Costs in Relation to Disability, Disease Activity, and Health-related Quality of Life in Rheumatoid Arthritis: Observational Data from Southern Sweden

Objective.To compare how costs relate to disability, disease activity, and health-related quality of life (HRQOL) in rheumatoid arthritis (RA).Methods.Antitumor necrosis factor (anti-TNF)-treated patients with RA in southern Sweden (n = 2341) were monitored 2005–2010. Health Assessment Questionnaire (HAQ), 28-joint Disease Activity Score (DAS28), and EQ-5D scores were linked to register-derived costs of antirheumatic drugs (excluding anti-TNF agents), patient care, and work loss from 30 days before to 30 days after each visit (n = 13,289). Associations of HAQ/DAS28/EQ-5D to healthcare (patient care and drugs) and work loss costs (patients < 65 yrs) were studied in separate regression models, comparing standardized β coefficients by nonparametric bootstrapping to assess which measure best reflects costs. Analyses were conducted based on both individual means (linear regression, comparing between-patient associations) and by generalized estimating equations (GEE), using all observations to also account for within-patient associations of HAQ/DAS28/EQ-5D to costs.Results.Regardless of the methodology (linear or GEE regression), HAQ was most closely related to both cost types, while work loss costs were also more closely associated with EQ-5D than DAS28. The results of the linear models for healthcare costs were standardized β = 0.21 (95% CI 0.15–0.27), 0.16 (0.11–0.21), and –0.15 (−0.21 to −0.10) for HAQ/DAS28/EQ-5D, respectively (p < 0.05 for HAQ vs DAS28/EQ-5D). For work loss costs, the results were standardized β = 0.43 (95% CI 0.39–0.48), 0.27 (0.23–0.32), and −0.34 (−0.38 to −0.29) for HAQ/DAS28/EQ-5D, respectively (p < 0.05 for HAQ vs DAS28/EQ-5D and for EQ-5D vs DAS28).Conclusion.Overall, HAQ disability is a better marker of RA costs than DAS28 or EQ-5D HRQOL.

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Extraarticular manifestations in Turkish patients with rheumatoid arthritis: impact of EAMs on the health-related quality of life in terms of disease activity, functional status, severity of pain, and social and emotional functioning

Rheumatology International ◽

10.1007/s00296-011-1822-1 ◽

2011 ◽

Vol 32 (6) ◽

pp. 1521-1525 ◽

Cited By ~ 8

Author(s):

Filiz Eser ◽

Yeşim Garip ◽

Hatice Bodur

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Disease Activity ◽

Health Related Quality ◽

Social And Emotional ◽

Related Quality ◽

Health Related ◽

Turkish Patients ◽

Extraarticular Manifestations

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Association between helplessness, disability, and disease activity with health-related quality of life among rheumatoid arthritis patients in a multiethnic Asian population

Rheumatology International ◽

10.1007/s00296-013-2938-2 ◽

2014 ◽

Vol 34 (8) ◽

pp. 1085-1093 ◽

Cited By ~ 15

Author(s):

Yu Heng Kwan ◽

◽

Ee Tzun Koh ◽

Khai Pang Leong ◽

Hwee-Lin Wee

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Disease Activity ◽

Asian Population ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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AB0218 FUNCTIONAL DISABILITY AND PAIN BUT NOT DISEASE ACTIVITY ARE ASSOCIATED WITH POOR HEALTH-RELATED QUALITY OF LIFE IN A COHORT OF RHEUMATOID ARTHRITIS PATIENTS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2524 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1409.1-1409

Author(s):

A. R. Prata ◽

H. Assunção ◽

M. Luis ◽

L. Brites ◽

F. Costa ◽

...

Keyword(s):

Quality Of Life ◽

Rheumatoid Arthritis ◽

Disease Activity ◽

Poor Health ◽

Visual Analogue Scale Pain ◽

Depression Symptoms ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Background:Rheumatoid Arthritis (RA) is a systemic autoimmune disease that presents with joint pain and inflammation leading to significant disability and poor health-related quality of life (HRQoL) (1,2). Optimizing long-term HRQoL is the primary goal of disease management in RA (3).Objectives:To evaluate HRQoL and identify its influencing clinical and demographic factors in a Portuguese RA population.Methods:This is a cross-sectional study including consecutive patients fulfilling the ACR/EULAR 2010 and/or ACR 1987 RA classification criteria, followed at a tertiary Rheumatology Department. Sociodemographic and clinical variables were collected. HRQoL was assessed using the EuroQoL 5-Dimensional Descriptive System (EQ-5D) total score (normal range from -0.496 to 1.000, lower values indicating poorer HRQoL). Independent t-test and Pearson’s correlation coefficient were performed to evaluate EQ-5D differences between groups and examine its relationships with continuous variables, respectively. Variables with p<0.1 in univariate analysis were included in a stepwise multiple linear regression analysis to evaluate the independent association of variables with the EQ-5D score.Results:358 RA patients were included (80.20% female, mean age ± SD: 63.22 ± 0.66 years old). Mean EQ5D total score ±SD was 0.48 ± 0.01. Based on EQ-5D domains, 0.60% reported extreme problems with mobility, 3.40% extreme problems with self-care, 2.50% extreme problems with usual activities, 12.0% extreme pain or discomfort, and 7.30% extreme anxiety or depression symptoms (Fig. 1). There was a significant difference in EQ-5D scores between male (M=0.55, SD=0.24) and female gender (M=0.46, SD= 0.27); t (356) = -2.41, p=0.016. EQ-5D was weakly correlated with DAS-28-CRP (r=-0.32; p<0.001), moderately correlated with patient’s global assessment of disease activity (r=-0.54; p<0.001) and pain-visual analogue scale (pain-VAS) scores (r=-0.58; p<0.001) and strongly with Health Assessment Questionnaire (HAQ) score (r=-0.72; p< 0.001). After multivariate analysis, HAQ-score (β=-0.57 [95% CI -0.24 to -0.17]; p<0.001) and pain-VAS ((β=-0.25 [95% CI -0.003 to -0.002]; p<0.001) remained as independent predictors of EQ-5D (R2=0.56, p<0.001).Conclusion:Greater functional impairment and pain are associated with poor HRQoL in RA patients, and thus special attention must be given to treatment strategies providing the best patient-centred outcomes.References:[1]Yaghoubi et al. J Cardiovasc Thorac Res 2012;4(4):95–101.[2]José E et al. Ann Rheum Dis 2018;1118–24.[3]Smolen JS et al. Ann Rheum Dis. 2010; 69:631–637Disclosure of Interests:Ana Rita Prata: None declared, Helena Assunção: None declared, Mariana Luis: None declared, Luisa Brites: None declared, Flavio Costa: None declared, João Dinis de Freitas: None declared, Stefanie Silva: None declared, José Antonio P. da Silva Grant/research support from: Pfizer, Abbvie, Consultant of: Pfizer, AbbVie, Roche, Lilly, Novartis, Catia Duarte: None declared

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