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Impact of corticosteroid-related symptoms in patients with immune thrombocytopenic purpura: Results of a survey of 985 patients
Abstract Background: Corticosteroid (CS) therapy is effective in many patients with immune thrombocytopenic purpura (ITP), although it is associated with adverse effects. Objective: This study was conducted to describe the CS-related symptom experience of adult patients with ITP and to compare the s...
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| Published in: | Clinical therapeutics 2008-08, Vol.30 (8), p.1540-1552 |
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| creator | Berti, Dana, MSN Moons, Philip, PhD, RN Dobbels, Fabienne, PhD Deuson, Robert, PhD, MS, MSHS Janssens, Ann, MD De Geest, Sabina, PhD, RN |
| description | Abstract Background: Corticosteroid (CS) therapy is effective in many patients with immune thrombocytopenic purpura (ITP), although it is associated with adverse effects. Objective: This study was conducted to describe the CS-related symptom experience of adult patients with ITP and to compare the symptom experience of current users of CS, previous users of CS, and those who have never used CS. Methods: In 2006, adult members of the Platelet Disorder Support Association (PDSA) who were listed in the organization's database, resided in the United States, and had a diagnosis of ITP were invited to participate in a Web-based survey. Symptom experience was assessed using 33 CS-related symptoms derived from a scale developed for use in patients undergoing organ transplantation. Symptom experience over the past 4 weeks was measured in terms of the occurrence of symptoms (rated on a 5-point scale from 1 [ never occurring ] to 5 [ always occurring ]) and the distress associated with those symptoms (rated on a 5-point Likert scale from 0 [ not at all distressing ] to 4 [ extremely distressing ]). Respondents were categorized according to 4 patterns of CS use: current users, nonusers, previous users who stopped CS use |
| doi_str_mv | 10.1016/j.clinthera.2008.08.005 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69576599</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0149291808002713</els_id><sourcerecordid>69576599</sourcerecordid><originalsourceid>FETCH-LOGICAL-c482t-223d443cc7485d50c0978221d2ee741f966c43ae683f0fc933277e199ef4c2663</originalsourceid><addsrcrecordid>eNqNkkuLFDEQxxtR3HH1K2hA9NZjHp2Xh4Vl8bGwIPgAbyGbrmYydnfaJL3SJ7-6aWaYhT0JBanDr_6pqn9V1SuCtwQT8W6_db0f8w6i3VKM1XYNzB9VG6Kkrglpfj6uNpg0uqaaqLPqWUp7jDHTnD6tzohSJdV8U_29HibrMgodciFm70LKEINv6wi9zdCitAxTDkNCfkSTzR7GnNAfn3fID8M8Asq7GIbb4JYcJhi9Q9McS9j36CukuS90EbcozfEOljXXip-UnldPOtsneHF8z6sfHz98v_pc33z5dH11eVO7RtFcU8rapmHOyUbxlmOHtVSUkpYCyIZ0WgjXMAtCsQ53TjNGpQSiNXSNo0Kw8-rtQXeK4fcMKZvBJwd9b0cIczJCcym41gV8_QDchzmOpTdDMKNack5XOXmgXAwpRejMFP1g41Igszpk9ubkkFkdMmtgXipfHvXn2wHa-7qjJQV4cwRscrbvoh2dTyeOYiGwaGjhLg8clLXdeYgmubJSB62P4LJpg_-PZi4eaKycL9_-ggXS_eQmUYPNt_Wg1nvCCmMqCWP_AIVXyVE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1032975526</pqid></control><display><type>article</type><title>Impact of corticosteroid-related symptoms in patients with immune thrombocytopenic purpura: Results of a survey of 985 patients</title><source>ScienceDirect Journals</source><creator>Berti, Dana, MSN ; Moons, Philip, PhD, RN ; Dobbels, Fabienne, PhD ; Deuson, Robert, PhD, MS, MSHS ; Janssens, Ann, MD ; De Geest, Sabina, PhD, RN</creator><creatorcontrib>Berti, Dana, MSN ; Moons, Philip, PhD, RN ; Dobbels, Fabienne, PhD ; Deuson, Robert, PhD, MS, MSHS ; Janssens, Ann, MD ; De Geest, Sabina, PhD, RN</creatorcontrib><description><![CDATA[Abstract Background: Corticosteroid (CS) therapy is effective in many patients with immune thrombocytopenic purpura (ITP), although it is associated with adverse effects. Objective: This study was conducted to describe the CS-related symptom experience of adult patients with ITP and to compare the symptom experience of current users of CS, previous users of CS, and those who have never used CS. Methods: In 2006, adult members of the Platelet Disorder Support Association (PDSA) who were listed in the organization's database, resided in the United States, and had a diagnosis of ITP were invited to participate in a Web-based survey. Symptom experience was assessed using 33 CS-related symptoms derived from a scale developed for use in patients undergoing organ transplantation. Symptom experience over the past 4 weeks was measured in terms of the occurrence of symptoms (rated on a 5-point scale from 1 [ never occurring ] to 5 [ always occurring ]) and the distress associated with those symptoms (rated on a 5-point Likert scale from 0 [ not at all distressing ] to 4 [ extremely distressing ]). Respondents were categorized according to 4 patterns of CS use: current users, nonusers, previous users who stopped CS use <6 months earlier, and previous users who stopped CS use ≥6 months earlier. Results: The survey was completed by 985 patients with ITP (8.2% of the PDSA membership). The median age of the sample was 47 years, and the ratio of women to men was 3:1. One hundred sixteen patients (11.8%) were current CS users, 171 (17.4%) were nonusers, 99 (10.1%) had stopped CS use <6 months earlier, and 599 (60.8%) had stopped CS use ≥6 months earlier. In all 4 groups, back pain, fatigue, sleep difficulties, muscle weakness, and difficulty seeing well were reported to be the most frequently occurring and most distressing symptoms. Current CS users and those who stopped CS treatment <6 months earlier also reported bruises to be among their most frequent and distressing symptoms. Twenty-five of the 33 symptoms occurred more frequently in current CS users than in nonusers, and 30 symptoms occurred more frequently in current users than in previous users who had stopped CS use ≥6 months earlier. Symptom occurrence was significantly greater for current users compared with those who stopped CS use <6 months earlier for puffy face ( q = 0.003), excessive appetite ( q = 0.002), changed facial features ( q = 0.033), and buffalo hump ( q = 0.048). Patients who had stopped CS use <6 months earlier reported 20 of the 33 symptoms significantly more often than those who had stopped CS use ≥6 months earlier ( q < 0.05). The only symptoms reported significantly more often in patients who had stopped CS use ≥6 months earlier compared with nonusers were buffalo hump and bruises ( q < 0.05). The distress associated with bruises was significantly higher in current users compared with nonusers and compared with previous users who had stopped CS use ≥6 months earlier (both, q = 0.047). Current users also reported significantly greater distress than nonusers for puffy face and excessive appetite (both, q = 0.047). Changed facial features was significantly more distressing in current users compared with those who had stopped CS use ≥6 months earlier ( q = 0.047). Conclusions: Different symptom profiles emerged based on the pattern of CS use. Patients who were currently using CS or who had stopped CS treatment <6 months earlier reported more symptoms than did patients who had never received CS or who had stopped CS treatment =6 months earlier.]]></description><identifier>ISSN: 0149-2918</identifier><identifier>EISSN: 1879-114X</identifier><identifier>DOI: 10.1016/j.clinthera.2008.08.005</identifier><identifier>PMID: 18803995</identifier><language>eng</language><publisher>Belle Mead, NJ: EM Inc USA</publisher><subject>Adult ; adverse effects ; Biological and medical sciences ; corticosteroids ; Data Collection ; Female ; Glucocorticoids - adverse effects ; Glucocorticoids - therapeutic use ; Health services ; Hematologic and hematopoietic diseases ; Hematology ; Humans ; immune thrombocytopenic purpura ; Internal Medicine ; Internet ; Male ; Medical Education ; Medical sciences ; Middle Aged ; Nursing ; patient-reported outcomes ; Patients ; Pharmacology. Drug treatments ; Platelet diseases and coagulopathies ; Product development ; Purpura ; Purpura, Thrombocytopenic, Idiopathic - drug therapy ; Quality of life ; Socioeconomic Factors ; Steroids ; Stress, Psychological - chemically induced ; symptom experience ; Time Factors</subject><ispartof>Clinical therapeutics, 2008-08, Vol.30 (8), p.1540-1552</ispartof><rights>Excerpta Medica Inc. All rights reserved</rights><rights>2008 Excerpta Medica Inc. All rights reserved</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c482t-223d443cc7485d50c0978221d2ee741f966c43ae683f0fc933277e199ef4c2663</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20660642$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18803995$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Berti, Dana, MSN</creatorcontrib><creatorcontrib>Moons, Philip, PhD, RN</creatorcontrib><creatorcontrib>Dobbels, Fabienne, PhD</creatorcontrib><creatorcontrib>Deuson, Robert, PhD, MS, MSHS</creatorcontrib><creatorcontrib>Janssens, Ann, MD</creatorcontrib><creatorcontrib>De Geest, Sabina, PhD, RN</creatorcontrib><title>Impact of corticosteroid-related symptoms in patients with immune thrombocytopenic purpura: Results of a survey of 985 patients</title><title>Clinical therapeutics</title><addtitle>Clin Ther</addtitle><description><![CDATA[Abstract Background: Corticosteroid (CS) therapy is effective in many patients with immune thrombocytopenic purpura (ITP), although it is associated with adverse effects. Objective: This study was conducted to describe the CS-related symptom experience of adult patients with ITP and to compare the symptom experience of current users of CS, previous users of CS, and those who have never used CS. Methods: In 2006, adult members of the Platelet Disorder Support Association (PDSA) who were listed in the organization's database, resided in the United States, and had a diagnosis of ITP were invited to participate in a Web-based survey. Symptom experience was assessed using 33 CS-related symptoms derived from a scale developed for use in patients undergoing organ transplantation. Symptom experience over the past 4 weeks was measured in terms of the occurrence of symptoms (rated on a 5-point scale from 1 [ never occurring ] to 5 [ always occurring ]) and the distress associated with those symptoms (rated on a 5-point Likert scale from 0 [ not at all distressing ] to 4 [ extremely distressing ]). Respondents were categorized according to 4 patterns of CS use: current users, nonusers, previous users who stopped CS use <6 months earlier, and previous users who stopped CS use ≥6 months earlier. Results: The survey was completed by 985 patients with ITP (8.2% of the PDSA membership). The median age of the sample was 47 years, and the ratio of women to men was 3:1. One hundred sixteen patients (11.8%) were current CS users, 171 (17.4%) were nonusers, 99 (10.1%) had stopped CS use <6 months earlier, and 599 (60.8%) had stopped CS use ≥6 months earlier. In all 4 groups, back pain, fatigue, sleep difficulties, muscle weakness, and difficulty seeing well were reported to be the most frequently occurring and most distressing symptoms. Current CS users and those who stopped CS treatment <6 months earlier also reported bruises to be among their most frequent and distressing symptoms. Twenty-five of the 33 symptoms occurred more frequently in current CS users than in nonusers, and 30 symptoms occurred more frequently in current users than in previous users who had stopped CS use ≥6 months earlier. Symptom occurrence was significantly greater for current users compared with those who stopped CS use <6 months earlier for puffy face ( q = 0.003), excessive appetite ( q = 0.002), changed facial features ( q = 0.033), and buffalo hump ( q = 0.048). Patients who had stopped CS use <6 months earlier reported 20 of the 33 symptoms significantly more often than those who had stopped CS use ≥6 months earlier ( q < 0.05). The only symptoms reported significantly more often in patients who had stopped CS use ≥6 months earlier compared with nonusers were buffalo hump and bruises ( q < 0.05). The distress associated with bruises was significantly higher in current users compared with nonusers and compared with previous users who had stopped CS use ≥6 months earlier (both, q = 0.047). Current users also reported significantly greater distress than nonusers for puffy face and excessive appetite (both, q = 0.047). Changed facial features was significantly more distressing in current users compared with those who had stopped CS use ≥6 months earlier ( q = 0.047). Conclusions: Different symptom profiles emerged based on the pattern of CS use. Patients who were currently using CS or who had stopped CS treatment <6 months earlier reported more symptoms than did patients who had never received CS or who had stopped CS treatment =6 months earlier.]]></description><subject>Adult</subject><subject>adverse effects</subject><subject>Biological and medical sciences</subject><subject>corticosteroids</subject><subject>Data Collection</subject><subject>Female</subject><subject>Glucocorticoids - adverse effects</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Health services</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Hematology</subject><subject>Humans</subject><subject>immune thrombocytopenic purpura</subject><subject>Internal Medicine</subject><subject>Internet</subject><subject>Male</subject><subject>Medical Education</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nursing</subject><subject>patient-reported outcomes</subject><subject>Patients</subject><subject>Pharmacology. Drug treatments</subject><subject>Platelet diseases and coagulopathies</subject><subject>Product development</subject><subject>Purpura</subject><subject>Purpura, Thrombocytopenic, Idiopathic - drug therapy</subject><subject>Quality of life</subject><subject>Socioeconomic Factors</subject><subject>Steroids</subject><subject>Stress, Psychological - chemically induced</subject><subject>symptom experience</subject><subject>Time Factors</subject><issn>0149-2918</issn><issn>1879-114X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><recordid>eNqNkkuLFDEQxxtR3HH1K2hA9NZjHp2Xh4Vl8bGwIPgAbyGbrmYydnfaJL3SJ7-6aWaYhT0JBanDr_6pqn9V1SuCtwQT8W6_db0f8w6i3VKM1XYNzB9VG6Kkrglpfj6uNpg0uqaaqLPqWUp7jDHTnD6tzohSJdV8U_29HibrMgodciFm70LKEINv6wi9zdCitAxTDkNCfkSTzR7GnNAfn3fID8M8Asq7GIbb4JYcJhi9Q9McS9j36CukuS90EbcozfEOljXXip-UnldPOtsneHF8z6sfHz98v_pc33z5dH11eVO7RtFcU8rapmHOyUbxlmOHtVSUkpYCyIZ0WgjXMAtCsQ53TjNGpQSiNXSNo0Kw8-rtQXeK4fcMKZvBJwd9b0cIczJCcym41gV8_QDchzmOpTdDMKNack5XOXmgXAwpRejMFP1g41Igszpk9ubkkFkdMmtgXipfHvXn2wHa-7qjJQV4cwRscrbvoh2dTyeOYiGwaGjhLg8clLXdeYgmubJSB62P4LJpg_-PZi4eaKycL9_-ggXS_eQmUYPNt_Wg1nvCCmMqCWP_AIVXyVE</recordid><startdate>20080801</startdate><enddate>20080801</enddate><creator>Berti, Dana, MSN</creator><creator>Moons, Philip, PhD, RN</creator><creator>Dobbels, Fabienne, PhD</creator><creator>Deuson, Robert, PhD, MS, MSHS</creator><creator>Janssens, Ann, MD</creator><creator>De Geest, Sabina, PhD, RN</creator><general>EM Inc USA</general><general>Excerpta Medica</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20080801</creationdate><title>Impact of corticosteroid-related symptoms in patients with immune thrombocytopenic purpura: Results of a survey of 985 patients</title><author>Berti, Dana, MSN ; Moons, Philip, PhD, RN ; Dobbels, Fabienne, PhD ; Deuson, Robert, PhD, MS, MSHS ; Janssens, Ann, MD ; De Geest, Sabina, PhD, RN</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c482t-223d443cc7485d50c0978221d2ee741f966c43ae683f0fc933277e199ef4c2663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>adverse effects</topic><topic>Biological and medical sciences</topic><topic>corticosteroids</topic><topic>Data Collection</topic><topic>Female</topic><topic>Glucocorticoids - adverse effects</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Health services</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Hematology</topic><topic>Humans</topic><topic>immune thrombocytopenic purpura</topic><topic>Internal Medicine</topic><topic>Internet</topic><topic>Male</topic><topic>Medical Education</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nursing</topic><topic>patient-reported outcomes</topic><topic>Patients</topic><topic>Pharmacology. Drug treatments</topic><topic>Platelet diseases and coagulopathies</topic><topic>Product development</topic><topic>Purpura</topic><topic>Purpura, Thrombocytopenic, Idiopathic - drug therapy</topic><topic>Quality of life</topic><topic>Socioeconomic Factors</topic><topic>Steroids</topic><topic>Stress, Psychological - chemically induced</topic><topic>symptom experience</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Berti, Dana, MSN</creatorcontrib><creatorcontrib>Moons, Philip, PhD, RN</creatorcontrib><creatorcontrib>Dobbels, Fabienne, PhD</creatorcontrib><creatorcontrib>Deuson, Robert, PhD, MS, MSHS</creatorcontrib><creatorcontrib>Janssens, Ann, MD</creatorcontrib><creatorcontrib>De Geest, Sabina, PhD, RN</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest Healthcare Administration Database</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest research library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Berti, Dana, MSN</au><au>Moons, Philip, PhD, RN</au><au>Dobbels, Fabienne, PhD</au><au>Deuson, Robert, PhD, MS, MSHS</au><au>Janssens, Ann, MD</au><au>De Geest, Sabina, PhD, RN</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of corticosteroid-related symptoms in patients with immune thrombocytopenic purpura: Results of a survey of 985 patients</atitle><jtitle>Clinical therapeutics</jtitle><addtitle>Clin Ther</addtitle><date>2008-08-01</date><risdate>2008</risdate><volume>30</volume><issue>8</issue><spage>1540</spage><epage>1552</epage><pages>1540-1552</pages><issn>0149-2918</issn><eissn>1879-114X</eissn><abstract><![CDATA[Abstract Background: Corticosteroid (CS) therapy is effective in many patients with immune thrombocytopenic purpura (ITP), although it is associated with adverse effects. Objective: This study was conducted to describe the CS-related symptom experience of adult patients with ITP and to compare the symptom experience of current users of CS, previous users of CS, and those who have never used CS. Methods: In 2006, adult members of the Platelet Disorder Support Association (PDSA) who were listed in the organization's database, resided in the United States, and had a diagnosis of ITP were invited to participate in a Web-based survey. Symptom experience was assessed using 33 CS-related symptoms derived from a scale developed for use in patients undergoing organ transplantation. Symptom experience over the past 4 weeks was measured in terms of the occurrence of symptoms (rated on a 5-point scale from 1 [ never occurring ] to 5 [ always occurring ]) and the distress associated with those symptoms (rated on a 5-point Likert scale from 0 [ not at all distressing ] to 4 [ extremely distressing ]). Respondents were categorized according to 4 patterns of CS use: current users, nonusers, previous users who stopped CS use <6 months earlier, and previous users who stopped CS use ≥6 months earlier. Results: The survey was completed by 985 patients with ITP (8.2% of the PDSA membership). The median age of the sample was 47 years, and the ratio of women to men was 3:1. One hundred sixteen patients (11.8%) were current CS users, 171 (17.4%) were nonusers, 99 (10.1%) had stopped CS use <6 months earlier, and 599 (60.8%) had stopped CS use ≥6 months earlier. In all 4 groups, back pain, fatigue, sleep difficulties, muscle weakness, and difficulty seeing well were reported to be the most frequently occurring and most distressing symptoms. Current CS users and those who stopped CS treatment <6 months earlier also reported bruises to be among their most frequent and distressing symptoms. Twenty-five of the 33 symptoms occurred more frequently in current CS users than in nonusers, and 30 symptoms occurred more frequently in current users than in previous users who had stopped CS use ≥6 months earlier. Symptom occurrence was significantly greater for current users compared with those who stopped CS use <6 months earlier for puffy face ( q = 0.003), excessive appetite ( q = 0.002), changed facial features ( q = 0.033), and buffalo hump ( q = 0.048). Patients who had stopped CS use <6 months earlier reported 20 of the 33 symptoms significantly more often than those who had stopped CS use ≥6 months earlier ( q < 0.05). The only symptoms reported significantly more often in patients who had stopped CS use ≥6 months earlier compared with nonusers were buffalo hump and bruises ( q < 0.05). The distress associated with bruises was significantly higher in current users compared with nonusers and compared with previous users who had stopped CS use ≥6 months earlier (both, q = 0.047). Current users also reported significantly greater distress than nonusers for puffy face and excessive appetite (both, q = 0.047). Changed facial features was significantly more distressing in current users compared with those who had stopped CS use ≥6 months earlier ( q = 0.047). Conclusions: Different symptom profiles emerged based on the pattern of CS use. Patients who were currently using CS or who had stopped CS treatment <6 months earlier reported more symptoms than did patients who had never received CS or who had stopped CS treatment =6 months earlier.]]></abstract><cop>Belle Mead, NJ</cop><pub>EM Inc USA</pub><pmid>18803995</pmid><doi>10.1016/j.clinthera.2008.08.005</doi><tpages>13</tpages></addata></record> |
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| ispartof | Clinical therapeutics, 2008-08, Vol.30 (8), p.1540-1552 |
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| language | eng |
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| subjects | Adult adverse effects Biological and medical sciences corticosteroids Data Collection Female Glucocorticoids - adverse effects Glucocorticoids - therapeutic use Health services Hematologic and hematopoietic diseases Hematology Humans immune thrombocytopenic purpura Internal Medicine Internet Male Medical Education Medical sciences Middle Aged Nursing patient-reported outcomes Patients Pharmacology. Drug treatments Platelet diseases and coagulopathies Product development Purpura Purpura, Thrombocytopenic, Idiopathic - drug therapy Quality of life Socioeconomic Factors Steroids Stress, Psychological - chemically induced symptom experience Time Factors |
| title | Impact of corticosteroid-related symptoms in patients with immune thrombocytopenic purpura: Results of a survey of 985 patients |
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