Health-Related Quality of Life and Burden of Fatigue in Chinese Patients with Immune Thrombocytopenia: A Cross-Sectional Study

Abstract

To describe the health-related quality of life (HRQoL) and fatigue burden among adult patients with immune thrombocytopenia (ITP) in China and determine whether they vary with disease phase. This is a cross-sectional, multi-centre observational study of adult ITP patients and the general population. Participants completed the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). We compared HRQoL and fatigue between ITP patients and the general population, overall and by disease phase (newly diagnosed, persistent, and chronic), using propensity score matching. 203 Patients and 269 members of the general population were recruited. Thirty-six ITP patients (17.7%) were newly diagnosed, 46 (22.7%) were persistent, and 121 (59.6%) were chronic. Compared with the general population, ITP patients had impaired HRQoL and greater fatigue burden. The persistent ITP group showed the largest number of SF-36 scales exceeding the minimally important difference: physical functioning [-10.5; 95% confidence interval (CI) -24.5 to 3.5; P \ 0.001], role physical (-16.7; 95% CI -36.4 to 3.0; P \ 0.001), social functioning (-15.6; 95% CI -34.5 to 3.3; P \ 0.001), and role emotional (-12.1; 95% CI -26.0 to 1.8; P \ 0.001). Chronic ITP patients had the worst FACIT-F scores (36.89 ± 5.21). Higher fatigue severity was associated with lower physical and mental HRQoL. The HRQoL and fatigue burden of Chinese adult patients with ITP vary by disease phase.Persistent ITP patients were the most vulnerable subgroup in terms of HRQoL, while chronic ITP patients bear the heaviest fatigue burden.

Fatigue perception in a cohort of children with chronic immune thrombocytopenia and their caregivers using the PedsQL MFS: Real‐life multicenter experience of the Italian Association of Pediatric Hematology and Oncology (AIEOP)

“…In several studies, fatigue is reported as an important clinical and psychological aspect for a significant number of children and adults affected by ITP 19–21 . To date, causes of fatigue in patients with ITP are not fully understood.…”

Romiplostim in adults with newly diagnosed or persistent immune thrombocytopenia

“…Around 16-21% of adults diagnosed with ITP present without any bleeding symptoms [7,8]. For patients who do experience symptoms, however, the impacts on physical and psychological health-related quality of life (HRQoL) can be high [9][10][11]. In addition to bleeds, patients with ITP have a slightly increased risk of thrombosis and venous thromboembolism [12][13][14] and many suffer from fatigue [5,[15][16][17] and depression [18].…”

I‐WISh: A wish list for immune thrombocytopenia quality of life indicators becomes reality

“…ITP has been previously shown to be associated with detriments to HRQoL; 4‐11 symptoms can impede physical functioning, social interactions, and emotional well‐being. The extent to which ITP impairs HRQoL varies by time since diagnosis and severity of symptoms 8,9,11 . Some treatments for ITP can also have side effects that negatively impact social and emotional well‐being, 9 but studies have demonstrated improvements to HRQoL when patients are successfully treated 12‐14 .…”

“…The extent to which ITP impairs HRQoL varies by time since diagnosis and severity of symptoms. 8,9,11 Some treatments for ITP can also have side effects that negatively impact social and emotional well-being, 9 but studies have demonstrated improvements to HRQoL when patients are successfully treated. [12][13][14] This illustrates that the impact of ITP on HRQoL is multi-faceted and complex.…”

“…ITP has been previously shown to be associated with detriments to HRQoL; [4][5][6][7][8][9][10][11] symptoms can impede physical functioning, social interactions, and emotional well-being. The extent to which ITP impairs HRQoL varies by time since diagnosis and severity of symptoms.…”