle Cell Disease (SCD) experience multiple disease-related complications, but few studies have examined relationships between these events and health-related quality of life (HRQOL). We determined the number and type of previous or co-occurring SCD-related complications and their reported HRQOL in a cohort of 1,046 adults from the Comprehensive Sickle Cell Centers (CSCC). Participants had a median age of 28.0 years (48% male, 73% SS or Sβ⁰ thalassemia) and had experienced several SCD-related complications (mean 3.8 ± 2.0), which were influenced by age, gender, and hemoglobinopathy type (P < 0.0001). In multivariate models, increasing age reduced all SF-36 scales scores (P < 0.05) except mental health, while female gender additionally diminished physical function and vitality scale scores (P < 0.01). Of possible complications, only vaso-occlusive crisis, asthma, or avascular necrosis diminished SF-36 scale scores. Chronic antidepressants usage predominantly diminished scores on bodily pain, vitality, social functioning, emotional role, and mental health scales, whereas chronic opioid usage diminished all scale scores (P < 0.01). Our study documents substantial impairment of HRQOL in adults with SCD that was influenced by only a few of many possible medical complications. It suggests that more effective treatments of persistent pain and depression would provide the largest HRQOL benefit.
Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia 30322, USA. cdampie@emory.edu
Carlton
C
Dampier
Petra
P
LeBeau
Seungshin
S
Rhee
Susan
S
Lieff
Karen
K
Kesler
Samir
S
Ballas
Zora
Z
Rogers
Winfred
W
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging; D000554:Ambulatory Care Facilities; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D000928:Antidepressive Agents / Q000627:therapeutic use; D001249:Asthma / Q000150:complications; D015331:Cohort Studies; D003191:Comprehensive Health Care; D003863:Depression / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006621:Hip Joint / Q000473:pathology; D006801:Humans; D007871:Leg Ulcer / Q000150:complications; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000209:etiology; D010146:Pain / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D011788:Quality of Life / Q000523:psychology*; D012727:Sex Characteristics; D012785:Shoulder Joint / Q000473:pathology; D014652:Vascular Diseases / Q000150:complications; D055815:Young Adult
D000701:Analgesics, Opioid; D000928:Antidepressive Agents
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