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Original Research: CYSTIC FIBROSIS |

Impact of Socioeconomic Status, Race, and Ethnicity on Quality of Life in Patients With Cystic Fibrosis in the United States

Alexandra L. Quittner, PhD; Michael S. Schechter, MD, MPH, FCCP; Lawrence Rasouliyan, MPH; Tmirah Haselkorn, PhD; David J. Pasta, MS; Jeffrey S. Wagener, MD
Author and Funding Information

From the Department of Psychology and Pediatrics (Dr Quittner), University of Miami, Coral Gables, FL; the Department of Pediatrics (Dr Schechter), Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, GA; ICON Clinical Research (Messrs Rasouliyan and Pasta), San Francisco, CA; EpiMetrix, Inc (Dr Haselkorn), Sunnyvale, CA; and the Department of Pediatrics (Dr Wagener), University of Colorado School of Medicine, Aurora, CO.

Correspondence to: Alexandra L. Quittner, PhD, University of Miami, Department of Psychology, PO Box 248185, Coral Gables, FL 33124-0751; e-mail: aquittner@miami.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;137(3):642-650. doi:10.1378/chest.09-0345
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Background:  Patient-reported outcomes are increasingly used in clinical trials to assess the natural history of chronic diseases and the efficacy of new treatments. Understanding the effects of socioeconomic and minority status on health-related quality of life (HRQOL) will facilitate interpretation of the results of clinical trials and suggest targets for interventions to improve patient care and outcomes. The objective of this study was to examine the effects of socioeconomic and minority status on HRQOL in patients with cystic fibrosis (CF) from childhood through adulthood in a large, comprehensive database containing medical and HRQOL data for patients with CF.

Methods:  A cross-sectional study was performed using data obtained from the Epidemiologic Study of Cystic Fibrosis on 4,751 patients and 1,826 parents who were non-Hispanic white, African-American, or Hispanic and who completed the Cystic Fibrosis Questionnaire-Revised (CFQ-R), a disease-specific HRQOL measure, during a stable clinic visit.

Results:  Multivariate models assessed the main effects of socioeconomic and minority status on clinical and HRQOL outcomes. Regression models that controlled for disease severity identified the contributions of these two variables to HRQOL. Low socioeconomic status was associated with significantly lower CFQ-R scores for children, parents, and adults on the majority of domains. After controlling for disease severity and socioeconomic status, African-American and Hispanic patients reported worse emotional and social functioning.

Conclusions:  Low socioeconomic and minority status may affect important clinical and patient-reported outcomes for patients with CF across their life span.

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