Administering the Sarcoidosis Health Questionnaire to sarcoidosis patients in Serbia

Objective:

The aim of this study was to use a Serbian-language version of the disease-specific, self-report Sarcoidosis Health Questionnaire (SHQ), which was designed and originally validated in the United States, to assess health status in sarcoidosis patients in Serbia, as well as validating the instrument for use in the country.

Methods:

This was a cross-sectional study of 346 patients with biopsy-confirmed sarcoidosis. To evaluate the health status of the patients, we used the SHQ, which was translated into Serbian for the purposes of this study. We compared SHQ scores by patient gender and age, as well as by disease duration and treatment. Lower SHQ scores indicate poorer health status.

Results:

The SHQ scores demonstrated differences in health status among subgroups of the sarcoidosis patients evaluated. Health status was found to be significantly poorer among female patients and older patients, as well as among those with chronic sarcoidosis or extrapulmonary manifestations of the disease. Monotherapy with methotrexate was found to be associated with better health status than was monotherapy with prednisone or combination therapy with prednisone and methotrexate.

Conclusions:

The SHQ is a reliable, disease-specific, self-report instrument. Although originally designed for use in the United States, the SHQ could be a useful tool for the assessment of health status in various non-English-speaking populations of sarcoidosis patients.

Fatigue in sarcoidosis: detection and treatment

Fatigue is a prominent symptom in a large number of medical conditions, malignant and infectious diseases. Fatigue is also a prominent symptom of sarcoidosis. The occurrence of fatigue in sarcoidosis is well known but exact incidence has not been established and varies from 30-70% of patients depending on age, sex and organ involvement by the granulomatous process. The exact definition of fatigue varies broadly. It can be both physical and mental. The patients describe their sensation of fatigue qualitatively different from that fatigue they experienced before they became sick. Fatigue has a major impact on the quality of life in sarcoidosis. Establishing the extent of fatigue in sarcoidosis provides relevant insight regarding the patient's quality of life. Unfortunately there is no objective parameter for assessing fatigue in sarcoidosis. Generally, fatigue is detected by means of questionnaires. Regarding the therapy, there is no effective treatment for fatigue in sarcoidosis.

Health related quality of life regarding to gender in sarcoidosis

Evaluation of the health-related quality of life (HRQoL) in patients with respiratory diseases has been increasingly included into regular clinical studies, and HRQL in sarcoidosis has been evaluated since not a long ago. The aim of the study was to evaluate HRQoL in patients with sarcoidosis regarding gender differences, pre and after therapy. We investigated 202 pathohistologically verified sarcoidosis patients (154 female and 48 male) without comorbidities. HRQL was assessed by the disease-specific Sarcoidosis Health Questionnaire (SHQ), which contains 29 items, and cover three domains: everyday functioning, physical activities and emotional state. Total score, as well as the scores for each SHQ domains were calculated. HRQoL was estimated pre and after three months of therapy. At the study start, the lowest score value for the whole group was reported in SHQ emotional state domain (4.24), and the highest in domain of physical functioning (4.7). After three months, the lowest values were reported in domain of everyday activities, while the highest scores were found in emotional domain; all SHQ scores increased, but reached the statistical significance only in the everyday functioning and the physical activities domains. Analyzing mean SHQ scores in male and female sarcoidosis pts before therapy we found high statistically lower emotional and total score in female pts, as well as lower physical score. After the three months therapy we found high statistical difference in physical domain (i.e. women had lower physical score than men). Female sarcoidosis pts showed lower emotional, physical and total score before therapy. After the three-month therapy we found that women had lower physical score than men. SHQ showed good measurement properties both in the cross-sectional and longitudinal assessment of sarcoidosis patients.

[Application of measuring instruments--quality of life questionnaires in patients with chronic sarcoidosis]

INTRODUCTION

Health-related quality of life in interstitial lung diseases, especially in sarcoidosis, has hardly received appropriate attention in clinical studies due to lack of validated methods of measurement. Until now, in patients with sarcoidosis and interstitial lung diseases, several generic and respiratory specific quality-of-life instruments were used in order to discover the most valid and reliable quality-of-life instrument. Sarcoidosis is a multi-system disease that affects quality of life in many different ways.

MATERIAL AND METHODS

In this study the Sarcoidosis Health Questionnaire was used to evaluate the quality of life in sarcoidosis patients. 89 biopsy positive sarcoidosis patients were analyzed (16 male, 73 female); their mean age 46.15 +/- 11.11 years. 34 (39%) patients presented with acute sarcoidosis, 53 (61%) with chronic sarcoidosis and 46 patients (51.7%) had extrapulmonary disease. In regard to treatment, 51 (57%) patients were treated with corticosteroids 18 (20%) with methotrexate and in 20 (23%) spontaneous remission was reported. All analyses were performed using the Statistical Package for Social Science Software: A probability value less than 0.01 considered being statistically significant.

RESULTS

Statistically significant correlation was found between the sarcoidosis health questionnaire scores and chronic sarcoidosis. daily 0.001, emotional 0.014 and total 0.01. In regard to treatment, significant difference between groups was found in the domain of physical (sig 0.006) emotional (sign 0.005) and total (sign 0.001) scores.

CONCLUSION

The first sarcoidosis specific questionnaire shows perfect correlation with the possible clinical course in patients with sarcoidosis.

[The role of EQ5D self-classifier in assessing quality of life in patients with sarcoidosis]

INTRODUCTION

In medicine, quality of life is a very important issue. Nowdays, in our circumstances, it is an important part of diagnostic and therapeutic procedures. The aim of this study was to analyze the role of EQ5D questionnaire in patients with sarcoidosis.

MATERIAL AND METHODS

EQ5D self-questionnaire was used in patients with sarcoidosis and we analyzed the obtained data.

RESULTS

The analysis included patients with previously proved sarcoidosis--pulnmonary and extrapulmonary (bronchoscopy and other biopsies). All patients were treated at the Institute of Tuberculosis and Lung Diseases. We analyzed a group of 84 (19 male and 65 female) patients with average age of 45 years. Most patients had a chronic state of disease and were nonsmokers. In regard to the radiographic stage of pulmonary sarcoidosis, levels of disease activity (acute, chronic and relapse), levels of sACE, levels of sIgE, smokers--non smokers, and in regard to obtained scores, no statistically significant difference was found in examined groups, except in the group of patients with low level sIgE (score 0.276).

CONCLUSION

EQ5D questionnaire is a good tool for analyzing the health status of patients with sarcoidosis, but still a more specific questionnaire should be designed for this multisystem disease.

[Quality-of-life assessment in patients with pulmonary diseases]

INTRODUCTION

Quality-of-life assessment as a measure of clinical and therapeutic outcome, is increasingly used in different branches of medicine. In contrast to conventional indicators of the disease and its objective outcomes, health related quality of life (HRQL) focuses on the patient's own assessment. This provides for the more active involvement of a patient, where the advantages of certain medication or therapeutic regimes over another are considered by a doctor. QUALITY-OF-LIFE QUESTIONNAIRES: Quality-of-life questionnaires have been developed to assess health related quality of life, and provide methodology for processing and interpretation. This kind of assessment is proved useful not only in clinical drug trials, but also efficacy in routine medical practice and in the evaluation of the health services. Quality-of-life assessment is widely used in all chronic pulmonary diseases, especially in asthma and chronic obstructive pulmonary diseases. Sarcoidosis is a great challenge for researchers in quality of life, since it is a chronic multisystem disease, not only a respiratory disorder.

CONCLUSION

Evaluation of quality of life in sarcoidosis patients is possible only using generic health questionnaires. However, in 2003, validated disease-specific questionnaires for sarcoidosis were developed, and they will make our approach to these patients easier.

[St. George's respiratory questionnaire (SGRQ) in sarcoidosis patients]

INTRODUCTION

Sarcoidosis is a chronic multisystem disorder which has a great impact on health-related quality of life (HRQL). Patients with sarcoidosis very often present with bronchial obstruction. The purpose of this study was to assess the impact of respiratory disorder on general HRQL using St. George's respiratory questionnaire (SGRQ).

MATERIAL AND METHODS

We examined 129 patients with histologically proven sarcoidosis. All patients underwent clinical examination, chest X-ray and spirometry, and in all skin prick tests and sera ACE and IgE were determined. Afterwards, they filled out SGRQ, and scores were compared with clinical and radiological findings, and also with serum markers of the disease.

RESULTS

Mean activity score values were significantly lower in men, in patients with newly diagnosed disease, and in patients with elevated ACE. Patients with extrathoracic disease had significantly higher scores. Clinical course showed significant correlation with impact and total score, and the number of relapses with the activity score. SGRQ scores significantly correlated with serum IgE and with most spirometric parameters.

CONCLUSION

Our data revealed a high validity of SGRQ in patients with sarcoidosis and a great influence of respiratory disorders on general health-related quality of life in these patients. However, reproducibility and responsiveness of SGRQ is yet to be established in patients with sarcoidosis.