Experiences and Perspectives of Patients with Non-HIV-Associated Lipodystrophies and Their Caregivers: A Qualitative Study.


Journal

The patient
ISSN: 1178-1661
Titre abrégé: Patient
Pays: New Zealand
ID NLM: 101309314

Informations de publication

Date de publication:
09 2021
Historique:
accepted: 14 03 2021
pubmed: 12 4 2021
medline: 8 1 2022
entrez: 11 4 2021
Statut: ppublish

Résumé

Lipodystrophy comprises a group of conditions characterized by loss of functional adipose tissue, resulting in severe metabolic complications and a complex range of symptoms. This study sought to gain a holistic understanding of the impact of congenital or non-human immunodeficiency virus acquired lipodystrophies on the quality of life of patients and their caregivers and to capture the impact of lipodystrophy on quality of life using a standard instrument. Ten patients with lipodystrophies and five caregivers from the USA and UK were recruited through convenience sampling and interviewed using a semi-structured questionnaire containing open-ended questions about disease symptoms and attributes and numerical rating scales to prompt discussion of symptom prevalence and impact. After the interview, participants filled out the 36-Item Short Form (SF-36) survey instrument. Conventional conceptual content analysis methods were used to analyze the anonymized transcripts. Four concepts were developed: diagnostic journey and symptom management, burden of disease, healthcare resource utilization, and support and advocacy. Participants described lengthy diagnostic journeys and frequent interactions with healthcare systems. Many participants became experts on lipodystrophy through the diagnostic journey and described difficulties accessing effective treatment, even after diagnosis. Both patients and caregivers emphasized the ongoing burden of living with lipodystrophy and the accompanying sense of isolation. Participants turned to disease-specific support groups to cope, engaging in knowledge sharing with other patients and caregivers and developing friendships based on shared experiences. Ten participants completed the SF-36, with a mean (standard deviation) SF-36 score of 0.6 (0.2). Currently, there are no qualitative studies that describe the experiences of patients with lipodystrophy and their caregivers. While additional research is needed, educational work like this study is a promising first step that could lead to early diagnosis and access to treatment and support.

Sections du résumé

BACKGROUND
Lipodystrophy comprises a group of conditions characterized by loss of functional adipose tissue, resulting in severe metabolic complications and a complex range of symptoms.
OBJECTIVE
This study sought to gain a holistic understanding of the impact of congenital or non-human immunodeficiency virus acquired lipodystrophies on the quality of life of patients and their caregivers and to capture the impact of lipodystrophy on quality of life using a standard instrument.
METHODS
Ten patients with lipodystrophies and five caregivers from the USA and UK were recruited through convenience sampling and interviewed using a semi-structured questionnaire containing open-ended questions about disease symptoms and attributes and numerical rating scales to prompt discussion of symptom prevalence and impact. After the interview, participants filled out the 36-Item Short Form (SF-36) survey instrument. Conventional conceptual content analysis methods were used to analyze the anonymized transcripts.
RESULTS
Four concepts were developed: diagnostic journey and symptom management, burden of disease, healthcare resource utilization, and support and advocacy. Participants described lengthy diagnostic journeys and frequent interactions with healthcare systems. Many participants became experts on lipodystrophy through the diagnostic journey and described difficulties accessing effective treatment, even after diagnosis. Both patients and caregivers emphasized the ongoing burden of living with lipodystrophy and the accompanying sense of isolation. Participants turned to disease-specific support groups to cope, engaging in knowledge sharing with other patients and caregivers and developing friendships based on shared experiences. Ten participants completed the SF-36, with a mean (standard deviation) SF-36 score of 0.6 (0.2).
CONCLUSIONS
Currently, there are no qualitative studies that describe the experiences of patients with lipodystrophy and their caregivers. While additional research is needed, educational work like this study is a promising first step that could lead to early diagnosis and access to treatment and support.

Identifiants

pubmed: 33840079
doi: 10.1007/s40271-021-00511-5
pii: 10.1007/s40271-021-00511-5
pmc: PMC8357740
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

673-685

Informations de copyright

© 2021. The Author(s).

Références

Garg A. Lipodystrophies: genetic and acquired body fat disorders. J Clin Endocrinol Metab. 2011;96(11):3313–25. https://doi.org/10.1210/jc.2011-1159 .
doi: 10.1210/jc.2011-1159 pubmed: 21865368 pmcid: 7673254
Garg A. Acquired and inherited lipodystrophies. N Engl J Med. 2004;350(12):1220–34. https://doi.org/10.1056/NEJMra025261 .
doi: 10.1056/NEJMra025261 pubmed: 15028826
National Organization for Rare Disorders (NORD). The physician’s guide to lipodystrophy disorders. 2014. https://rarediseases.org/physician-guide/lipodystrophy-disorders/ . Accessed 9 May 2018.
Rodriguez AJ, Mastronardi CA, Paz-Filho GJ. New advances in the treatment of generalized lipodystrophy: role of metreleptin. Ther Clin Risk Manage. 2015;11:1391–400. https://doi.org/10.2147/tcrm.s66521 .
doi: 10.2147/tcrm.s66521
Javor ED, Cochran EK, Musso C, Young JR, Depaoli AM, Gorden P. Long-term efficacy of leptin replacement in patients with generalized lipodystrophy. Diabetes. 2005;54(7):1994–2002.
doi: 10.2337/diabetes.54.7.1994
Oral EA, Simha V, Ruiz E, Andewelt A, Premkumar A, Snell P, et al. Leptin-replacement therapy for lipodystrophy. N Engl J Med. 2002;346(8):570–8. https://doi.org/10.1056/NEJMoa012437 .
doi: 10.1056/NEJMoa012437 pubmed: 11856796
Chiquette E, Oral EA, Garg A, Araújo-Vilar D, Dhankhar P. Estimating the prevalence of generalized and partial lipodystrophy: findings and challenges. Diabetes Metab Syndr Obes. 2017;10:375–83. https://doi.org/10.2147/dmso.S130810 .
doi: 10.2147/dmso.S130810 pubmed: 29066925 pmcid: 5604558
Budych K, Helms TM, Schultz C. How do patients with rare diseases experience the medical encounter? Exploring role behavior and its impact on patient-physician interaction. Health Policy. 2012;105(2–3):154–64. https://doi.org/10.1016/j.healthpol.2012.02.018 .
doi: 10.1016/j.healthpol.2012.02.018 pubmed: 22464590
EURODIS-Rare Disease Europe. Juggling care and daily life: the balancing act of the rare disease community. A rare barometer survey. Paris: EURODIS-Rare Disease Europe; 2017.
Eatough V, Santini H, Eiser C, Goller M-L, Krysa W, Paduanello M, et al. The personal experience of parenting a child with juvenile Huntington’s disease: perceptions across Europe. Eur J Hum Genet. 2013;21(10):1042.
doi: 10.1038/ejhg.2013.15
Strehle E, Middlemiss P. Children with 4q-syndrome: the parents’ perspective. Genet Couns. 2007;18(2):189–200.
pubmed: 17710871
Rivard MT, Mastel-Smith B. The lived experience of fathers whose children are diagnosed with a genetic disorder. J Obstet Gynecol Neonatal Nurs. 2014;43(1):38–49.
doi: 10.1111/1552-6909.12268
Schieppati A, Henter JI, Daina E, Aperia A. Why rare diseases are an important medical and social issue. Lancet. 2008;371(9629):2039–41. https://doi.org/10.1016/s0140-6736(08)60872-7 .
doi: 10.1016/s0140-6736(08)60872-7 pubmed: 18555915
Jalal Eldin A, Akinci B, Meral R, Rus D, Swaidan M, Hench R, et al. MON-101 The LD Lync Study: natural history study of lipodystrophy syndromes: early lessons from the pilot data. J Endocrine Soc. 2019. https://doi.org/10.1210/js.2019-MON-101 .
doi: 10.1210/js.2019-MON-101
Cook K, Adamski K, Gomes A, Tuttle E, Kalden H, Cochran E, et al. Effects of metreleptin on patient outcomes and quality of life in generalized and partial lipodystrophy. J Endocrine Soc. 2021. https://doi.org/10.1210/jendso/bvab019 .
doi: 10.1210/jendso/bvab019
Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.
doi: 10.1177/1049732305276687
Elo S, Kääriäinen M, Kanste O, Pölkki T, Utriainen K, Kyngäs H. Qualitative content analysis: a focus on trustworthiness. SAGE Open. 2014;4(1):2158244014522633.
doi: 10.1177/2158244014522633
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57. https://doi.org/10.1093/intqhc/mzm042 .
doi: 10.1093/intqhc/mzm042 pubmed: 17872937
von der Lippe C, Diesen PS, Feragen KB. Living with a rare disorder: a systematic review of the qualitative literature. Mol Gen Genom Med. 2017;5(6):758–73. https://doi.org/10.1002/mgg3.315 .
doi: 10.1002/mgg3.315
Cook K, Stears A, Araujo-Vilar D, Santini F, O’Rahilly S, Ceccarini G, et al. Real-world experience of patients with generalized and partial lipodystrophy enrolled in the metreleptin early access program. In: 21st European Congress of Endocrinology; 18–21 May 2019; Lyon.
Akinci B, Oral EA, Neidert A, Rus D, Cheng WY, Thompson-Leduc P, et al. Comorbidities and survival in patients with lipodystrophy: an international chart review study. J Clin Endocrinol Metab. 2019;104(11):5120–35. https://doi.org/10.1210/jc.2018-02730 .
doi: 10.1210/jc.2018-02730 pubmed: 31314093 pmcid: 6760298
Kent EE, Ambs A, Mitchell SA, Clauser SB, Smith AW, Hays RD. Health-related quality of life in older adult survivors of selected cancers: data from the SEER-MHOS linkage. Cancer. 2015;121(5):758–65.
doi: 10.1002/cncr.29119
Ge T, Fan J, Yang W, Cui R, Li B. Leptin in depression: a potential therapeutic target. Cell Death Dis. 2018;9(11):1096. https://doi.org/10.1038/s41419-018-1129-1 .
doi: 10.1038/s41419-018-1129-1 pubmed: 30367065 pmcid: 6203758
Doyle M. Peer support and mentorship in a US rare disease community: findings from the Cystinosis in Emerging Adulthood Study. Patient. 2015;8(1):65–73. https://doi.org/10.1007/s40271-014-0085-9 .
doi: 10.1007/s40271-014-0085-9 pubmed: 25231828

Auteurs

Aparna Gomes (A)

Analysis Group, Inc, Menlo Park, CA, USA. Aparna.Gomes@analysisgroup.com.

Keziah Cook (K)

Analysis Group, Inc, Menlo Park, CA, USA.

Alex Wong (A)

Analysis Group, Inc, Menlo Park, CA, USA.

Edward Tuttle (E)

Analysis Group, Inc, Menlo Park, CA, USA.

A Stratton (A)

Lipodystrophy United, Los Lunas, NM, USA.

Rebecca Sanders (R)

Lipodystrophy UK, Oxford, UK.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH