title: Health-related quality of life associated with systemic corticosteroids.
abstract: Systemic corticosteroids (SCS) are commonly used but are associated with adverse effects. Given their prevalent use, the potential impact of SCS use on health-related quality of life (HRQoL) is important to characterize.
  
  
  
  To assess the HRQoL of patients taking SCS.
  
  
  
  The 2000-2003 Medical Expenditure Panel Survey was used to examine EQ-5D and SF-6D scores associated with SCS use in adults. The study sample was restricted to those with a condition for which SCS are prescribed. SCS use was categorized into three levels: none; 1-3; and ≥4 prescriptions per year. HRQoL scores were regressed on SCS use (1-3 or ≥4 annual prescriptions) controlling for age, gender, race, ethnicity, education, income category, geographic region, number of ER visits, number of outpatient visits, total number of chronic conditions (for which SCS are not used) and conditions for which SCS are clinically indicated.
  
  
  
  There were 54,856 individuals with no SCS exposure, 2245 with 1-3 and 624 with ≥4 annual SCS prescriptions. In adjusted analyses, use of ≥4 annual SCS prescriptions appeared to be associated with significantly lower EQ-5D (US), EQ-5D (UK), SF-6D and EQ-5D VAS scores compared to no exposure: -0.032, -0.047, -0.036, and -7.58.
  
  
  
  While SCS are efficacious and widely used for numerous conditions, results suggest that their use may be associated with a substantial deleterious impact on HRQoL. This potential negative effect should be considered in balance with the cost and efficacy of comparable treatments.
authors.affiliation: Regis University School of Pharmacy, Denver, CO, USA. psulliva@regis.edu.
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Sullivan
authors.affiliation: Department of Clinical Pharmacy, Center for Pharmaceutical Outcomes Research, University of Colorado Aurora, Aurora, CO, USA.|American University of Armenia, Yerevan, Armenia.
authors.forename: Vahram H
authors.initials: VH
authors.lastname: Ghushchyan
authors.affiliation: Amgen, Inc., Thousand Oaks, CA, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Globe
authors.affiliation: Regis University School of Pharmacy, Denver, CO, USA.
authors.forename: Brandon
authors.initials: B
authors.lastname: Sucher
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D015203:Reproducibility of Results; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Health-related quality of life; Patient-reported outcomes; Preference-based health-related quality of life; Utility