Decrease Patient Quality Of Life Research Articles

Weekly touch calls with high-risk cohort of patients with commercial Medicare Advantage to reduce avoidable hospital admissions.

282 Background: Patients who have been diagnosed with cancer have an increased risk of complications and potential hospitalization instances. Those in more advanced age groups have an additional risk, especially those of the age group of 65 and higher. Avoidable hospitalizations increase the total cost of care and decrease patient quality of life during treatment. Methods: To reduce potentially avoidable hospital admissions, patients enrolled in a commercial insurance contract were reviewed weekly for a high-risk potential. Criteria for high-risk inclusion included: Any patient >75 years of age receiving treatment; Any patient receiving chemotherapy/radiation combination therapy; Any patient with the following diagnosis: Metastatic lung cancer, Metastatic pancreatic cancer, Multiple myeloma, Breast cancer, Prostate cancer with multiple HCC; Any patient receiving: Cisplatin, Adriamycin, Taxanes, Ifosfimide, Doxorubicin, or Carbo with AUC 4 or greater; Any patient that has had one visit to ER/hospital during the program During the recording period, the high-risk list of patients was reviewed weekly. Before the weekend, each patient identified was contacted by phone by a registered nurse for a weekly “touch call” to address side effects, treatment questions, complications, or concerns. Patients were reminded to contact the practice first when a non-life-threatening concern occurs. Results: The program began on April 1, 2020, with a baseline admission rate of 1.8%. At the conclusion of the program on March 31st, 2023, this cohort of patients had a 53.1% reduction in admission rates from their baseline. Additionally, the reimbursement PPPM was under target yearly, concluding at $65.64, $14.46 below the target amount of $80. The cohort consisted of a range of 36-75 patients per quarter, program total of 185 enrolled patients. Conclusions: Identifying potentially high-risk patients and conducting weekly, personalized calls before the weekend reduced the overall avoidable admission rate. Timely identification and support for high-risk patients reduces the total cost of care and potentially increases patient care quality during treatment. Period Practice Inpatient Admits per 1000 Benchmark Target Target Difference Targeted Reimbursement PPPM Actual Reimbursement PPPM Reimbursement Difference 2020 Q1 1.8% 754 378 $80 2020 Q4 -17.9% 680 233 $80 $75.56 -$4.44 2021 Q4 -31.5% 622 3 $80 $66.66 -$13.34 2022 Q4 -51.3% 602 -235 $80 $65.64 -$14.46

Harnessing Immunomodulatory Polymers for Treatment of Autoimmunity, Allergy, and Transplant Rejection.

Autoimmunity, allergy, and transplant rejection are a collection of chronic diseases that are currently incurable, drastically decrease patient quality of life, and consume considerable health care resources. Underlying each of these diseases is a dysregulated immune system that results in the mounting of an inflammatory response against self or an innocuous antigen. As a consequence, afflicted patients are required to adhere to lifelong regimens of multiple immunomodulatory drugs to control disease and reclaim agency. Unfortunately, current immunomodulatory drugs are associated with a myriad of side effects and adverse events, such as increased risk of cancer and increased risk of serious infection, which negatively impacts patient adherence rates and quality of life. The field of immunoengineering is a new discipline that aims to harness endogenous biological pathways to thwart disease and minimize side effects using novel biomaterial-based strategies. We highlight and discuss polymeric micro/nanoparticles with inherent immunomodulatory properties that are currently under investigation in biomaterial-based therapies for treatment of autoimmunity, allergy, and transplant rejection.

The analysis of quality of life of patients with glioblastoma after adjuvant radiation therapy

Background. Optimizing approaches to the treatment of patients with glioblastoma (GB) is an urgent task partly owing to the wider implementation of hypofractionated radiation therapy (HRT) regimens. At the same time, increasing survival without maintaining the patient’s quality of life (QoL) cannot be considered successful treatment. Purpose – to analyze QoL of patients with GB after adjuvant radiation treatment in the groups of standard and hypofractionated radiation regimens. Materials and methods. 159 patients with verified GB, who had undergone surgery in State Institution «Romodanov Neurosurgery Institute of the National Academy of Medical Sciences of Ukraine» over the period from 2014 to 2020, were divided into two groups according to the regimen of RT: SRT group (n = 49) – standard regimen (total dose 60.0 Gy in 30 fractions over 6 weeks); HRT group (n = 110) – hypofractionated regimen (total dose 52.5 Gy in 15 fractions over 3 weeks). The patients were surveyed about QoL three times during their follow-up (3, 6 and 12 months after RT) according to the Global Health Status Scale (GHSS), domains of insomnia and fatigue of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core-30 (QLQ-C30 version 3.0). Statistical analysis was performed separately for each group (SRT and HRT; intragroup analysis), as well as between SRT and HRT groups as comparison of independent groups with a different number of follow-up examinations for each period of the follow-up (intergroup analysis). Results. The H0 hypothesis about the absence of statistically significant difference between the results of three subsequent surveys according to the GHSS, domains of insomnia and fatigue in both SRT (p = 0.00003; p = 0.00002; p = 0.00002, respectively) and HRT (p = 0.00000; p = 0.00001; p = 0.00001, respectively) groups in the intragroup analysis according to the Friedman test was rejected. The pairwise comparison of the results of the second and the first survey (6 vs. 3 months) according to the Wilcoxon test showed a statistically significant decrease in QoL in the domain of insomnia (р = 0.000733) in SRT group and in the domain of fatigue (р = 0.016813) in HRT group. When comparing the results of the third and the second survey (12 vs. 6 months), the H0 hypothesis for all the studied parameters of QoL (GHS, insomnia, and fatigue) was rejected in both SRT and HRT groups (p ≤ 0.017 with the Bonferroni correction). When comparing the results of the third and the first survey (12 vs. 3 months), a statistically significant decrease in QoL in all studied parameters of QoL was observed: GHSS (р = 0.000078); fatigue (р = 0.000294); insomnia (р = 0.000318). The comparison of the results of these surveys in SRT group showed a statistically significant decrease of QoL in GHSS (р = 0.004650) and fatigue (p = 0.017938), with the level of statistical significance getting closer to the set critical value considering the Bonferroni correction. The intergroup analysis according to the Mann-Whitney U test showed a statistically significant advantage of HRT over SRT in all studied parameters of QoL in three subsequent surveys (p < 0.05). The ρ-test confirmed these data: HRT group patients had better parameters of QoL than SRT group patients over the whole period of the follow-up. Conclusions. The analysis of QoL according to the results of three subsequent surveys 3, 6, and 12 months after RT according to the GHSS, domains of insomnia and fatigue of the EORTC QLQ-C30 demonstrated a decrease in QoL of patients in both SRT and HRT groups. At the same time, a statistically significant advantage of HRT group over SRT group in all studied parameters of SRT was observed when the results of three subsequent surveys were compared. The proposed regimen of HRT for patients with primarily diagnosed GB may be considered an acceptable alternative to SRT in view of impact on QoL.

Efficacy and Feasibility of Remote Cognitive Remediation Therapy in Parkinson's Disease: A Randomized Controlled Trial.

Non-motor symptoms of Parkinson's disease (PD) such as cognitive impairment are common and decrease patient quality of life and daily functioning. While no pharmacological treatments have effectively alleviated these symptoms to date, non-pharmacological approaches such as cognitive remediation therapy (CRT) and physical exercise have both been shown to improve cognitive function and quality of life in people with PD. This study aims to determine the feasibility and impact of remote CRT on cognitive function and quality of life in patients with PD participating in an organized group exercise program. Twenty-four subjects with PD recruited from Rock Steady Boxing (RSB), a non-contact group exercise program, were evaluated using standard neuropsychological and quality of life measures and randomized to the control or intervention group. The intervention group attended online CRT sessions for one hour, twice a week for 10 weeks, engaging in multi-domain cognitive exercises and group discussion. Twenty-one subjects completed the study and were reevaluated. Comparing groups over time, the control group (n = 10) saw a decline in overall cognitive performance that trended towards significance (p = 0.05) and a statistically significant decrease in delayed memory (p = 0.010) and self-reported cognition (p = 0.011). Neither of these findings were seen in the intervention group (n = 11), which overwhelmingly enjoyed the CRT sessions and attested to subjective improvements in their daily lives. This randomized controlled pilot study suggests that remote CRT for PD patients is feasible, enjoyable, and may help slow the progression of cognitive decline. Further trials are warranted to determine the longitudinal effects of such a program.

Факторы, ассоциированные с качеством жизни на додиализных стадиях хронической болезни почек. Обзор литературы

Health-related quality of life (QoL) is one of the main patient-reported outcomes. Monitoring QoL in patients with chronic kidney disease (CKD) can be considered one of the approaches to the implementation of the principles of personalized medicine in clinical nephrology. The review provides a brief description of the questionnaires most used to assess QoL in patients with CKD and summarizes the results of studies of factors related to QoL at predialysis stages. It is customary to distinguish sociodemographic, clinical, and psychological factors associated with health-related QoL. Being female, smoking, low levels of education and income, the presence of coronary heart or cerebrovascular diseases, depression, and anxiety were shown to be associated with a decrease in QoL of patients with predialysis CKD. As for other clinical and socio-demographic factors, the literature data are not so unambiguous. Thus, several studies have demonstrated that a decrease in glomerular filtration rate, albumin and hemoglobin levels, the presence of diabetes, and an increase in age and creatinine level negatively affect the parameters of the physical component of QoL. At the same time, a significant number of studies have not found a relationship between these variables and the parameters of the psychosocial component of QoL, which is explained by the dependence of this QoL component primarily on the characteristics of the emotional state and personality. Of the psychological factors associated with QoL in patients with CKD treated conservatively, the attention of researchers was focused mainly on the level of depression. Only a few studies have analyzed other psychological variables (personality traits, coping strategies, effects of psychosocial interventions) related to QoL in patients with predialysis CKD. Identification and systematization of potentially modifiable factors affecting patients’ QoL set the directions for the prevention and correction of reduced QoL

Improving the understanding of how patients with non-dystrophic myotonia are selected for myotonia treatment with mexiletine (NaMuscla): outcomes of treatment impact using a European Delphi panel

BackgroundNon-dystrophic myotonias (NDMs) comprise muscle chloride and sodium channelopathies due to genetic defects of the CLCN1- and SCN4A-channels. No licensed antimyotonic treatment has been available until approval of mexiletine (NaMuscla®) for adult patients by the EMA in December 2018. This Delphi panel aimed to understand how outcomes of the pivotal phase III Mexiletine study (MYOMEX) translate to real world practice and investigate health resource use, quality of life and the natural history of NDM to support economic modelling and facilitate patient access.MethodsNine clinical experts in treating NDM took part in a two-round Delphi panel. Their knowledge of NDM and previous use of mexiletine as an off-label treatment prior to NaMuscla’s approval ensured they could provide both qualitative context and quantitative estimates to support economic modelling comparing mexiletine (NaMuscla) to best supportive care. Consensus in four key areas was sought: healthcare resource utilization (HRU), treatment with mexiletine (NaMuscla), patient quality of life (QoL), and the natural history of disease. Concept questions were also asked, considering perceptions on the feasibility of mapping the validated Individualized Neuromuscular Quality of Life (INQoL) instrument to the generic EQ-5D™, and the potential impact on caregiver QoL.ResultsConsensus was achieved for key questions including the average long-term dosage of mexiletine (NaMuscla) in practice, the criteria for eligibility of myotonia treatment, the clinical importance of QoL outcomes in MYOMEX, the higher proportion of patients with increased QoL, and the reduction in the need for mental health resources for patients receiving mexiletine (NaMuscla). While consensus was not achieved for other questions, the results demonstrated that most experts felt mexiletine (NaMuscla) reduced the need for HRU and was expected to improve QoL. The QoL mapping exercise suggested that it is feasible to map domains of INQoL to EQ-5D. Points of interest for future research were identified, including that mexiletine (NaMuscla) may slow the annual decrease in QoL of patients over their lifetime, and a significant negative impact on QoL for some caregivers.ConclusionsThis project successfully provided data from an informed group of clinical experts, complementing the currently available clinical trial data for mexiletine (NaMuscla) to support patient access decisions.

Symptom distress and quality of life among Black Americans with cancer and their family caregivers

Black Americans are disproportionately affected by cancer and chronic diseases. Black patients with cancer and their family caregivers may concurrently experience symptoms that influence their wellbeing. This study investigates the influence of mental and physical symptom distress on quality of life (QOL) among Black Americans with cancer and their family caregivers from a dyadic perspective. One hundred and fifty-one dyads comprised of a Black American with breast, colorectal, lung or prostate cancer and a Black family caregiver were included in this secondary analysis of pooled baseline data from three studies. Self-reports of problems managing 13 symptoms were used to measure mental and physical symptom distress. Descriptive statistics and the actor-partner interdependence model were used to examine symptom prevalence and the influence of each person's symptom distress on their own and each other's QOL. Fatigue, sleep problems, pain and mental distress were prevalent. Patients and caregivers reported similar levels of mental distress; however, patients reported higher physical distress. Increased patient mental distress was associated with decreased patient QOL (overall, emotional, social, functional). Increased patient physical distress was associated with decreased patient QOL (overall, physical, emotional, functional) and decreased caregiver emotional wellbeing. Increased caregiver mental distress was associated with decreased caregiver QOL (overall, emotional, social, functional) and decreased patient overall QOL. Increased caregiver physical distress was associated with decreased caregiver QOL (overall, physical, functional), decreased patient emotional wellbeing, and better patient social wellbeing. Supporting symptom management in Black patient/caregiver dyads may improve their QOL.

Antiemetic Efficacy of Adding Olanzapine 5 mg to Aprepitant, Palonosetron and Dexamethasone-Sparing After Day Two for Cancer Patients Receiving Anthracycline and Cyclophosphamide.

PurposeChemotherapy-induced nausea and vomiting (CINV) decrease patient quality of life (QOL). We evaluated the efficacy of adding 5 mg Olz to a three-drug steroid-sparing antiemetic regimen (aprepitant, palonosetron, and dexamethasone-sparing after day two) for breast cancer (BC) patients receiving anthracycline plus cyclophosphamide (AC) chemotherapy.Patients and MethodsWe retrospectively reviewed the records of 177 BC patients with no previous highly emetogenic chemotherapy history receiving AC plus the steroid-sparing three-drug regimen or the steroid-sparing four-drug regimen including Olz 5mg at our hospital between January 2012 and December 2018. The primary endpoint was complete response (CR), defined as no vomiting and no usage of rescue medication during the first AC cycle. We analyzed the odds ratio (OR) of the CR with 95% confidence interval (CI) in the three-drug group against the four-drug group. The OR was adjusted for types of anticancer drugs by the Cochran–Mantel–Haenszel (CMH) test. Secondary endpoints were incidences of nausea, anorexia, fatigue, and somnolence during the first cycle.ResultsCompared to the three-drug group, the four-drug group demonstrated high incidence of no vomiting (71% vs 95%), a similar incidence of no rescue medication usage (50% vs 51%), and a similar CR rate (45% vs 49%). The OR of the CR rate in the three-drug group against the four-drug group after CMH adjustment for drug type was 0.958 (95% CI, 0.46–1.98). Compared to the three-drug group, the four-drug group demonstrated identical incidence of nausea (66%), but lower incidences of anorexia (78% vs 35%) and fatigue (86% vs 73%). The incidence of somnolence in the four-drug group was 49%. We did not have data of somnolence for the three-drug group in the records.ConclusionAdding 5 mg Olz to the steroid-sparing three-drug combination can reduce vomiting, anorexia, and fatigue, although there was no difference in CR rate.

A Systematic Review of Neuropsychiatric Symptoms and Functional Capacity in Huntington's Disease.

Neuropsychiatric symptoms are known to increase caregiver burden and decrease patient quality of life among patients with Huntington's disease. Functional capacity is an outcome commonly used in Huntington's disease clinical trials to quantify disease progression or intervention response. Some studies have examined the relationship between neuropsychiatric symptoms and functional capacity; however, this evidence has not been synthesized. The authors reviewed existing evidence on the association between neuropsychiatric symptoms and functional capacity in Huntington's disease. A systematic review was conducted using PubMed and CINAHL. Articles were included if they described primary research in humans with Huntington's disease, measured one or more neuropsychiatric symptoms and functional capacity, and reported statistical methods to identify associations between the two concepts. Additional eligible articles were identified through reference mining and review of other relevant literature. Fourteen articles were eligible for review. Neuropsychiatric symptoms were measured individually, in clusters (i.e., depression, anxiety, and suicide items contributing to a depression cluster score), or with an overall score. Significant associations with decreased functional capacity were found most commonly with depression (N=7, median r=0.48) and apathy (N=5, median r=0.47). Other neuropsychiatric symptoms, clusters, and overall scores were all associated with functional capacity in three or fewer studies. There is some evidence that depression and apathy are associated with decreased functional capacity in Huntington's disease. Other neuropsychiatric symptoms have been infrequently examined. Further knowledge of the relationships between neuropsychiatric symptoms and functional capacity will identify areas for intervention and improvement of outcomes in patients with Huntington's disease.

THE PECULIARITIES OF THE QUALITY OF LIFE OF PATIENTS, SUFFERED FROM ANEURYSMAL SUBARACHNOID HAEMORRHAGE

The analysis of data from a number of scientific sources shows that even those patients, with favorable outcomes after suffering from aneurysmal subarachnoid hemorrhage (aSAH), may often experience a decline in quality of life (QoL), both at the physical and psychosocial levels. The influence of functional dependence on the patient’s quality of life remains controversial, because among the number of patients, who save the ability of self-care, there exists a part of those, who are not able to return to their previous lifestyle, kind of activity, they have difficulties in their relationships and emotional disorders.
 The aim of study was to assess the quality of life of patients in recovery and residual periods of aSAH.
 Material and methods. We examined 114 patients (64.91 % - males, 35.09 % - females). The patients’ quality of life was studied by using the questionnaire SF-36. The control group consisted of 20 healthy participants, matched by age and gender.
 Results. The significant decrease in QoL of patients was observed in all scales, with the exception of physical functioning, vital activity and social functioning. It should be noted, that "mental health" scale rates correlated with the level of anxiety (r = -0,55) and depression (r = -0,61). In the different age groups, the QoL indicators were almost identical, with the exception of "physical functioning" component, because older patients received a lower score for this scale (p<0.01). Patients with a moderate level of disability were observed with a decline in all QoL categories of the scale SF-36. Patients, who were totally independent, had also a significant decline in all QoL scale components, with the exception of physical functioning. 
 Conclusions. We found the decrease in QoL of patients in recovery and residual periods of aSAH, which does not depend on one’s level of functional dependence. The influence of anxiety (r = -0,55) and depression (r = -0,61) on the subscale "mental health" was established.

THE PECULIARITIES OF THE QUALITY OF LIFE OF PATIENTS, SUFFERED FROM ANEURYSMAL SUBARACHNOID HAEMORRHAGE

The analysis of data from a number of scientific sources shows that even those patients, with favorable outcomes after suffering from aneurysmal subarachnoid hemorrhage (aSAH), may often experience a decline in quality of life (QoL), both at the physical and psychosocial levels. The influence of functional dependence on the patient’s quality of life remains controversial, because among the number of patients, who save the ability of self-care, there exists a part of those, who are not able to return to their previous lifestyle, kind of activity, they have difficulties in their relationships and emotional disorders.
 The aim of study was to assess the quality of life of patients in recovery and residual periods of aSAH.
 Material and methods. We examined 114 patients (64.91 % - males, 35.09 % - females). The patients’ quality of life was studied by using the questionnaire SF-36. The control group consisted of 20 healthy participants, matched by age and gender.
 Results. The significant decrease in QoL of patients was observed in all scales, with the exception of physical functioning, vital activity and social functioning. It should be noted, that "mental health" scale rates correlated with the level of anxiety (r = -0,55) and depression (r = -0,61). In the different age groups, the QoL indicators were almost identical, with the exception of "physical functioning" component, because older patients received a lower score for this scale (p<0.01). Patients with a moderate level of disability were observed with a decline in all QoL categories of the scale SF-36. Patients, who were totally independent, had also a significant decline in all QoL scale components, with the exception of physical functioning. 
 Conclusions. We found the decrease in QoL of patients in recovery and residual periods of aSAH, which does not depend on one’s level of functional dependence. The influence of anxiety (r = -0,55) and depression (r = -0,61) on the subscale "mental health" was established.

Clinical Utility of Cxbladder for the Diagnosis of Urothelial Carcinoma.

IntroductionThis study aimed to demonstrate the clinical utility of non-invasive multigene Cxbladder urine tests in reducing the overall number of diagnostic tests and invasive procedures used in the clinical evaluation of patients presenting with microhematuria, a key symptom of urothelial carcinoma (UC). There is a belief that using non-invasive molecular diagnostic tests in patients with hematuria may lead to patients undergoing unnecessary and costly invasive procedures that can cause adverse events and decrease patient quality of life. The objective of this study was to determine whether or not this was the case, using Cxbladder.MethodsData from 396 patient-by-urologist interactions generated 792 decision points from a standardized cohort of 33 patients evaluated by 12 urologists. Participant physicians recommended a selection of tests and procedures based on referral data, then reviewed and amended their recommendations in the context of diagnostic information from Cxbladder used in the Triage and Triage and Detect clinical modalities.ResultsAll urologists changed their diagnostic behavior in at least one patient case with the addition of Cxbladder results. The total number of diagnostic procedures was reduced by 5% and 25% following disclosure of results from Cxbladder in the Triage and the Triage and Detect modalities, respectively. The total number of requested invasive procedures was reduced from 425 at referral to 379 (−11%) and 292 (−31%) following disclosure of Cxbladder information in the Triage and Triage and Detect modalities, respectively.ConclusionsUrologists made compelling changes to their clinical decision-making when they were provided with Cxbladder results for patients presenting with hematuria. Cxbladder provides an increase in clinical utility by focusing the use of invasive diagnostic procedures to appropriate patients, reducing both the total number and number of invasive procedures used in the clinical management of patients with hematuria, thereby improving the diagnostic experience and outcomes for patients.FundingPacific Edge Ltd.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-017-0518-7) contains supplementary material, which is available to authorized users.

The Effects of Delayed Gastric Emptying After Pancreaticoduodenectomy on Oncological Prognosis

Introduction: Delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD) is known to cause prolonged hospitalization, decrease patient quality of life (QOL) and poor nutrition. However, the effects of DGE after PD on oncological prognosis is unknown. Objective in this study is to examine the effect of DGE after PD on the oncological prognosis. Methods: The subjects consisted of 436 patients who underwent PD at the 4 affiliate hospitals from 2003 to 2010. DGE and pancreatic fistula were defined in accordance with ISGPS classification. The patients were classified into those without DGE (Group A, n=269) and those with DGE (Group B, n=167). The effect of DGE on prognosis was investigated by analyzing background factors and preoperative, intraoperative as well as postoperative factors. Results: The overall incidence of DGE after PD was 38.3% (167/436 cases), with the distribution of the degree of DGE of Group B in the order of grade A, B, and C as follows: 58 (34.8%), 53 (31.7%), and 56 (33.5 %). Significantly different background factors (P < 0.05) between the two groups consisted of intraoperative blood loss (905 vs. 1,098 ml), postoperative day of pancreaticojejunal drain removal (7 vs. 9 days), duration of postoperative hospital stay (31 vs. 37 days), and the extent of gastrectomy (PD, SSPPD, or PPPD). With regard to prognosis, the three- and 5-year OS rate of Group A were 51.3% and 34.9%, respectively, as compared to were 35.7% and 26.1%, respectively in Group B, with a significant difference between the two groups (P=0.001). Analysis of gender, age, primary disease and stage, operation time, intraoperative blood loss, DGE (grade A, B, or C), and pancreatic fistula (grade A, B, or C) as confounding factors using Cox proportional hazards model found that primary disease [hazard ratio: pancreatic cancer 2.99 (P=0.001) and cholangiocarcinoma 2.25 (P=0.001) as compared to papilla Vater cancer], staging [hazard ratios of stage II, III, IV were 4.12, 6.37, 13.2, respectively (P < 0.003) as compared to stage I], and DGE (grade C) [hazard ratio 2.38 (P=0.017) ] have been identified as significant poor prognostic factors. Conclusion: DGE particularly grade C leads not only to prolonged hospitalization and deterioration of QOL, but also is associated with worse oncological prognosis.Figure 1

When is pre-emptive treatment necessary after endoscopic mucosal resection of early esophageal neoplasm?

When is pre-emptive treatment necessary after endoscopic mucosal resection of early esophageal neoplasm?

Patients with psoriatic arthritis have worse quality of life than those with psoriasis alone

PsA is an inflammatory arthritis present in ∼30% of people with psoriasis (PsC). Both conditions have a significant impact on quality of life (QoL). Our objective was to test the hypothesis that people with PsA have poorer QoL than patients with PsC because of the added burden of arthritis, age and comorbidities. Consecutive patients with PsA (CASPAR criteria) and PsC were approached to participate in this study. Patients with PsC were examined by a rheumatologist using a standardized protocol to exclude PsA. Patients completed the HAQ, Medical Outcome Study 36-item Short Form Health Survey, Dermatology Life Quality Index (DLQI), EuroQoL 5 domains (EQ-5D) and Fatigue Severity Scale (FSS). Mean scores were compared and multivariate analyses were conducted to compare the QoL measures between the two patient groups. Two hundred and one patients with PsC and 201 patients with PsA were studied. A significant decrease in QoL for patients with PsA compared with those with PsC was identified by all questionnaires except for the DLQI. This skin-specific questionnaire revealed a lower QoL in patients with PsC. Multivariate analyses for each QoL measure confirmed the results of these analyses. After adjusting for age, sex, duration of PsC, comorbidities, DMARDs and biologic therapy, HAQ and DLQI were independently associated with PsA in a logistic regression. Patients with PsA have a poorer QoL compared with those with PsC as measured by all questionnaires except the DLQI.