Volume 20, Issue 10 p. 1167-1174

Health-Related Quality of Life for Adults with Cystic Fibrosis: A Regression Approach to Assessing the Impact of Recombinant Human DNase

Dr. Jeffrey A. Johnson Ph.D.

Corresponding Author

Dr. Jeffrey A. Johnson Ph.D.

Institute of Health Economics, Edmonton, Alberta, Canada

Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada

3118 Dentistry/Pharmacy, University of Alberta, Edmonton, AB, Canada T6G 2N8.Search for more papers by this author
Ms. Melinda Connolly M.Sc.

Ms. Melinda Connolly M.Sc.

Institute of Health Economics, Edmonton, Alberta, Canada

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Dr. Peter Zuberbuhler M.D.

Dr. Peter Zuberbuhler M.D.

Cystic Fibrosis Clinic, University of Alberta Hospital, Edmonton, Alberta, Canada

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Dr. Neil E. Brown M.D.

Dr. Neil E. Brown M.D.

Cystic Fibrosis Clinic, University of Alberta Hospital, Edmonton, Alberta, Canada

Division of General Internal Medicine, Faculty of Medicine, University of Edmonton, Alberta, Canada.

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First published: 17 January 2012
Citations: 20

Abstract

Study Objectives. To examine the general health-related quality of life (HRQOL) of adults with cystic fibrosis (CF) using available generic instruments, and to determine important predictors of change in HRQOL, including therapy with recombinant human Dnase (rhDNase).

Design. Prospective, observational study.

Patients. Fifty-nine adults with CF.

Intervention. The Medical Outcomes Study Short-Form 36 (SF-36) and the EuroQol (EQ-5D) were mailed to patients; follow-up surveys were mailed 1 year later.

Measurements and Main Results. Multivariate regression analyses assessed the relationships between clinical and demographic variables and change in health status. The 39 respondents reported lower HRQOL scores compared with general population norms for generic instruments. Regression analyses indicated that age (p=0.010), percentage predicted forced expiratory volume in 1 second (p=0.005), hospital admission (p=0.023), and rhDNase therapy (p=0.026) were positively associated 1998 EQ-5D index scores, whereas body mass index was negatively associated (p=0.025) with 1998 EQ-5D index scores after controlling for baseline 1997 scores. The size of the regression coefficients indicated that only 1997 scores and hospital admission in the year were quantitatively importantly associated with 1998 scores. Baseline HRQOL assessments showed that adults with CF reported important decrements in health status and functioning. An interesting relationship between functional status and total household income was observed.

Conclusion. Although a statistically significant association between rhDNase and 1-year change in HRQOL was found on multivariate regression analysis, the magnitude of this relationship may not be clinically important.