General Health Status and Health-Related Quality of Life among Patients with Postural Tachycardia Syndrome (POTS)
Ratthanon Prasitwarachot1, Casey Tak1, Kirti Sivakoti2, Melissa Cortez3
1Pharmacotherapy, College of Pharmacy, University of Utah, 2Pediatrics, 3Neurology, School of Medicine, University of Utah
Objective:
To estimate general health status and quality of life (QOL)–known as health utility–among individuals with postural tachycardia syndrome (POTS)
Background:
POTS is a chronic autonomic disorder that impacts ~1-3 million people in the US. Despite its prevalence, the key clinical factors that most impact QOL are poorly understood.
Design/Methods:
Participants ≥18 with confirmed and unconfirmed POTS were identified using an IRB-approved institutional database and invited to complete a survey that collected information on QOL (EuroQol; EQ-5D-5L), Work Ability Index (WAI), demographics, medications, and comorbidities. EQ-5D-5L responses were used to calculate health utilities estimates. T-test/Mann-Whitney/ANOVA/Kruskal Wallis tests, as appropriate, examined differences across groups.
Results:
Of 54 responses, 66.7% had confirmed POTS (94.4% female, 88.9% white); mean (standard deviation) age 38 (12.9) and BMI 26.1 (6.9). Fifty percent reported a diagnosis of chronic fatigue syndrome, 52.8% reported moderate-severe depression, and 87.0% scored poor-moderate in their ability to work (WAI). Most common medications reported: antihistamines (33.3%), SSRI/SNRIs (33.3%), other antidepressants (29.6%), and beta-blockers (24.1%).
The mean health utility value in this sample was 0.56 (0.27), on a scale of 0 (death) to 1 (perfect health). Pain/Discomfort and Usual Activities contributed to the highest decrement in valued QOL (0.14 and 0.10, respectively). Stratified by characteristics, there were significant differences in health utility between confirmed and unconfirmed POTS (0.52 vs 0.67, p=0.02), as well as when stratified by severity of depression (mild: 0.67, moderate: 0.52, severe: 0.27; p=<0.01), anxiety (mild: 0.62, moderate: 0.48, severe: 0.09; p<0.01), and WAI (Poor: 0.43, Moderate: 0.7, Good: 0.76; p<0.01).
Conclusions:
People living with POTS experience a significant reduction in health-related QOL (utility), with a health utility of 0.56 (compared to an estimated 0.87 in the general adult US population). Variability in health utilities exists across demographic and clinical strata, meriting additional investigation into these clinical factors.
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