EXPLORING THE IMPACT OF COMORBIDITY, MULTIMORBIDITY, AND MENTAL HEALTH CONDITIONS ON HEALTH RELATED OUTCOMES IN SYSTEMIC LUPUS ERYTHEMATOUS: A GLOBAL STUDY.
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All Authors
Sukhija, G.
Elfar E.
Holloway A.
Lee S.Y.
Nikiphorou E.
Parodis I.
Naveen R.
Day J.
Joshi M.
Saha S.
LTHT Author
Tan, Ai Lyn
LTHT Department
NIHR Leeds Biomedical Research Centre
Non Medic
Publication Date
2024
Item Type
Conference Abstract
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Subject
Subject Headings
Abstract
Objective This study aimed to investigate the prevalence of comorbidity, multimorbidity and mental health disorders in patients with systemic lupus erythematous (SLE) and the association with patient reported physical and mental outcome scores (PROMIS). Methods Data from the COVAD survey was utilised for analysis. Comorbidities including cardiovascular disease (ischaemic heart disease, hypertension, hypercholesterolaemia), diabetes, respiratory disease (interstitial lung disease, chronic obstructive pulmonary disease), chronic liver and renal failure were included. Comorbidity was categorised into 1. No comorbidities (nil); 2. Single comorbidity (SM); 3. Basic multimorbidity (BM, defined as two or more comorbidities); and 4. Complex multimorbidity (CM, defined as three or more chronic conditions affecting three different organ systems).1 The occurrence of mental health comorbidities (MHC) including anxiety and depression was evaluated separately. The association between prevalence of comorbidity and patient reported outcome score were analysed ANOVA, Chi square test and multivariate linear regression. Results 1292 patients with SLE were included in this study. As shown in table 1, 41.56% of patients had at least one comorbidity (29.8% SM, 8.59%, BM, 3.17% CM). The complexity of comorbidity increased with age (p<0.0001) and disease duration (p<0.0001). The proportion of females was significantly higher in patients with no comorbidity (p<0.0001). Lower patient reported outcome scores for physical and mental health was higher with increasing complexity of comorbidity (p<0.0001) (figure 1). The decrease in physical function scores with comorbidity was still significant (p<0.0001) despite correcting for age or disease duration in multivariate analysis. Steroid use was more frequent with increasing multimorbidity (figure 1H). Hydroxychloroquine use was associated with lower complexity of comorbidity (p=0.0007). Conclusions In this study, complex comorbidities were associated with lower patient reported outcomes scores relating to physical function and mental health. Increased steroid use (particularly at high dose) associated with CM, indicating either potential glucocorticoid related damage or more active disease. Female gender was protective and hydroxychloroquine use was associated with fewer comorbidities, supporting previous evidence. This study underscores the substantial need for insights into addressing comorbidities in SLE, and tailoring treatment for holistic patient management globally.
Journal
Lupus Science and Medicine