Impact of socio-demographic and clinical characteristics on functional disability and health-related quality of life in patients with rheumatoid arthritis: a cross-sectional study from Palestine

Abstract

Background Rheumatoid arthritis (RA) is a chronic autoimmune disorder, which has a significant impact on patients' health-related quality of life (HRQoL), and limits physical function as well as increases pain and fatigue. Therefore, this study aimed to evaluate the HRQoL and functional disability profile of patients with RA in Palestine to determine the socio-demographic and clinical features associated with low HRQoL and functional disability in patients with RA and to investigate the impact of drugs used on functional disability and HRQoL. Methodology A cross-sectional, observational study conducted at rheumatology clinics in Northern West-Bank, Palestine (Alwatani Hospital—Nablus, Khalil Suleiman Hospital—Jenin, Thabet Thatbet Hospital-Tulkarem, and Darweesh Nazzal Hospital—Qalqilia). EuroQoL-5 Dimension scale (EQ-5D-5L) was used to evaluate HRQoL, Health Assessment Questionnaire, Disability Index (HAQ-DI) to evaluate the functional disability, and the Health Assessment Questionnaire pain visual analog scale (HAQ-VAS) to evaluate pain. Results 300 patients were included in the study, 229(76.3%) were females, the mean ± standard deviation age was 49 ± 13.10 years, and the median RA duration (lower–upper quartiles) was 6 (4–12) years. The median EQ-5D-5L index value and Euro QOL visual analogue scale (EQ-VAS) scores were 0.56 and 60, respectively. There was a significant strong positive correlation (R = 0.773; p < 0.001) between the EQ-5D-5L index values and the reported EQ-VAS scores. The median HAQ-DI and HAQ-VAS were 0.94 and 40, respectively. The results of multiple linear regression showed that treatment with biological DMARD (Etanercept), having work, higher income, absence of night pain, and absence of comorbid diseases were significantly associated with higher EQ-5D-5L index score (better HRQoL) and lower HAQ-DI scores (less disability). On the other hand, older age and the presence of morning stiffness were significantly associated with higher HAQ-DI scores (more disability). Conclusions This study revealed the impact of treatment, clinical variables, and socio-demographic factors on disability and HRQoL in RA patients. Healthcare providers should be aware of the association between treatment with biological DMARD and improved HRQoL and functional status to make early interventions that reduce disability and improve HRQoL in susceptible patients.

Health-related quality of life and treatment satisfaction in Palestinians with rheumatoid arthritis: a cross-sectional study

“…According to the previous study [ 29 ], approximately 1042 RA patients were referred to rheumatology clinics in Northern West Bank, Palestine, during the year 2012. Therefore, using the proportional quota sampling process, a convenience sample of 281 RA patients was taken to represent the general RA population.…”

Quality of Life in Cohabitants of Patients Suffering Inflammatory Bowel Disease: A Cross-Sectional Study

“…Many factors may affect quality of life, but disease activity and disability seem to be of major importance in our research. Research in other fields with an autoimmune background and articular involvement, such as rheumatoid arthritis, has observed a direct relationship between disease activity, pain, and disability with QoL of patients [ 22 ]. These findings are quite similar to ours, supporting the hypothesis that disease activity, which is related to disability, and extraintestinal manifestations, especially articular ones, significantly affect patients’ QoL, therefore impacting on cohabitants QoL.…”

“…In these patients, calprotectin in the last control was related with IBDQ 32 well as Harvey-Bradshaw index (p < 0.0001) (Table 3). Type of IBD Ulcerative colitis (22) 150.55 ± 32 121.5 ± 33 Patients with Crohn's disease had a significantly lower IBDQ 32 score than UC patients, higher number of disease flares (p = 0.024) and higher need for surgery (p = 0.033). In these patients, calprotectin in the last control was related with IBDQ 32 (p = 0.017), as well as Harvey-Bradshaw index (p < 0.0001) (Table 3).…”

Evaluation of nurse practitioners’ roles and competencies among rheumatology nurses: Results of a national survey

“…Patients with rheumatic diseases may have decreased physical, emotional, and social functions due to disease activity, comorbidities, and treatment-related side effects [1] leading to significantly impaired health-related quality of life. [1][2][3][4] Rheumatic diseases are the second most common cause of disability and the second largest contributor to the burden of years lived with disability at the global level. [5] A national health service survey analysis (Center for Health Statistics and Information, 2015) ranked the prevalence of rheumatic diseases 3rd after circulatory and endocrine/metabolic diseases in China in 2013.…”

“…Rheumatic diseases comprise heterogeneous disorders involving the musculoskeletal system, characterized by inflammation, degeneration, or metabolic derangement. Patients with rheumatic diseases may have decreased physical, emotional, and social functions due to disease activity, comorbidities, and treatment-related side effects [1] leading to significantly impaired health-related quality of life. [1][2][3][4] Rheumatic diseases are the second most common cause of disability and the second largest contributor to the burden of years lived with disability at the global level.…”