IMPACT OF COMORBIDITIES ON SELF-REPORTED QUALITY-OF-LIFE IN US ADULTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (SLE): A POOLED ANALYSIS OF THE 2016-2022 MEDICAL EXPENDITURE PANEL SURVEY (MEPS)
Author(s)
Cindy M. Chan, PharmD, MHI, Pooja M. Rajadhyaksha, MS, Kangho Suh, PharmD, PhD;
University of Pittsburgh, Pittsburgh, PA, USA
University of Pittsburgh, Pittsburgh, PA, USA
OBJECTIVES: To evaluate the impact of comorbidities on self-reported health and mental health among adults with systemic lupus erythematosus (SLE) using a nationally representative survey in the US.
METHODS: Adults with SLE diagnosis (ICD-10 code, M32) and positive survey weights from 2016 to 2022 Medical Expenditure Panel Surve (MEPS) data were included if they had ≥1 inpatient/ER visit, ≥2 outpatient visits, or ≥1 outpatient rheumatology visit with SLE diagnosis, or use of SLE-related medications. Ten comorbidities with higher reported prevalence in SLE were analyzed, including mental health conditions (MH), thyroid disorders, diabetes, myocardial infarction/cerebrovascular accidents (MI/CVA), hypertension, pulmonary diseases, rheumatoid arthritis (RA), osteoarthritis, gastroesophageal reflux disease, and cancer. Recycled predictions were used to estimate the average effect of each comorbidity on quality-of-life outcomes, including perceived health and mental health (modeled with ordered logistic regression) and the Veterans-RAND 12-Item Health Survey (VR-12) physical component summary (PCS) and mental component summary (MCS) scores (modeled with ordinary linear regression). All multivariable regressions adjusted for demographics, year, and Charlson comorbidity index and accounted for MEPS survey design using individual-level weights.
RESULTS: After weighting, 3,725,287 adults with SLE were included. Statistically significant reductions in PCS scores were associated with hypertension (mean difference [MD]=-3.8, P=0.02), RA (MD=-3.8, P=0.02), and osteoarthritis (MD=-3.6, P=0.02). Pulmonary diseases (joint P=0.003) were significantly associated with higher probabilities of worse perceived health and lower probabilities of better health. Regarding mental health, MH (MD=-4.7, P=0.003) and MI/CVA (MD=-6.3, P=0.004) were significantly associated with reduced MCS scores, whereas MI/CVA (joint P=0.02), pulmonary diseases (joint P=0.0001), and osteoarthritis (joint P=0.005) were significantly associated with higher probabilities of worse perceived mental health and lower probability of better perceived mental health.
CONCLUSIONS: In patients with SLE, hypertension, RA, osteoarthritis, and pulmonary comorbidities were linked to poorer physical health, while MH, MI/CVA, and pulmonary diseases were associated with poorer mental health.
METHODS: Adults with SLE diagnosis (ICD-10 code, M32) and positive survey weights from 2016 to 2022 Medical Expenditure Panel Surve (MEPS) data were included if they had ≥1 inpatient/ER visit, ≥2 outpatient visits, or ≥1 outpatient rheumatology visit with SLE diagnosis, or use of SLE-related medications. Ten comorbidities with higher reported prevalence in SLE were analyzed, including mental health conditions (MH), thyroid disorders, diabetes, myocardial infarction/cerebrovascular accidents (MI/CVA), hypertension, pulmonary diseases, rheumatoid arthritis (RA), osteoarthritis, gastroesophageal reflux disease, and cancer. Recycled predictions were used to estimate the average effect of each comorbidity on quality-of-life outcomes, including perceived health and mental health (modeled with ordered logistic regression) and the Veterans-RAND 12-Item Health Survey (VR-12) physical component summary (PCS) and mental component summary (MCS) scores (modeled with ordinary linear regression). All multivariable regressions adjusted for demographics, year, and Charlson comorbidity index and accounted for MEPS survey design using individual-level weights.
RESULTS: After weighting, 3,725,287 adults with SLE were included. Statistically significant reductions in PCS scores were associated with hypertension (mean difference [MD]=-3.8, P=0.02), RA (MD=-3.8, P=0.02), and osteoarthritis (MD=-3.6, P=0.02). Pulmonary diseases (joint P=0.003) were significantly associated with higher probabilities of worse perceived health and lower probabilities of better health. Regarding mental health, MH (MD=-4.7, P=0.003) and MI/CVA (MD=-6.3, P=0.004) were significantly associated with reduced MCS scores, whereas MI/CVA (joint P=0.02), pulmonary diseases (joint P=0.0001), and osteoarthritis (joint P=0.005) were significantly associated with higher probabilities of worse perceived mental health and lower probability of better perceived mental health.
CONCLUSIONS: In patients with SLE, hypertension, RA, osteoarthritis, and pulmonary comorbidities were linked to poorer physical health, while MH, MI/CVA, and pulmonary diseases were associated with poorer mental health.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PCR152
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)