Assessment of Activity Limitations with the Health Assessment Questionnaire Predicts the Need for Support Measures in Patients with Rheumatoid Arthritis: A Multicenter Observational Study

Abstract

ObjectiveThis study investigated whether the Health Assessment Questionnaire (HAQ) can be used as an instrument to assess the need for social support measures that address activity limitations and participation issues in patients with rheumatoid arthritis (RA).MethodsThis multicenter observational study included patients with RA and disease duration of at least one year, consulting their rheumatologist for routine evaluation of disease activity. In the single study visit data on demographics, disease history and current treatment were collected. DAS28 values were collected to evaluate current RA disease activity. Patients were asked to fill out the HAQ and SF-36 questionnaires. Receiver Operator Characteristics (ROC) curves were constructed to evaluate the performance of the HAQ, SF-36 and DAS28 in predicting the need for nine supporting measures available for chronically ill patients in the Belgian social security system. The expert opinion of the treating rheumatologist was used as a reference.ResultsThe study included 316 patients with a mean age of 59.8±12.6 years, disease duration of 11.4±9.3 years, mean DAS28 values of 2.83±1.17. Mean HAQ score was 0.95±0.73, mean SF-36 score 56.5±21.3. HAQ scores >1 were observed in 39.4% of patients. The area under the HAQ ROC curve was consistently >0.7 and higher for the HAQ than for SF-36 or DAS28 for all support measures. Rheumatologists on average recommended 3.67 support measures.ConclusionThe HAQ score was found to be a good predictor of the need for social support measures in patients with RA.

The Multidimensional Illness Severity Questionnaire: Preliminary evaluation of a brief parent‐reported measure of illness severity

“…Multiple studies highlight the importance of the perception of illness severity as perception relates to key patient‐related outcomes, including compliance and willingness to engage in treatment and seek essential resources . Patient‐ or parent‐reported measures of illness severity are essential to the conduct of health services and outcomes research.…”

“…Patient‐reported outcomes are widely recognised as a critical component of health services and quality‐of‐care research . Illness perceptions have been linked to patient‐related outcomes in both physical and mental health and are specifically associated with levels of psychological distress, help‐seeking behaviours and patient engagement with services or social supports . Reliable and valid patient‐ and parent‐reported measures of illness severity are essential to a range of health services, outcomes and health behaviour research.…”

Comparison of the Belgian Rheumatoid Arthritis Disability Assessment and Health Assessment Questionnaires as Tools to Predict the Need for Support Measures in Patients with Rheumatoid Arthritis

“…The setup of this multicenter observational study was extensively described in a previous study [ 14 ]. Briefly, the study included patients of at least 18 years of age who fulfilled the American College of Rheumatology diagnostic criteria for RA [ 19 ] and had a disease duration of at least one year.…”

“…We previously observed that HAQ score is a good predictor of the need for support measures in adult patients with RA and a disease duration of at least one year assessed against the expert opinion of the treating rheumatologist as a reference [ 14 ]. In this context, the HAQ performed better than SF-36 scores or DAS28 [ 14 ].…”

Arthritis/Rheumatoid Arthritis

“…In progress of time, rheumatoid arthritis leads to a decline in well-being and quality of life, depending on the individual's functional capacity and decreased mobility, decreased productivity, and difficulties in daily life performance [6,51,56,57]. For this reason, it is very important to implement the evaluation with an interdisciplinary approach [58].…”