Disability and health-related quality of life among patients with rheumatoid arthritis: association with radiographic joint damage, disease activity, pain, and depressive symptoms.
OBJECTIVE
To study the associations between disability and health-related quality of life (HRQoL), respectively, and radiographic joint damage, disease activity, pain, and depressive symptoms among patients with rheumatoid arthritis (RA).


METHODS
Data were collected through questionnaires and clinical examinations at baseline (1997) and at 2 years' follow-up among patients with RA (n = 307). Disability was measured with a validated Dutch questionnaire, derived from the Health Assessment Questionnaire (HAQ), and HRQoL with a validated Dutch version of the RAND-36, using physical (PCS) and mental (MCS) component summary scales. Multivariate linear regression analyses were performed to assess the relationship between disability or HRQoL and radiographic damage, disease activity, pain, and depressive symptoms.


RESULTS
Pain, with respect to disability and PCS, and depressive symptoms, with respect to MCS, were more important predictors than radiographic damage and disease activity.


CONCLUSIONS
Daily RA practice needs to be broadened by regular assessment of disease burden from the patients' perspectives. Patient-reported measures, such as disability or HRQoL, should be incorporated for monitoring health outcomes of individual patients and for initiating and evaluating therapy.
Rupp
I
I
Department of Social Medicine, Academic Medical Centre, University of Amsterdam, the Netherlands. i.rupp@amc.uva.nl
Boshuizen
H C
HC
Dinant
H J
HJ
Jacobi
C E
CE
van den Bos
G A M
GA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000503:physiopathology; D005260:Female; D033023:Foot Joints / Q000000981:diagnostic imaging / Q000503:physiopathology*; D050823:Hand Joints / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D011788:Quality of Life / Q000523:psychology; D011859:Radiography