Exploration of health-related quality of life, anxiety and depression in antineutrophil cytoplasmic antibody-associated vasculitis

Abstract

Objectives: To explore health-related quality of life (HRQoL), anxiety, depression and fatigue among persons with ANCA-associated vasculitis (AAV).

Methods: In this cross-sectional study, patients were assessed with the EuroQoL five-dimension three-level questionnaire (EQ-5D-3L) and visual analogue scale (EQ-VAS), the Hospital Anxiety and Depression Score (HADS) and the Multidimensional Assessment of Fatigue questionnaire (MAF).

Results: HRQoL measured with EQ-VAS was higher in younger patients, those with inactive disease (BVAS = 0) and those with long disease duration (≥3 years), while EQ-5D-3L only varied with disease activity. Women, patients with active disease and patients with shorter disease duration reported more anxiety, and younger persons with active disease and short disease duration reported more fatigue. In the total group, disease activity and disease duration were both associated with HRQoL, anxiety, depression and fatigue. Four clusters based on EQ-5D, EQ-5D index and HADS were identified, containing patients with various levels of HRQoL and psychological distress across the disease course.

Conclusion: In patients with AAV, HRQoL, anxiety, depression and fatigue are persistent but vary depending on disease activity, disease duration, gender and age. Associations between disease activity and duration and HRQOL, anxiety, depression and fatigue were present in all patients. Four clusters revealed the ongoing influence of AAV, emphasizing the continuous need for multiprofessional support during the disease course. In this study, EQ-VAS was better able than the EQ-5D-index to effectively distinguish subgroups with different levels of HRQoL.

Keywords: ANCA-associated vasculitis; anxiety; cluster analysis; depression; fatigue; health-related quality of life; patient perspective.