Persons with Rheumatoid Arthritis Challenge the Relevance of the Health Assessment Questionnaire: A Qualitative Study of Patient Perception

Background. The Stanford Health Assessment Questionnaire-Disability Index (HAQ) is widely used to measure functional ability in persons with Rheumatoid Arthritis (RA). The instrument was developed with limited involvement from persons with RA, and their perception of the instrument has not been studied in depth. The aim of this study was to explore how persons with RA experience the use of the HAQ in care. Methods. Forty persons with RA were purposefully recruited to participate in semi-structured interviews. The interviews were then analyzed qualitatively using thematic analysis. Results. The participants questioned the relevance of the HAQ but nevertheless experienced that the instrument had a profound effect on their understanding of health and how care is delivered. The analysis resulted in three themes: Problems with individual items, meaning of the summative score, and effects on care and health perceptions. Conclusions. To make the HAQ relevant to persons with RA, it needs to be revised or to include an option to select items most meaningful to the respondent. To ensure relevance, the HAQ update should preferably be co-created by researchers, clinicians and persons with RA.

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Evaluation of the Health Assessment Questionnaire Disability Index in Chilean patients with rheumatoid arthritis

Revista médica de Chile ◽

10.4067/s0034-98872019000500612 ◽

2019 ◽

Vol 147 (5) ◽

pp. 612-617 ◽

Cited By ~ 1

Author(s):

Josefina Durán ◽

Angélica Domínguez ◽

Manuel Espinoza

Keyword(s):

Rheumatoid Arthritis ◽

Health Assessment Questionnaire ◽

Health Assessment ◽

Assessment Questionnaire ◽

Questionnaire Disability

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Validating and Assessing the Sensitivity of the Health Assessment Questionnaire-Disability Index-derived Short Form-6D in Patients with Early Aggressive Rheumatoid Arthritis

The Journal of Rheumatology ◽

10.3899/jrheum.080959 ◽

2009 ◽

Vol 36 (6) ◽

pp. 1150-1157 ◽

Cited By ~ 8

Author(s):

SOGOL S. AMJADI ◽

PAUL M. MARANIAN ◽

HAROLD E. PAULUS ◽

ROBERT M. KAPLAN ◽

VEENA K. RANGANATH ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Construct Validity ◽

Health Assessment Questionnaire ◽

Short Form ◽

Health Assessment ◽

Correlation Coefficients ◽

Patient Reported ◽

Clinical Measures ◽

Assessment Questionnaire ◽

Questionnaire Disability

Objective.New methodologies allow the scores for the Health Assessment Questionnaire-Disability Index (HAQ-DI) to be translated into preferences/utility scores. We evaluated the construct validity of the HAQ-DI-derived Short Form-6D (SF-6D) score and assessed its responsiveness to change over 6- and 12-month followup periods in patients with early aggressive rheumatoid arthritis (RA).Methods.Patients (n = 277) participating in an RA observational study completed self-reported measures of symptoms and the HAQ-DI at baseline and at 6 and 12 months. Total Sharp scores, C-reactive protein, and erythrocyte sedimentation rate were assessed along with clinical data. Construct validity was assessed by examining the association between SF-6D score and patient-reported and clinical measures using Spearman correlation coefficients. The responsiveness of SF-6D to change was assessed using patient and physician assessments of the disease as clinical anchors. The magnitude of responsiveness was calculated using SF-6D effect size (ES).Result.Mean SF-6D scores were 0.690, 0.720, and 0.723 at baseline and 6 and 12-month followup, respectively. Baseline patient-reported measures had moderate to high correlations with baseline SF-6D (r = 0.43 to 0.52); whereas clinical measures had negligible to low correlations with SF-6D (r = 0.001 to 0.32). ES was moderate for the groups that were deemed to have improved (ES 0.63–0.75) but negligible to small for those that did not (ES 0.13–0.46).Conclusion.Our data support the validity and responsiveness of the HAQ-DI derived SF-6D score in an early RA cohort. These results support the use of the HAQ-DI derived SF-6D in RA cohorts and clinical trials lacking preference-based measures.

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