title: High disease activity scores predict the need for additional health services in patients over 60 with rheumatoid arthritis.
abstract: OBJECTIVE
  To determine whether we meet perceived need, in terms of appropriate supportive health services (physiotherapy, occupational therapy, chiropody and footwear, surgery, education and information), of patients aged 60 years and over with rheumatoid arthritis (RA).
  
  
  METHODS
  A cross-sectional survey.
  
  
  METHODS
  123 patients attending rheumatology outpatient clinics.
  
  
  RESULTS
  The response rate was 82% (99/123). Of the respondents 78% had one or more perceived needs. Respondents were more likely to express a need for chiropody or footwear (46%), education about RA (29%), or physiotherapy (22%) than for occupational therapy (7%) or surgery (6%). Further analysis compared this group with the 'non-needy' group. There was a correlation between high disease activity scores and high anxiety scores and greater perceived need for additional health services.
  
  
  CONCLUSIONS
  There was significant unmet demand for chiropody and footwear, education about RA, physiotherapy, occupational therapy and surgery. It is possible that strategies to reduce anxiety and improve control of active inflammatory disease may reduce demand for supportive services in certain patients.
authors.affiliation: Department of Rheumatology, East Surrey Hospital, Redhill, Surrey, UK. lynda.martin@sash.nhs.uk
authors.forename: Lynda J
authors.initials: LJ
authors.lastname: Martin
authors.forename: Siân M
authors.initials: SM
authors.lastname: Griffith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012189:Retrospective Studies; D012720:Severity of Illness Index