title: Quality of life in Indian patients with rheumatoid arthritis.
abstract: OBJECTIVE
  Rheumatoid arthritis (RA) is a multisystem disease with various extra-articular manifestations (EAMs). Health-related quality of life (HRQOL) issues are assuming increasing importance in chronic rheumatic diseases like RA. No data on QOL in RA is available from the Indian subcontinent. There is also a paucity of literature on the impact of EAMs on HRQOL in RA. The objective of this study was to address these lacunae.
  
  
  METHODS
  The study group comprised 81 patients with RA from a rheumatology clinic in India. Quality of life was estimated by the generic HRQOL measure: World Health Organization quality of life instrument (WHOQOL-Bref). Disease activity in RA was measured by calculating Disease Activity Score-28 (DAS28).
  
  
  RESULTS
  The mean HRQOL scores of the patients were 12.0+/-2.8, 13.2+/-2.7, 14.4+/-2.9 and 13.3+/-2.6 in the physical, psychological, social, and environmental domains of the WHOQOL-Bref respectively. Age, gender, disease duration, educational status, constitutional symptoms, rheumatoid factor positivity, erosions and deformities did not influence HRQOL. Disease activity had a negative influence on the physical and psychological domains. Patients with EAMs had significantly higher DAS28 scores compared to patients without EAMs. Even after adjustment for disease activity, patients with EAMs had lower HRQOL scores than patients without these features (statistically significant for physical domain).
  
  
  CONCLUSIONS
  The physical domain of HRQOL is most affected in Indian patients with RA. Increasing disease activity and presence of EAMs worsens the quality of life.
authors.affiliation: Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar 110029, New Delhi, India.
authors.forename: Gurdesh S
authors.initials: GS
authors.lastname: Bedi
authors.forename: Nikhil
authors.initials: N
authors.lastname: Gupta
authors.forename: Rohini
authors.initials: R
authors.lastname: Handa
authors.forename: Hemraj
authors.initials: H
authors.lastname: Pal
authors.forename: R M
authors.initials: RM
authors.lastname: Pandey
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000523:psychology*; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires