Weekly home self-assessment of RAPID-4/3 scores in rheumatoid arthritis: a 6-month study in 26 patients.
OBJECTIVE
To investigate whether weekly determination of Routine Assessment of Patient Index Data (RAPID) scores 3 and 4 in patients with rheumatoid arthritis (RA) improved the assessment of disease activity and detected additional activity peaks (predictive of additional structural damage).


METHODS
Each week for 6 months, 26 patients with RA completed the patient-reported outcome questionnaires RAPID-3 and RAPID-4. During the study period, the treatment regimen for RA remained unchanged in 23 of the 26 patients.


RESULTS
RAPID-3 was as informative as RAPID-4. Mean values were 3.85±1.66 (range: 0.72-6.85) and 3.43±1.57 (range: 0.81-6.77), respectively. The areas under the RAPID-3 score curves plotted using only the first and last weeks or all the weeks showed a statistically significant difference in 19 (73%) of the 26 patients. The difference between the highest and lowest RAPID-3 scores was greater than the clinically significant threshold of 1.2 in all 26 patients (mean difference: 2.95±0.71; range: 1.6-5.5). In 13 patients, the RAPID-3 score detected one (one patient) or several (12 patients) activity peaks. Among RAPID-3 score components, the visual analog scale (VAS) pain score had the greatest influence (37% of the total score), followed by the VAS disease-activity score (36%) then by the multidimensional Health Assessment Questionnaire score (27%). Scores were not influenced by patient mood at questionnaire completion.


CONCLUSIONS
Self-evaluation at home using the RAPID-3 score provides additional information that should improve the accuracy of RA monitoring between physician visits and that may help to optimize visit scheduling.
Blanchais
Anne
A
Service de rhumatologie, Hôtel-Dieu, CHU de Nantes, 44093 Nantes cedex 01, France.
Berthelot
Jean-Marie
JM
Fontenoy
Anne-Maëlle
AM
le Goff
Benoît
B
Maugars
Yves
Y
D000328:Adult; D000339:Affect; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D059026:Diagnostic Self Evaluation; D006305:Health Status Indicators; D006699:Home Care Services; D006801:Humans; D007596:Joints / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D010147:Pain Measurement; D010358:Patient Participation; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013997:Time Factors