Health-related quality of life in patients with rheumatoid arthritis

Abstract

Background Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that primarily affects joints with some extraarticular involvement. If inappropriately treated, it usually results in persistent joint pain, irreversible deformities, and functional disability, leading to poor quality of life. Our objective was to evaluate health-related quality of life (HRQoL) and related factors in patients with RA. Methods Four hundred sixty-four patients from the Rheumatoid Arthritis registries of Siriraj and Phramongkutklao teaching hospitals were enrolled. Sociodemographic, clinical and laboratory data related to disease activity, and functional status were collected. HRQoL was assessed using the Thai version of EuroQol five dimensional questionnaire (EQ-5D) and EQ global health visual analogue scale (EQ VAS). Univariate and multivariate analyses were employed to identify factors related to HRQoL. Results Eighty-five percent were female with a mean age ± SD of 59.15 ± 11.43 years and a mean disease duration ± SD of 11.53 ± 8.3 years. The mean educational level ± SD was 9.42 ± 5.21 years. Almost half were unemployed or retired (47%). They had moderate disease activity (mean cumulative DAS28 ± SD, 3.5 ± 0.8) and mild functional impairment (mean HAQ ± SD, 0.70 ± 0.68). The mean EQ-5D ± SD (0–1) was 0.87 ± 0.13 and mean EQ VAS ± SD (0–10) was 7.94 ± 1.7. Based on the EQ-5D domain, 49% reported that they had no problem with mobility, 83% had no difficulties with self-care, 65% had no difficulties with usual activity, 30% had no pain or discomfort, and 61% had no depression or anxiety. The relationship between problems of each dimension in EQ-5D significantly increased according to severity of RA assessed by the Disease Activity Score (DAS) 28 and Health Assessment Questionnaire (HAQ) ( p < 0.01). In multivariate analyses, high cumulative disease activity, functional disability, depression, and anxiety were negatively associated with EQ-5D (adjusted R 2 0.38, p < 0.001) and EQ VAS (adjusted R 2 0.19, p < 0.001). Conclusion Disease severity and psychological disturbance have a negative impact on quality of life in patients with RA. These factors should be considered in management of RA patients to improve the standard of care. Electronic supplementary material The online version of this article (10.1186/s41927-019-0080-9) contains supplementary material, which is available to authorized users.

Disease activity, morning stiffness and missing teeth are associated with oral health-related quality of life in individuals with rheumatoid arthritis

“…Altogether, difficulties in self-care experienced by patients with RA, especially those with severe or longstanding forms of the disease, can be seen as a psychological burden with a potential effect on individual oral health perception. Therefore, disease activity, functional disability, depression and anxiety are important factors affecting patients' self-care and quality of life [35]. This might lead to a continuous reduction in general quality of life as well as OHRQoL in RA patients.…”

Lung function is associated with minimal EQ-5D changes over time in patients with systemic sclerosis

“…In rheumatoid arthritis it is valid, reliable, and responsive to change [20]. EQ-5D is associated with disease activity, functional impairment, coronary artery syndrome, depression, and anxiety [21]. Moreover, EQ-5D has been included among patient reported outcomes investigated in trials of new treatments [22] and to assess the efficacy of disease modifying antirheumatic drugs, indicating the need to achieve control of disease activity to improve patients' quality of life [23].…”

Demodex Species Frequency and Risk Factors in Patients With Rheumatoid Arthritis

“…[ 39 ] There is a negative relationship between disease severity and quality of life in RA patients. [ 40 ] Advanced disease and limitations of joint movements may cause insufficiency in personal care in RA patients. The relationship between the presence of Demodex species and personal hygiene ability in patients with RA can be speculated.…”