Main Article Content
Health-related quality of life in patients with rheumatoid arthritis and the clinical associations of EQ-5D utility scores
Abstract
Purpose: To assess health-related quality of life (HR-QoL) and the clinical associations in patients with Rheumatoid Arthritis (RA).
Methods: A cross-sectional study on multi-ethnic RA patients was performed. Disease activity was assessed using DAS28-ESR. HR-QoL was measured by EQ5D, functional disability by HAQ-DI and fatigue by FACIT-F.
Results: A total of 214 predominantly female (86.9 %) patients were recruited. Median age was 62 years; Inter-quartile range (IQR): 53 – 68 years. Median and mean EQ-5D scores were 0.793 (IQR: 0.647 – 0.879) and 0.752 (SD: 0.165) respectively. Median EQ-5D scores for patients in remission, low, moderate, and high disease activity were 0.879 (IQR: 0.742 – 0.933), 0.795 (IQR: 0.645 – 0.880), 0.742 (IQR: 0.564 – 0.818) and 0.653 (IQR: 0.323 – 0.775) respectively. Median EQ-5D scores for patients with mild to moderate, moderate to severe, and severe to very severe disability were 0.795 (IQR: 0.714 – 0.933), 0.728 (IQR: 0.564 – 0.818) and 0.554 (IQR: 0.287 – 0.765) respectively. DAS28-ESR, HAQDI, ethnicity and FACIT-F correlated with HR-QoL. EQ-5D scores were lowest in patients requiring biologic disease- modifying anti-rheumatic drugs (DMARDs) compared to none or conventional DMARDs, although this was not significant.
Conclusion: HR-QoL declined as RA disease activity and disability increased. Treat-to-target strategies and preventing joint destruction may improve health-related outcomes of RA patients. It is recommended that future studies be conducted in multiple health centers across Malaysia to capture variations in HR-QoL of RA patients nationally.