The Effect of Medication-related Support on the Quality of Life of Patients with Vasculitis in Relapse and Remission

Objective. Few studies have investigated whether the utility of social support for patients with a relapsing, remitting illness varies by activity level of the disease. Our goal was to determine whether disease status (relapse vs remission) moderates the effect of medication-related support from physicians and partners on the health-related quality of life (HRQOL) of patients with vasculitis. Methods. Patients with vasculitis (n = 228) completed baseline measures of disease status and medication-related support and a 3-month followup measure of HRQOL (RAND 36-item health survey 1.0). We calculated 8 HRQOL dimensions: physical functioning, physical role limitations, bodily pain, general health, vitality, social functioning, emotional role limitations, and mental health. Bonferroni-corrected t tests compared the HRQOL of patients in relapse to patients in remission, and multivariate analysis of covariance determined whether disease status moderated the effect of medication-related support from physicians and partners on patient HRQOL. Wilks' lambda assessed whether the support-by-disease status interaction terms were significant. Results. Relapsing patients reported significantly worse quality of life compared with nonrelapsing patients for every HRQOL dimension except physical role limitations. Disease status did not moderate the effect of physician (lambda = 0.48; p = 0.86) or partner (lambda = 1.51; p = 0.16) medication-related support on HRQOL, although greater physician and partner support predicted better HRQOL for all dimensions except bodily pain and vitality. Conclusion. Vasculitis patients experience compromised HRQOL but the magnitude of the compromise is greater for patients experiencing a relapse. Medication-related support from physicians and partners is beneficial for patients' HRQOL, regardless of disease status. (First Release Feb 1 2011; J Rheumatol 2011;38:709-15; doi:10.3899/jrheum.100808)