scholarly journals POS0515 FIBROMYALGIA IN MEXICAN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 491.1-492
Author(s):  
L. D. Fajardo Hermosillo
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Multivariate Analysis ◽  
Disease Activity ◽  
Functional Status ◽  
Univariate Analysis ◽  
The Mean ◽  
The Impact ◽  
Mexican Patients

Background:Rheumatoid Arthritis (RA) is a disabling chronic inflammatory disease that shows an unpredictable and severe clinical course [1]. Global assessment, functional status and disease activity of patients with RA can be influenced also by non-inflammatory factors as concomitant presence of fibromyalgia (FM) [1,2]. FM occur up to 20% in RA patients, who present chronic widespread pain, fatigue and cognitive symptoms that impacts achieving a complete disease remission, having more comorbidities, bearing a higher medical cost and finally exhibiting a worse quality of life [1,3,4]. Range of manifestations of FM varies according ethnical and cultural differences between patients [1]. Here is presented the impact of fibromyalgia in Mexican patients with RA.Objectives:To determinate the frequency and factors associated to fibromyalgia in Mexican RA patients.Methods:624 patients with RA that fulfilled ACR/EULAR 2010 criteria (≥18 years) from a Mexican population recruited from 2012 to 2020 were examined. Patients with or without presence of FM diagnosed by ACR 2010/2011 criteria were included. Demographic factors, clinical features, disease activity measured using DAS28 (Disease Activity Score 28-joint counts), functional status evaluated by HAQ (Health Assessment Questionnaire), comorbidities and pharmacologic treatments were explored for RA patients with and without FM. Charlson’s comorbidity index (CCI) was used to analyze comorbidities. Chi-square, Student´s-t, U Mann-Whitney tests were performed by univariate analysis and logistic regression was executed by multivariate analysis adjusted for age and gender. Statistical tests were conducted at 5% level of significance.Results:Of 624 patients with RA 88.8% were women. The mean age [standard deviation (SD)] was 55.0 (12.3) years. The mean of time at onset of RA (SD) was 11.2 (9.1) years. A total of 311(49.8%) patients had FM; of them 91.6% were women and the mean age (SD) was 54.5 (12.2) years. In the univariate analysis RA patients with FM were more likely to be older and smokers, have seropositive RA, higher body mass index and longer time at onset of RA, show worse functional status by HAQ and more radiographic progression, present more extra-articular and Sicca manifestations, exhibit increased demand of hip and knee arthroplasty, also reveal a higher frequency of comorbidities including depression, osteoporosis and type 2 diabetes mellitus, besides to use a greater number of disease-modifying anti-rheumatic drugs (DMARDs), more biologic agents and higher doses of corticosteroids. Also, CCI was higher in RA patients with FM. Nevertheless, no differences were found for RA disease activity in both groups. In multivariate analysis, higher score of CCI (OR 1.21, 95% CI 1.01–1.44, p=0.037) remained significant in RA patients with FM.Conclusion:This study suggests that RA patients from Mexico have high prevalence of the FM. Those with FM have a worse functional status, a higher frequency and score of comorbidities that impact in a reduction of their quality of life. On the other hand, no differences were found for RA disease activity in both groups. However, these observations must be confirmed in larger and prospective studies.References:[1]Zhao SS et al. Best Pract Res Clin Rheumatol. 2019;33(3):101423;[2]Duffield SJ et al. Rheumatology (Oxford). 2018;57(8):1453;[3]Kim H et al. Arthritis Care Res (Hoboken) 2017;69(12):1871;[4]Salaffi Fet al. Rheumatol Int. 2017;37(12):2035.Disclosure of Interests:None declared

scholarly journals AB0064 EVALUATION OF QUALITY OF LIFE IN RHEUMATOID ARTHRITIS USING SF-36 AND HAQ SCALES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1063.1-1063
Author(s):  
M. Brahem ◽  
M. Hassayoun ◽  
H. Hachfi ◽  
R. Sarraj ◽  
M. Ardhaoui ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Short Form ◽  
Bodily Pain ◽  
Global Score ◽  
Sf 36 ◽  
The Mean ◽  
The Impact

Background:The assessment of health-related quality-of-life (HRQoL) in rheumatoid arthritis (RA) is becoming a common tool in clinical practice. The medical outcomes survey short form 36 (SF- 36) is one of the most widely used tools for measuring HRQoL in RA as well as the HAQ scale.Objectives:The aim of our study is to evaluate the impact of the RA in the quality of life (QoL) of our patients using the SF-36 and the HAQ questionnaires.Methods:This is a cross-sectional study during a period of the year 2020, including 70 patients followed in the department of Rheumatology in Mahdia, Tunisia. All patients were diagnosed with RA based in ACR 1987/EULAR 2010. We evaluated for each patient, the mean global scale and the eight domains of SF-36 (physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), a social functioning (SF), role emotional (RE) and mental health (MH)), scored from 0 (worst) to 100 (best).Results:Our study included 70 patients (59 females/11males) with an age ranged from 21 to 76 years. The mean age was 54 ± 12 years. The mean duration of the disease was 11 ± 10 years [1-40]. The mean number of tender joints was 9.7 ±9.4 and swollen joints were 4.2 ±6.1. The mean disease activity score (DAS28) was 4.6 ±1.9 [1.2-8.4]. The mean HAQ score was 1.5±1.3, 47.1% of patients had specific joint deformations, 82.9% had radiologic involvement and 31.4% had osteoporosis. The biologic analysis showed that the mean ESR was 46.7 ± 30.5 and the CRP was 15.8 ±23.3. Rheumatoid factors were positive in 42.9% of cases, the ACPA were positive in 50% of cases. 84.3% of RA patients were treated by methotrexate, 4.3% were treated by salazopyrin and 11.4% were treated by biologic treatments.The SF-36 global score was 50.4 ± 26.3 [15.3-92.8]. 46 patients (65.7% of cases) had impaired QoL (SF-36<66.7). The means of different domains (PF, RP, BP, GH, VT, SF, RE, MH) were respectively 51; 41.4; 51.4; 50; 51.2; 57.7; 41.9; 59.2. The most severely impacted domains were the RP and RE.Our study showed a significant correlation between the SF-36 global score and the number of tender joints (p=0.002), the DAS28 (p=0.017) and the HAQ(p=0.000).Conclusion:Our study showed that 65.7% of RA patients presented impaired QoL (SF-36<66.7), which is associated with high disease activity. So it’s important to jugulate the disease, in order to ameliorate the quality of life of our patients.References:[1]Matcham, F., Scott, IC, Rayner, L., Hotopf, M., Kingsley, GH, Norton, S.,… Steer, S. (2014). L’impact de la polyarthrite rhumatoïde sur la qualité de vie évalué à l’aide du SF-36: une revue systématique et une méta-analyse. Séminaires sur l’arthrite et les rhumatismes, 44 (2), 123-130. doi: 10.1016 / j.semarthrit.2014.05.001.Disclosure of Interests:None declared

scholarly journals Rheumatoid arthritis in real clinical practice. Results of the «Computer Terminals of Self-Assessment for Patients with Rheumatic Diseases» («TERMINAL-I») project

2019 ◽  
Vol 13 (2) ◽  
pp. 25-30 ◽  
Author(s):  
V. N. Amirdzhanova ◽  
E. Yu. Pogozheva ◽  
A. E. Karateev ◽  
R. R. Samigullina ◽  
O. B. Nesmeyanova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Clinical Practice ◽  
Disease Activity ◽  
Functional Status ◽  
Disease Duration ◽  
The Mean ◽  
Real Clinical Practice

Objective: to describe the portrait of a patient with rheumatoid arthritis (RA) in real clinical practice, to assess disease activity from the point of view of a physician and a patient, functional status, quality of life (QOL), and the efficiency of the therapy performed.Patients and methods. The investigation enrolled 976 RA patients from a cohort of patients in the TERMINAL-I multicenter study, who, when visiting a rheumatologist, independently assessed the disease activity and QOL using a computer system (the «Computer Terminals of SelfAssessment for Patients with Rheumatic Diseases» project). The mean age of the patients was 52.30±13.3 years; women accounted for 85%; the median disease duration 8.0 [4.0; 14.0] years. Baseline clinical parameters and pharmacotherapy were evaluated for 6 months. The disease activity was determined by the DAS28 and RAPID-3 indices; functional status and quality of life were evaluated by the HAQ and the EQ-5D, respectively.Results. 83% of the RA patients were positive for rheumatoid factor and 60% were for anti-cyclic citrullinated peptide antibodies. There was a preponderance of patients with high (40.5%) and moderate (46.8%) RA activity; 6.9% were observed to have a low activity; 5.8% had clinical remission. The mean values of DAS28 and RAPID-3 were 4.7±1.3 and 13.7±3.6, respectively. Only 14.3% of patients had a good functional status that was comparable with the population-based control (HAQ≤0.5). The remaining patients were found to have a substantial decrease in joint functional parameters (median HAQ 1.88 [1.0; 2.5]) and EQ-5D QOL (0.60 [0.60; 0.74). Prosthetic joints were present in 7.4% of patients. At visit 1 to a rheumatologist, the therapy was changed in 15% of patients. During 6-month follow-up, conventional disease-modifying anti-rheumatic drugs were taken by almost all (91.2%) patients. Of them, 70.9% of the patients were treated with methotrexate (MTX): 77.0% received the latter at a dose of 15 mg/week and 23.0% had it at a dose of >15 mg (17.5 to 40 mg/week). Glucocorticoids could be stopped in 20.5% of the patients within six months. Tumor necrosis factor-α inhibitors and anti-B-cell therapy were used in 6.6 and 16.2% of patients, respectively. At 6-month follow-up (Visit 2), 54% of patients achieved a 20% clinical improvement in the ACR criteria. At the same time, the DAS28 scores decreased substantially from 4.5±1.2 to 3.8±1.1 (p = 0.0001). There was a minimal functional improvement in the HAQ index in 64% of patients and a better EQ-D QOL scores in 16%.Conclusion. The majority of RA patients who came to the rheumatologists showed high to moderate disease activity. This was due to long disease duration, inadequate MTX dose, and insufficient patient monitoring in real clinical practice. Introduction of a computer system for selfassessment of their health status by RA patients in an outpatient setting could improve the interaction of physicians, nurses, and patients, better monitor disease activity, and enhance therapeutic efficiency. 

scholarly journals Reverse shoulder joint replacement in rheumatoid arthritis: medium-term results in 37 patients

2018 ◽  
Vol 12 (3) ◽  
pp. 89-93
Author(s):  
M. A. Makarov ◽  
A. A. Roskidailo ◽  
M. V. Panteleev
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Functional Status ◽  
Upper Limb ◽  
Joint Replacement ◽  
Shoulder Joint ◽  
Joint Damage ◽  
Dash Score ◽  
The Mean

Objective:to assess functional results and quality of life in patients with rheumatoid arthritis (RA) after reverse shoulder joint replacement.Patients and methods.Examinations were made in 37 patients with RA involving the shoulder joint, who underwent shoulder joint replacement using a reverse DeltaX-tend DePuy prosthesis in 2006–2017. The investigators studied the volume of movements, the level of pain using the visual analogue scale, the function of the shoulder joint using the American Shoulder and Elbow Surgeons (ASES) Shoulder Score and the upper limb as a whole by the Disability of the Arm, Shoulder and Hand (DASH) questionnaire, a patient's functional status by the Health Assessment Questionnaire (HAQ), quality of life (QL) by EQ-5D (Euro Quolish instrument) and analyzed shoulder X-ray films before and in the late periods after surgery.Results.The volume of shoulder joint movements was found to increase. At 28.7 months postsurgery, the mean volume of flexion, abduction, and external rotation was 107.4Ѓ}15.2, 128.3Ѓ}8.5, and 46.4Ѓ}5.5°; respectively (p≤0.05). The patients experienced no pain in the late periods following surgery. Prior to surgery and at control examination, the mean ASES scores were 25.0Ѓ}4.7 and 79.4Ѓ}6.4, respectively (p≤0.05). Before surgery, the mean DASH score was 63.8Ѓ}4.2; in the late periods it decreased to 18.2Ѓ}8.6 (p ≤ 0.05). The mean preoperative HAQ score was 2.81; following surgery, it also decreased to 1.39 (p≤0.05). The postoperative EQ-5D QOL index score increased from 0.41 to 0.72. The rate of complications reached 10.8%.Conclusion.Reverse endoprosthetic replacement for end-stage shoulder joint damage (Larsen 4–5) with rotator cuff defect makes it possible to increase the volume of movements, to reduce pain, and to improve upper limb function, functional status, and quality of life in patients with RA.

Frailty and Quality of Life After Cochlear Implantation in Older Adults

2021 ◽  
pp. 019459982110045
Author(s):  
Alana Aylward ◽  
Morganne Murphy-Meyers ◽  
Chelsea McCarty Allen ◽  
Neil S. Patel ◽  
Richard K. Gurgel
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Speech Recognition ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Frailty Index ◽  
Univariate Analysis ◽  
The Mean ◽  
The Impact

Objective To examine the relationship among frailty index, hearing measures, and hearing-related quality of life (QOL) in older recipients of cochlear implants. Study Design Cross-sectional survey. Setting Academic medical center. Methods Adults aged ≥65 years at the time of receiving cochlear implants between July 13, 2000, and April 3, 2019, were asked to complete a questionnaire on hearing-related QOL. Chart review was performed to identify patients’ characteristics. Correlations were calculated between frailty index and audiologic outcome measures as well as between speech recognition scores and QOL scores. Linear regression models were developed to examine the impact of clinical characteristics, frailty index, and hearing measures on hearing-related QOL. Results Data for 143 respondents were included. The mean age was 80.7 years (SD, 7.1), with a mean 27.8 years of hearing loss (SD, 17.4) before implantation. The mean frailty index was 11.1 (SD, 10.6), indicating that patients had 1 or 2 of the measured comorbidities on average. No correlation was found between lower frailty index (better health) and hearing scores, including pure tone averages (PTAs) and speech recognition scores. Lower frailty index and larger improvement in PTA after cochlear implantation predicted better QOL scores on univariate analysis (respectively, P = .002, β = −0.42 [95% CI, −0.68 to −0.16]; P = .008, β = −0.15 [95% CI, −0.26 to −0.04]) and multivariate analysis ( P = .047, β = −0.28 [95% CI, −0.55 to −0.01]; P = .006, β = −0.16 [95% CI, −0.28 to −0.05]). No speech recognition scores correlated with QOL after cochlear implantation. Conclusions Frailty index does not correlate with hearing scores after cochlear implantation in older adults. Lower frailty index and more improvement in PTA predict better QOL scores after cochlear implantation in older adults.

scholarly journals The Impact of Time Length to Boolean Remission for Tight Disease Activity Control After Acquisition in Rheumatoid Arthritis Patients

2021 ◽  
Author(s):  
Ichiro Yoshii ◽  
Tatsumi Chijiwa ◽  
Naoya Sawada
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Remission Rate ◽  
Health Assessment ◽  
Time Length ◽  
First Remission ◽  
The Impact ◽  
Questionnaire Disability

Abstract Importance of time length to achieving clinical remission on disease activity control, daily activities (ADL) and quality of life (QOL) maintenance after the remission was investigated for patients with rheumatoid arthritis (RA).In patients who achieved remission once or more, relationship between time length from initiation to achieve remission (TL) and patients’ background data at baseline, and relationship between TL and mean simplified disease activity score (SDAI), modified Health Assessment Questionnaire Disability Index (HAQ-DI) score, pain score with visual analog scale (PS-VAS), Sharp/van der Heijde Score (SHS) and quality of life score (QOLS) at the first remission and thereafter were evaluated statistically. Patients were divided into two groups whether TL was within 6 months or longer (G≤6 and G>6). Change of the parameters and Boolean remission rate (BRR) after the first remission between the two groups were compared statistically.In 465 patients, TL correlated significantly with the SDAI score, the HAQ score, PS-VAS, SHS, and the QOLS after the remission. The SDAI score and the BRR after the first remission were significantly better in the G≤6 than in the G>6.TL is an important key to guarantee good disease activity control, ADL and QOL.

scholarly journals Improving the quality of life of patients with rheumatoid arthritis after rehabilitation irrespective of the level of disease activity

2020 ◽  
Author(s):  
Daniel Szewczyk ◽  
Teresa Sadura-Sieklucka ◽  
Beata Sokołowska ◽  
Krystyna Księżopolska-Orłowska
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Rehabilitation Program ◽  
Activity Level ◽  
Subjective Perception ◽  
Das28 Score ◽  
Comprehensive Rehabilitation ◽  
The Impact

Abstract Due to the exacerbation of the disease, the rehabilitation of patients with rheumatoid arthritis is often limited. The aim of the study was to analyze the impact of a comprehensive rehabilitation on a subjective perception of pain and quality of life in patients with rheumatoid arthritis depending on the level of disease activity. The study involved 58 women with rheumatoid arthritis aged 18–60, who underwent a 4-weeks comprehensive rehabilitation program. The assessment included the disease activity level on the DAS28 scale, pain intensity on the 10-point pain scale (VAS) and the value of the CRP protein. The HAQ-DI and KALU questionnaire were used to assess the quality of life. In both groups (group A—DAS28 < 4.2, group B—DAS28 ≥ 4.2) the statistically significant effects in decreasing the level of pain and improvement of quality of life were observed. This indicates the need and effectiveness of rehabilitation regardless of the level of activity of rheumatoid arthritis according to the DAS28 scale. There were no significant changes in the CRP protein level. In conclusion, the rehabilitation of patients with moderate to high disease activity is effective and the success of comprehensive rehabilitation is demonstrated by the decrease of the DAS28 score and the pain level reported by patients, as well as improving self-assessment of health and quality of life.

scholarly journals P1530QUALITY OF LIFE AND MORTALITY IN PATIENTS UNDERGOING HEMODIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Gun Woo Kang ◽  
Seoung Gyu Kim ◽  
In Hee Lee ◽  
Ki Sung Ahn
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Coronary Heart Disease ◽  
Multivariate Analysis ◽  
Univariate Analysis ◽  
Health Domain ◽  
The Mean ◽  
The Relationship ◽  
Physical Health Domain

Abstract Background and Aims The mortality of patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) is higher than the general population. And it is well known that quality of life (QOL) falls immediately after receiving HD. However, studies on the relationship between reduced QOL and mortality in HD patients were very rare. This study aims to observe the correlation between impaired QOL and mortality in HD patients and to identify risk factors that affect mortality. Method The study included 160 patients with ESRD undergoing HD during over 3 months. The QOL was evaluated using WHO Quality of Life-BREF (WHOQOL-BREF). The WHOQOL-BREF instrument comprises 26 items, which measure the following four domains: physical health (domain 1), psychological health (domain 2), social relationships (domain 3), and environment (domain 4). Univariate analysis was used to determine the relationship between comorbidities, sex, age, laboratory findings, and QOL and mortality in HD patients. Multivariate analysis was performed by cox proportional hazard regression. Expected survival at 5 and 10 years was determined by two-sample t-tests. Results The mean age was 58.1 years old. 95 patients (59.7%) received HD due to diabetes mellitus. 42 patients (26.4%) had been diagnosed with coronary heart disease. In univariate analysis, age, coronary heart disease, malignancy, comorbidities, and blood calcium level were positively correlated with mortality. In particular, the domain 1 and 2 of WHOQOL-BREF were negatively associated with mortality. The mean scores of domain 1 and 2 was 18.2±5.2 and 15.9±4.5 for survivors and 15.5±5.7 and 13.7±4.9 for deaths. Multivariate analysis identified the age, comorbidity, serum calcium, and domain 1 of WHOQOL-BREF were independent risk factors for mortality (Table 1). Additionally, predicting 5- and 10- year survival, mortality was correlation with older age, higher Charlson Comorbidity Index, lower serum calcium, and lower domain 1 of WHOQOL-BREF (Table 2). Conclusion The impaired QOL of patients with ESRD undergoing HD was closely related to mortality. In particular, low QOL in physical health domain significantly increased mortality. Therefore, in order to improve the survival of HD patients, we should be considered about QOL as well as medical problems

Diet quality of individuals with rheumatoid arthritis using the Healthy Eating Index (HEI)-2010

2017 ◽  
Vol 23 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Lauren Thomas Berube ◽  
Mary Kiely ◽  
Yusuf Yazici ◽  
Kathleen Woolf
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Functional Status ◽  
Healthy Eating ◽  
Diet Quality ◽  
Functional Disability ◽  
Healthcare Providers ◽  
Healthy Eating Index ◽  
The Mean

Background: Rheumatoid arthritis (RA) afflicts approximately 1.5 million American adults and is a major cause of disability. As disease severity worsens, individuals with RA may experience functional decline that can impact dietary intake. Objective: The objective of this study is to assess the diet quality of individuals with RA using the Healthy Eating Index (HEI)-2010 and examine associations between diet quality and disease activity and functional status. Methods: This cross-sectional study assessed diet quality and disease activity and functional status in adults with RA. Participants completed seven-day weighed food records, which were scored using the HEI-2010. Participants had a fasting blood draw and completed the Multidimensional Health Assessment Questionnaire to determine disease activity and functional status. Results: The mean age of individuals with RA ( N = 84) was 53 ± 14 years, and 86.9% were female. The mean HEI-2010 total score was 58.7 ± 15.9, with 7.1% of participants scoring “good”, 58.3% “fair”, and 34.5% “poor”. Most participants did not adhere to recommended intakes of total fruit, total vegetables, whole grains, fatty acids, refined grains, sodium, and empty calories. An unadjusted multiple linear regression model found duration of morning stiffness and C-reactive protein concentration to be significant variables to inversely predict HEI-2010 total score. Conclusions: The diet quality of many individuals with RA needs improvement and may be related to functional disability associated with RA. Healthcare providers should encourage individuals with RA to meet dietary guidelines and maintain a healthy diet. Moreover, healthcare providers should be aware of the potential impacts of functional disability on diet quality in individuals with RA.

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