Health-related quality of life among people with rheumatic and musculoskeletal diseases in Cyprus: a cross-sectional study of disease burden and time since diagnosis

Nikoleta Nikolaou; Victor Hadjiroussos; Christiana Nicolaou; Michalis Michaelides; Andrie G Panayiotou; Nicos Middleton; rECORD project team

doi:10.1186/s41927-026-00617-z

Health-related quality of life among people with rheumatic and musculoskeletal diseases in Cyprus: a cross-sectional study of disease burden and time since diagnosis

BMC Rheumatol. 2026 Jan 20;10(1):14. doi: 10.1186/s41927-026-00617-z.

Authors

Nikoleta Nikolaou¹, Victor Hadjiroussos², Christiana Nicolaou³, Michalis Michaelides², Andrie G Panayiotou⁴, Nicos Middleton³; rECORD project team

Affiliations

¹ Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus. np.nikolaou@edu.cut.ac.cy.
² Cyprus Rheumatology Society, Nicosia, Cyprus.
³ Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.
⁴ Department Rehabilitation Sciences, School of Health Sciences, Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus.

Abstract

Background: Rheumatic and musculoskeletal diseases (RMDs) profoundly affect health-related quality of life (HRQoL), imposing a significant distinct burden on physical and mental well-being. Given the high prevalence and long-term disability associated with RMDs, understanding their impact is essential for informing public health priorities. This study aims to delineate the multifaceted impact of RMDs on HRQoL across diverse disease categories and examine how the impact on HRQoL varies by diagnosis and time since diagnosis.

Methods: This cross-sectional study (July 2023 - July 2024) employed a mixed sampling approach, combining a stratified sample of participants from clinical settings with an open call through online channels to reach a broader population of individuals with RMD in Cyprus. Physical (PCS) and Mental Component Scores (MCS) of the SF-12 questionnaire were used to assess HRQoL. Demographic and clinical variables, including age, gender, marital status, smoking status, and time since diagnosis were recorded. Multivariable regression analyses were used to explore differences in HRQoL scores by disease group and time since diagnosis, adjusting for demographic characteristics.

Results: The study enrolled 789 participants (mean age 55.4 ± 13.2 years, 76.6% female). Among participants, 57.4% reported low PCS (< 40) and 38.7% reported low MCS (< 40). Fibromyalgia demonstrated the most pronounced HRQoL impairments, with significantly lower scores, compared to inflammatory diseases, for both physical (B = - 11.45; 95% CI: - 15.06, - 7.83) as well as mental components of HRQoL (B = - 12.31; 95% CI: - 16.18, - 8.4). Notable reductions in PCS and MCS were also recorded among patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) reflecting the systemic and psychological burden of these conditions. Marked HRQoL reductions were recorded among participants in early disease stages (0-2 years), while those with a longer time since diagnosis (2-10 years) demonstrated relative improvements.

Conclusion: RMDs significantly impact HRQoL, with substantial variability across disease categories and time since diagnosis. While the cross-sectional nature of the study does not capture trajectories across stages of disease progression, the significant and differential by disease category impairment in HRQoL at the early stages emphasize the need for disease-specific, multidisciplinary care approaches and highlight the critical importance of early diagnosis and optimized management to mitigate the long-term impact of RMD.

Keywords: Chronic disease; Cross-Sectional studies; Cyprus; Disease progression; Health status; Musculoskeletal diseases; Quality of life; Rheumatic diseases; Surveys and questionnaires; Time factors.