Longitudinal assessment of fatigue and health-related quality of life in adults with immune thrombocytopenia in China

Background: Currently, there are few studies focusing on fatigue and health-related quality of life (HRQoL) longitudinally among immune thrombocytopenia (ITP) adults, especially in China. We aimed to evaluate changes in fatigue and HRQoL and identify the associated factors from admission to three months after discharge in Chinese adult ITP patients. Methods Patients’ characteristics, and the self-reported answers of the Functional Assessment of Chronic Illness Therapy (FACIT-F) and the ITP-specific Patient Assessment Questionnaire (ITP-PAQ) at admission (T0), at discharge (T1), and three months after discharge (T2) were collected. Linear mixed effects models were used to examine overall changes over time and associated factors in FACIT-F and ITP-PAQ scores at T0, T1, T2. Results The data of 175 ITP adults were included. The mean score of FACIT-F at T0 was 37.2 and increased to 39.0 at T1, while then tended to decrease to the level of baseline at T2 (34.7). Patients who were single, retired, had persistent ITP, splenomegaly had more severe fatigue, whereas those who had not received any prior treatment and had a bleeding score of 0 at admission had milder fatigue. The mean score of ITP-PAQ was 57.7 at T0, then gradually increased to 60.3 at T1 and 62.8 at T2. Patients with persistent ITP and those who have never received treatment for ITP have better HRQoL. Conclusion Adult ITP patients in China have non-negligible impairment in fatigue and HRQoL. Patients' fatigue improved at discharge but worsened at three months after discharge, while HRQoL gradually improved over time.